The Berrys Carehome

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed when they started living at the service. Some care records did not always capture people’s current needs, risks and preferences as their previous needs and history were intertwined with new information about them. The way people’s assessed needs were written, and the care plans were organised, such as recording people’s monthly reviews separately and not updating the care plan since the original assessment, made it difficult to understand people’s current needs and situation clearly. These would not always provide staff with enough information about people’s assessed needs so they would be able to meet them effectively. This included information about people’s risks of falls, seizures and using the community.

The registered manager used information provided by the referrer and people’s family to inform the plan of care. People were involved in assessments and their views about their health, care, well being and communication needs had been discussed. A staff member told us, “I sit with people and discuss about what has been written and inform them what changes have been updated. This is really helpful as they themselves inform other staff what has been updated even though other staff are aware.”

We saw some evidence that families, advocates and professionals were involved to varying degrees in people’s care arrangements where appropriate.

The provider did not always plan and deliver people’s care and treatment with them in line with legislation and current evidence-based good practice and standards. People were settled living at The Berrys and staff had created ways in which to work with people positively. However, some people were getting older and for example experiencing difficulties with their mobility. There was no plan about how the service kept up to date and developed positively in this area to ensure the care provided was thought through and reflected best practice.

Staff supported and encouraged people to eat a healthy and balanced diet. People were involved in going shopping with staff and preparing drinks and snacks. Main meals were cooked by staff. Menu choices were discussed and agreed with people, and they could eat as a group or individually. People were happy with the food offered. A person told us, “The staff help me in the kitchen with cooking, I like cooking.” Another person told us, “I like to go and get my beer from the shops.” A family member told us, “[Relative] is well fed, has lost weight and is very well looked after.”

People’s weight was regularly monitored. A staff member told us about how they had helped a person to manage their weight and had worked together with them by doing daily exercises and managing their diet which had resulted in weight loss and more confidence. "I was so proud, and it all happened from teamwork.”

The staff team worked effectively with health and social care professionals to ensure people received joined up care to meet their needs. We saw some good practice in relation to advice and information obtained from professionals such as with the GP to work with people effectively.

Relatives were complimentary about the staff team and the support provided to their loved ones. Guidance on the actions staff should take when there were changes in people's behaviour or physical needs were in place. Staff worked closely with health care professionals for the benefit of people in the service and liaised with them where needed.

Staff work collaboratively to understand and meet people's needs. This included, daily handovers, staff meetings, and supervisions to ensure staff had up to date information to support and promote people’s well being. There was good evidence of how staff worked together to understand triggers, warning signs and support people with their distress and behaviour. This had had a positive effect on a person’s well being.

People were encouraged and supported to make healthier choices to help promote and maintain their health and well being. A person said, “I use my exercise machine, and I really like playing football.” Staff told us they understood the importance of supporting people to live healthier lives and to engage in decision making about their care. A staff member said, “It is important for people to keep active and look after themselves, and we help them do this.”

The provider supported people to manage their health and well being in discussion with them. People were supported to attend medical and other appointments such as access to opticians, dentists and chiropody appointments. Staff reported back any actions needed. Staff responded to changes in people’s acute care needs by contacting medical services such as the GP and district nurse, psychiatrist or social worker when needed.

People were supported to understand and make choices about their diet, lifestyle and physical activity. Where these were declined, it was recorded in their daily notes.

There was not always a robust approach to monitoring the effectiveness of people’s care, treatment and support and action taken to continuously improve it. There was a disparity in how the provider monitored people’s care and support. People were not always engaged in planning their life ahead to ensure it was a life they chose or needed. This included not forward thinking about people’s needs relating to age, frailty and declining mobility which could put them at risk of receiving unsafe care.

There were some positive outcomes for people using the service. Their skills, life experience and strengths were discussed with them and those involved in their care, to understand how people’s short, mid and long-term life choices, goals, ambitions and outcomes could be planned and achieved. The triggers causing people distress, how this affected their behaviour and how staff supported them with positive outcomes were recorded. Where needed, people’s blood pressure was taken and recorded and information routinely shared with the GP to help manage their ongoing health needs. The provider gave us examples of where people had achieved goals through co-production, encouragement and support of staff. A family member said, “The care is brilliant as it has made all the difference to [relative], and their life is so changed for the better.”

The provider did not always have effective systems in place to ensure that people’s capacity was assessed and recorded as mental capacity assessments were not always completed correctly and up to date. We saw one mental capacity assessment completed for a person in 2023, where 5 tasks had been assessed all at once. It said they had capacity to make decisions about all these tasks and then said they did not have capacity. The provider did not demonstrate they always respected and considered people’s rights when assessing their individual needs, capacity and ability to make every day or significant decisions.

Where people could consent to their plan of care, their signature had been obtained. However, some information seen in the care plans regarding people’s consent was out of date, such as people signing their consent in 2015 without it being updated to reflect their current wishes.

Some people had representatives such as the Court of Protection (COP) which looked after their best interests in relation to their finances and welfare. The provider liaised with the COP regarding finance and welfare decisions. Family members were aware of these arrangements. Deprivation of Liberty Safeguards (DoLS) authorisations were in place where this was agreed for people. DoLS set out the legal authority for people to be deprived of their liberty, in their best interests.

Staff had received Mental Capacity Act 2005 (MCA) training and understood the principles of applying the MCA in their day-to-day work. Staff supported people wherever possible to make day to day decisions such as what to wear, eat, drink, meeting their personal care needs and what they would like to do. This enabled people to have some autonomy over their day to day lives. Staff gave examples of how they applied the principles when supporting people in the service and in the community.