Beige Healthcare Services

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.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. However, assessments were not comprehensive and information in care plans was not always current or clear. There was not enough information in care plans on people’s health conditions and how they affected them. Also, there was a lack of details on people’s communication needs.

Daily records did not always evidence appropriate communication or action when changes to people’s needs, health or wellbeing had been noted.

The registered manager had daily oversight of people’s needs but some of the information provided verbally about people’s support was not recorded in their care plan.

However, people told us staff met their needs, and due to there being a small staff team they knew the people they supported really well.

Staff told us they were informed by the registered manager about any changes to a person’s support needs and they could access care plans and risk assessments.

When asked about their initial assessment 1 person told us, “[Registered manager] met me [and] discussed my care needs”.

The provider did not always plan and deliver people’s care and treatment in line with legislation and current evidence-based good practice and standards.

Care plans did not consistently include details of enhanced monitoring requirements. For example, staff recorded 1 person's exact fluid intake volumes in the daily records, but the care plan did not specify that enhanced monitoring was required, when the monitoring commenced, the recommended fluid intake, or when and to whom concerns should be escalated.

In addition, care plans did not clearly reflect guidance provided by other healthcare professionals or detail any monitoring arrangements in place to support people's health conditions.

However, staff knew people well and supported them to develop independence, maintain life skills and achieve positive outcomes. For 1 person whose health had deteriorated their relative told us, “[Staff] still sit [family member] up for meals and allow [family member] to feed themselves to maintain as much independence as possible.”

The provider worked well across teams and services to support people. However, care plans were not clear or contemporaneous. Staff, partners and other services would not have an accurate understanding of a person’s needs from information available. Care plans did not document input from partners and records were not reviewed to reflect new guidance from professionals. For example, guidance from the District Nursing team about wound management.

The registered manager advised they had liaised with other professionals, teams and services on behalf of people however there was no recording of this communication. There was also no evidence of how documentation and updates or guidance and recommendations from other services were shared with staff. For example, following someone’s hospital admission.

However, people felt there was effective information sharing. One relative told us, “The registered manager arranges all of my family member’s appointments. [Registered manager] liaises with the GP, District Nurse team, Pharmacy, Optician, Dietician and Boots hearing department. If possible, [registered manager] will arrange for these appointments to take place at [family member’s] home. At all times there is a Carer present at these appointments and while traveling in the taxi. I am always informed of the outcome of [family member’s] visit afterwards.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

One person told us, “If I go out with friends or see family at weekends, they accommodate my times so I can spend as much time as I can with them.”

However daily records did not evidence choice and control and 1 person told us that when there were previous issues with staff and time keeping this impacted their wellbeing.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. 

More information was needed in care plans relating to people’s physical and mental health needs, so the service could effectively monitor the risks relating to the health, safety and welfare of people. For example, clearer information about people’s nutritional needs so staff know if they are meeting their clinical expectations and if appropriate referrals have been made.

However, staff were committed to improving people’s quality of life and supporting them to achieve positive outcomes. For example, for someone whose health had deteriorated the registered manager liaised with their relative, health professionals and local religious leader to meet all their needs.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

One relative told us, “Consent is always obtained from my family member before the staff carry out any care. [Family member’s] dignity is maintained at all times.”

When asked about consent 1 staff member told us, “People I am supporting can make their own decisions. If someone lacks capacity, we may work with someone with legal authority but still involve the person and make them aware.”