Bikur Cholim Ltd

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 people’s needs were not always met.
 

This service scored 54 (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 did not always make sure people’s care and treatment were effective. Care plans contained information relating to people’s physical health, wellbeing, and communication needs. However, for people with communication needs, care plans frequently relied on staff interpreting facial expressions or body language, without ensuring staff had received appropriate training in non-verbal communication techniques. There were no structured communication tools or alternative methods in place to support people with communication or non-verbal needs, such as photos, symbols, pictures or easy-read formats.

In addition, when people using the service required behaviour support plans to help manage and improve their behaviour, these were not in place. As a result, staff did not have the necessary guidance to promote positive behaviour or respond appropriately when challenges arose.

The service had not always ensured that up-to-date approaches were used to support people’s conditions, health or behavioural needs. For example, there was no documented evidence of repositioning charts for people at risk of pressure sores, and there was no monitoring or recording systems in place for people identified as being at risk of poor nutrition or hydration. However, staff supported people to manage their dietary needs and had access to guidance detailing specific dietary requirements and how these should be met.

The service did not always share their assessment of people’s needs. When people using the service required support from external services or healthcare professionals, this was not always co-ordinated effectively. Staff did not consistently work collaboratively to develop a shared understanding of people’s needs or to ensure those needs were fully met.

People were supported to make healthier choices. For example, people were supported to be as physically active as possible to retain their mobility and stay active. Staff told us they had collected people’s medicines to ensure they were available when needed and to support people who were unable to collect their medicines.

The service did not always routinely monitor people’s care and treatment to continuously improve it. This meant there was no robust approach for assessing the effectiveness of care, and appropriate actions were not always taken to improve outcomes. For example, monitoring tools were not in place to identify known or emerging behavioural needs, address concerns, or take action to improve outcomes for these individuals.

Consent was not always sought appropriately by staff before delivering care and support. People using the service did not always receive information about their care and treatment in a way they could understand, and they were not always provided with the appropriate support to make informed decisions. Staff had not completed mental capacity assessments appropriately to check if people using the service could make informed decisions about their care and treatment. Where care plans stated that individuals lacked capacity to make decisions, there was no evidence of completed mental capacity assessments or best-interests decision meetings prior to appointing an advocate. An advocate is someone who supports a person to express their views and wishes and helps ensure their rights are upheld.
We found that some members of staff had not received training on the Mental Capacity Act, to ensure they fully understood how to obtain consent appropriately and support people who may lack capacity.