The Beeches (The Drive)

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

Before people started to use the service, the registered manager carried out an assessment of their needs. However, the assessment lacked details with regards to the skills and capabilities of the person and information about them or their background. The management team worked closely with other health professionals to help ensure people had access to the services they required to maintain their health.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We noted people’s needs were assessed previously, however the assessment for the person who moved in most recently could not be found. As a result, staff did not have all the information available to them to meet the person’s support needs. We were later sent this information via e-mail. Whilst there was evidence that people’s health needs were reviewed regularly there was no evidence that people’s broader needs and wishes were reviewed annually. There was a lack of evidence of people’s aspirations and of what they would like to learn or achieve.

A staff member told us, “When the manager completes a needs assessment for a [person] they will meet with staff to discuss the assessment.” A senior staff member told us, “I support the manager to complete people assessment, and I feed back to staff at our staff meetings.”

Mental capacity assessments (MCA’s) and best interest (BI) records were not accessible on our first visit and had been kept in a locked filing cabinet. We saw them on our second visit. We noted that a person’s MCA had been copied from one to another. In 1 case with information that was clearly from the wrong form. MCA was not personalised to the individual person, for example, MCA did not have evidence that other ways were tried to support the person to understand the decision that was being assessed. This could have been done by using a number of different accessible formats. We also found that people’s Deprivation of Liberty Safeguards (DoLS) did not include the use of CCTV. Both concerns were discussed with the registered manager.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

Staff were very positive on joint working with other professionals and that people received assessments such as, health care assessment. A staff member told us, “We support people to attend appointments like OT assessment. We also review people’s care plans on a regular basis.” The registered manager told us that they completed reviews of people’s support needs. They stated, “Reviews are completed with family and health professionals when required.”

We saw the provider had systems in place to carry out pre-admission assessment to identify people’s health conditions and support needs which helped the service to establish if they were able to meet the persons support needs. The staff monitored people’s health care needs and informed the registered manager of any changes.

We received feedback from an advocate who was positive about the service and how staff supported people. We also spoke with a care manager from a local authority social work team who discussed a person’s one-to-one hours and what they were used for as we were unable to see this information in the person’s care plan.

People and their relatives were very complimentary about the staff team and how they worked together. A relative told us, “We are involved in reviews, we have been involved recently with reviews on medication.”

Evidence showed that the staff supported people to see their GP or other health and social care professionals as needed. We saw that people were supported to have a hospital passport, which was up to date. Relatives felt staff supported people to access healthcare and they were kept informed of the outcomes of those visits. We found care records had information regarding health appointments such as GP appointments, dentists and yearly health assessments.

The service worked in partnership with other agencies such as health and social professionals. Records showed people had been referred to different health care professional as and when required. Staff handovers were completed during shift change, which included tasks completed, tasks outstanding and information relating to people’s wellbeing. Care plans detailed people’s outcomes and regular reviews were carried out to ensure peoples support and outcomes were monitored.

The registered manager told us people’s outcomes were monitored through daily observations and care reviews. The management team worked well with other health and social care professionals to support people using the service and this helped to ensure people’s needs were met.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

The registered manager and staff had a good understanding of the principles of MCA. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. The provider had policies and procedures for them to follow. Staff received training on the MCA. Staff sought people’s permission before they carried out any tasks. There were policies and procedures for them to follow.

During our discussions with staff, they were able to explain the principles of the MCA and the need for people to give consent. A staff member told us, “I have received training regarding the Mental Capacity Act as well as Deprivation of Liberty safeguards training. I would always ask a [person] if I can support them with personal care before support was given.”

The Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) assessments were completed. However, the MCA assessments were not always completed in a person-centred way. For example, we saw that a person’s MCA assessment had been copied from another person’s assessment. We also found that people’s DoLS assessments did not include the use of closed-circuit television (CCTV). 2 people’s DoLS assessments had expired in March and April 2023 respectively and this was not followed up until January 2024. People were consulted about their care and treatment and families told us about their involvement in key decisions with regards to care and treatment. However, we saw no evidence of how involvement and consent was gained in decisions that made about a person. We noted a person had a lock on their wardrobe door, and this had not been mentioned in their MCA or Best interest records. We were also told conflicting information from staff. A staff member told us the lock was on the door to prevent the person from taking their clothes out in an appropriate way. The registered manager said that they no longer had a lock the wardrobe door as there was no longer a need to do so. However, the lock was not removed from the wardrobe.