Archived: Bethrey House

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

The service was not always effective. We identified 2 breaches of the legal regulations. Assessments were not always in place and therefore people’s needs were not always planned for. The principles of The Mental Capacity Act 2005 were not always followed. People’s health needs were not fully considered or responded to or advice from professionals followed. People had access to GP’s and felt the home was responsive when they were unwell.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives raised no direct concerns with this, however when asked people were not aware of if they had assessments in place or if they were involved with this process.

We discussed the assessment process with the nominated individual who told us there was a process in place however they were unable to share any further details around what areas this covered or how the process worked. Staff were not always aware of this process; they were not always able to tell us if people had assessments in place.

Effective systems were not in place to ensure needs assessments were completed consistently and when required. Care records did not always contain assessments, therefore we could not ensure care was planned and delivered in line with people’s individual needs.

Some people raised concerns with how their care was delivered, including when they could have a bath, how they were treated and the levels of support they received.

The nominated individual told us they were aware of evidence based care and treatment and they told us they were working towards delivering this. However, staff we spoke with were not always aware of what evidence-based care and treatment was and when asked they were not always able to demonstrate they understood what safe care was.

Effective processes were not in place to ensure care was consistently delivered based on evidence based practice. People’s needs had not always been assessed and recorded so it was unclear about how decisions were made in relation to how people’s care was delivered. Some clinical tools such as the ‘waterlow score’ were in place for people. However, there was no further evidence around what this meant for people and how the outcomes of these tools were used to deliver effective care.

People and relatives raised no concerns with how staff teams and services worked together. People felt they had access to health professionals when needed including the GP. One person told us they felt confident that staff would call her GP if they were unwell.

Staff told us when other professionals had been involved with people, they worked with them to ensure they followed their advice. However, when asked specific questions relating to individual people, they could not always evidence that this was the case. For example, when people were not using the correct mobility aids staff confirmed they had not been referred to or seen by professionals for advice. Staff also confirmed they were not aware a person had been seen by the physio despite records showing the physio had made recommendations for them to follow.

As part of this assessment, we asked for feedback from the local authority They told us they had recently attended Bethrey House and found concerns. They had worked with the provider to put in place an action plan which they shared with us. They also shared they felt the provider had not been responsive to actioning and responding to these concerns.

There were processes in place to work with professionals however these were not always followed. When 1 person had been seen by a physio, we saw they had recommended the person mobilise more. There were no plans in place identifying this advice and this was not completed. Therefore, professional advice was not always followed.

We received mixed feedback from people with how their health was managed. One person said, “They never bother with [specific area identified], say they’re a care home but they’re not caring for my [specific area identified].” Other people raised no concerns.

The nominated individual told us care plans were in place for people and referrals were made to professionals to enable people to live healthier lives. However, staff confirmed action had not always been taken when indicated regarding people’s mobility concerns and deteriorating health needs.

People did not have individual care plans in place for their health needs, for example when people had known health conditions, such as high blood pressure, mental health needs and heart disease. This placed people at risk of not receiving care and support when needed.

People were unable to explain to us how their care was monitored and improved but shared no concerns with this.

The nominated individual told us this was monitored for people but was unable to tell us how and when this monitoring was completed. Staff were also unable to tell us how people’s outcomes were monitored.

There were no processes in place to monitor care and the outcomes for people. Care plans and risk assessments were not reviewed when changes had occurred, and people were not always receiving care in line with their needs.

People and relatives raised no concerns around how they consented to care.

Staff were not always able to explain how people consented to their care and there was a lack of understanding around when people were able to consent and the actions they would take when they were unable to. One staff member said, “No, I don’t know about this.”

There were some capacity assessments in place for people when needed, however there was no evidence to show how decisions had been made in people’s best interests. When people were seated in reclining chairs, they had not considered this could be restrictive. People were also restricted and could not move around the home independently due to needing a portable ramp, the ramp was needed so that people could access the conservatory and garden, when people used wheelchairs they needed this ramp to exit the home.