Birch Abbey

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 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 because they did not always check and discuss people’s health, care, wellbeing and communication needs with them or relatives. A 'resident of the day' process was in place, where 2 people’s records were reviewed daily, with updates made to care plans and risk assessments. However, it was not always clear if, where appropriate, relatives had been included in the care plan review process. Some relatives told us they had not been involved in reviewing the care of their family members and records supported this.

The provider was working towards improving care that was delivered to people. For example, a digital pain assessment tool was used to assess and score pain in people, particularly following incidents such as falls or distressed behaviour. This was especially beneficial for determining treatment required for people and supporting people who could not always communicate their pain.

However, further improvements were needed as the provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. For example, care plans had not always been followed by staff.

The provider did not always work well across internal teams within the home to support people. Further improvements were needed with teamwork within the service. Feedback from staff, including the management team, highlighted ongoing concerns regarding the collaboration between day and night shift staff, as well as the distribution and completion of tasks. However, some processes in place did support continuity of care. For example, when a person was admitted to hospital, a ‘care passport’ was in place. This contained all relevant documentation including care needs and an up-to-date medicines administration record.

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. Care plans included detailed information about people’s healthcare needs and how they were met.

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. For example, for people with wounds, dressings were not always changed on time or correctly, and documentation was not always updated accurately, making it difficult to monitor wound progress. As a result, the registered manager was monitoring wound records daily, and this was part of the ongoing action plan.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack capacity, any decisions made on their behalf must be in their best interests and as least restrictive as possible. However, mental capacity assessments and best interest decisions were not always in place as required. For example, people's capacity to consent to restrictions upon their freedom, such as assistance with medication administration and personal care, was not always assessed. The provider acknowledged this and has since reviewed all mental capacity assessments in place for people.