Beacon 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

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 inspection 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. During our assessment of this key question, we found concerns around the management of consent to care and treatment which resulted in a breach of regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence.

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 found limited evidence to demonstrate people using the service were involved in the assessment of their needs or developing their care plan and risk assessments. However, we saw for 1 person who had transferred to Beacon House the service demonstrated they had carried out a face to face assessment and also completed a virtual assessment. This was to ensure they were confident they could meet the person’s needs. A relative told us, “[Name] is happy and content, staff know [name] very well and are able to make decisions and I am always involved.”

Records we looked at failed to demonstrate people’s needs were being regularly reviewed through assessment to ensure their support plans continued to reflect their needs. People’s care and support plans failed to include dates and details of their last reviews. The nominated individual and registered manager told us this was something they were working on to improve as they had previously relied on local authority reviews being held.

Staff spoken with, the registered manager and deputy manager demonstrated an awareness of people’s care and support needs. Staff confirmed they had read people’s care plans and risk assessments, and this was recorded in most cases but not by all staff employed at the service. However, the management team and staff did not know what type of catheter a person had. The registered manager did not know how frequently their catheter was to be changed. The registered manager told us they were unaware of the gaps in people’s care plan and risk assessments until recently and there were no care plan audits completed to identify this. Staff spoken with had no awareness of the terminology of Right Care, Right Support, Right Culture [RSRCRC]. The registered manager confirmed staff had no training relating to RSRCR. The senior team had undertaken Oliver McGowan training; however, this had not been cascaded down to the care staff team. We found no effective staff role models amongst the senior staff/team leaders that made management aware of gaps in people’s care/support plans.

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.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The providers processes for monitoring and improving people’s outcomes was not always robust. We found for people using the service who required more specialist input either with their catheter care or regular repositioning due to potential deterioration in their skin integrity the monitoring and documentation of records were poor. Records of a person’s fluid intake and output were incomplete and repositioning charts for a person identified long periods of time where repositioning had not taken place. For example, we reviewed repositioning records for a person from 1 January 2024 up to 16 January 2024. These showed gaps of 12 hours plus where no repositioning had been undertaken and on several occasions no record of when the persons continence aid had been changed. We also noted there were gaps in documentation where there had been no repositioning records maintained from the 12 January to the 15 January 2024. The registered manager and deputy manager advised at night there were only 1 waking night member of staff on duty, therefore they were unable to change the persons continence product or reposition them on their own, consequently the provider failed to evidence the service had effective arrangements in place to monitor and improve outcomes for people.

People we spoke with told us they were able to make some informed choices. For example, the times they like to get up in the morning and go to bed, what clothes they like to wear, choice of meals and drinks and whether or not they choose to participate in social activities particularly in the local community. One person told us, “I like to stay here [Beacon House], I don’t always want to go out really.”

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA 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. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service was not always working within the principles of the MCA. We found a DoLS application submitted on 31 August 2023, the 7 day urgent authorisation expired 5 September 2023. We were advised by the registered manager that the Local Authority came out and, completed a telephone DoLS assessment, 11 days after the DoLS for this person had expired and were yet to receive the outcome. The registered manager stated they were aware their understanding of the DoLS process required improvement and with the help of the nominated individual additional training was being sourced. People’s capacity had been assessed and best interests’ decisions completed for certain aspects of people’s care and support. For example, administration of people’s medicines, management of people’s finances and accessing the community, however we found no MCA’s or best interest decisions completed for people who were monitored throughout the day/night via the use of monitoring/listening devices to demonstrate how the provider had attempted to obtain consent and how it was in the persons best interests to be monitored this way. We found no evidence to demonstrate staff had been consulted nor consented to the use of CCTV monitoring in Beacon House.

Staff demonstrated a basic understanding of the main requirements of the Mental Capacity Act and how these impact on people using the service. Two staff we spoke to were able to provide examples about how they offered and provided choice to people using the service. They were able to clearly state which people using the service could consent to their care and treatment, where people had variable capacity and who lacked capacity. Both members of staff confirmed they had completed MCA training.