Kingsthorpe View Care Home

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed 5 quality statements in the caring key question and found areas of concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which was requires improvement. People were not supported to have choice and control and make decisions about how their support was provided. They were not encouraged and helped by staff to do as much as they could for themselves to maintain their independence. People were not supported to understand their rights and how the service would make sure these were respected. People were not encouraged to take part in a wide range of activities both at the service and in the community to support their independence, health and well-being. People’s friends and families were free to visit them with no restrictions.

This service scored 35 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We received mixed feedback regarding kindness and compassionate care. One person told us,” I mix with anybody. The staff are kind but 1 or 2 can be a bit nippy. I appreciate all that the staff do but don’t feel I could talk to them; perhaps this is me but I don’t feel I can open up to them.” All the relatives we received feedback from spoke highly of the staff team and told us they were caring and tried their best. A relative told us, “So, I think the regular staff who were involved with my mum, will try and interact with mum and I can tell they care. Staff have told me they have tried to tell the manager what they need because they care but don’t feel they can always go to the manager.” Another relative told us, “All the staff are lovely and caring.” Some relatives felt management were not always kind and compassionate. A relative told us, “I don’t think the manager is warm, caring, approachable, not empathetic and not that feeling you want to communicate. I feel this is why there isn’t any communication with relatives such as meetings.” Another relative told us, “I don’t think it’s managed well or staffed well. I think it’s based on money and how much money they can make. Why did they make the extra bedroom to cramp all the residents into a small lounge area. That was not caring. I do not know why they are mixing up all the staff. Staff should be respected more. I’m not sure they have a way to be listened to and the staff are afraid to talk. The feeling I get is the staff are giving up.”

Staff were able to explain how they treated people with compassion and understood how to ensure people’s dignity was respected. However, staff told us they could not always do this due to insufficient staffing.

Partners did not raise any concerns in this area.

We observed staff rushed and the care was task and staff focused rather than person-led. Staff were caring and kind to people when they had the time to support them. Staff expressed feeling ‘guilty’ of not having time to provide wellbeing care such as chats and meaningful activities. We observed at breakfast a person had spilled a cup of tea down their shirt. We found after lunch that no staff had noticed this or changed the shirt. We raised this with the senior care staff member and they immediately supported them to change their top. We found people had overgrown fingernails and toenails with dirt in their nails. This meant people’s dignity was not always maintained. There was no culture to ensure people received caring and compassionate care to meet their assessed physical, mental and wellbeing needs. People had nothing to do with their time or enough staff to interact with them in a meaningful way.

Relatives told us their loved ones were not always treated as individuals. A relative told us, “[Person] has been soiled for a long time; it is not good care. [Person] is here left in the dark (curtains closed) and alone. [Person] needs company. They scream when alone. I visit every day but can’t do when it is the school holidays.” Another relative told us, “Staff are so kind and caring, a new person had come to the care home who didn’t have anything, so staff rooted around to find things and went out to buy things themselves. I told my boss at Tesco, and they sorted some clothes for the person. But why did the management not have a process for this to ensure the person had all the basics.”

Staff told us people were not treated as an individual. One staff member told us, “We have people who have different dietary requirements to meet their cultural needs, but they are not met. We have a Caribbean person who likes Caribbean food but doesn’t get Caribbean food, got it for a week and never again. [Person] likes a proper Indian curry, gets a curry once in a while but it’s not an Indian curry. To me [management] know people's needs and they are not providing it. We have [a person] who is Italian and does not get a choice of food. [Person] is Persian who also likes certain foods such as chicken but isn't offered the foods he likes. [Person] is vegetarian and not asked what they would like just has to have what there is. [Person] doesn’t eat meat a lot of the time their family bring in food for them. For all the people who are diabetic they have the same pudding. Jelly, yogurt or fruit.” The registered manager told us there was no activity staff member from Saturday to Monday. They told us care staff were responsible to provide this support when no activity staff member was on shift. This meant care staff could only provide activities if they found spare time.

We observed a lack of person-centred social activities and stimulation to meet people’s social needs. People were observed on both days of our onsite assessment without access to stimulating activities. There was no allocated activities staff member. This placed people at risk of boredom, low mood and social isolation.

People’s care plans evidenced that staff were not provided with meaningful information on what people wanted to do in their time and how they wanted to be supported to ensure their hobbies and interests were maintained.

Relatives did not feel people were supported to have choice and control over their own care. One relative told us, “It doesn’t happen, there isn’t an activities person, and there isn’t anything for him to do. I personally think people do not have choices, if you don’t want to watch tv, there isn’t anything else to do.” People told us that they were not able to live their lives as they wanted. One person explained that staff did not support them to leave the care home and access the community. They told us they had absconded twice because they did not have control over how to spend their time and was bored.

Staff understood people’s ability to make choices and told us they would always encourage people to make their own choices. One staff member said, “The residents do get to make some choices like what to wear or what to eat. The residents don’t get a choice on what to do with their time always because we don’t have time to do things with them.” Staff told us they had completed training in Dignity and Respect. Staff told us how they could not always apply this training to improve people’s experiences because they were always rushing.

We observed a person had asked three times be taken to their bedroom and a staff member each time told them they had to wait for a staff member to became available. This meant there were not sufficient staff to allow people to have choice and control over their care.

Staff were not provided with clear guidance on how to support people to be as independent as possible. People were not supported to understand their rights. People could not access activities within the care home and could not go out to the local community with support as they wished. One person required support from a staff member at all times. There was not clear guidance on the person’s preferred routine. One staff member told us they were not aware of the person’s preferred routine and the person did what everyone else did but had one staff member to watch them. People could access their friends and family. There were no restrictions on people having visitors to the care home.

We found there were not enough staff to always respond to people’s immediate needs. We saw people who were distressed and required staff support but this was not provided in a timely manner. For example, one person was distressed and there were no staff to provide support to de-stress them and their behaviour escalated. Because the situation had not been managed by supporting the person when they were showing their early warning signs of distress, staff had to administrate anxiety medication called lorazepam. Relatives told us staff could not always support people immediately when they needed support. A relative told us, “[My family member] wanted to go to the toilet, and I was told he would have to wait for 10 minutes; so, I had to do it [take the person to the toilet]. I did complain.”

Staff told us people’s immediate needs were not always met and they would need to tell people to wait for staff because there were not always enough staff. Staff did feel that any urgent help and support people might need such as a result of fall would be provided.

We observed people’s needs, views, wishes and comforts were not always prioritised in order to avoid any preventable discomfort, concern or distress as detailed within the safe section of this report. We found staff were not provided with the time to communicate and engage with people in discussions about their immediate needs to ensure they could respond in the most appropriate way.

We found staff wellbeing was not always considered. Staff told us they had raised concerns but they were not listened to by management and no action was taken in response to concerns that they had raised. The registered manager told us they had sent staff a survey but no staff had responded. We were not fully assured those surveys had been sent because staff told us their views regarding the service were not asked. There were no records to demonstrate when these surveys were sent to staff.

Staff were not provided with meaningful opportunities to provide feedback, raise concerns and suggestions to improve the service or staff experience.