Kingsthorpe View Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We assessed 7 quality statements in the responsive 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. We identified one breach of the legal regulations. People were not supported to live in a safe, inclusive environment in which they were treated fairly and free from the fear of being discriminated against. People were not supported to understand their equality and human rights and how staff and managers would respect these. Managers did not obtain feedback from people, their relatives or staff to improve care to reduce any barriers people might experience due to their protected characteristics.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not experience person-centred care. Management did not ensure people received care and treatment that met their needs and reflected their preferences. This meant people did not have care that enabled them to live as they wanted and opportunities were missed to find out people’s skills, strengths and goals. Relatives told us they were not sure staff knew about their loved ones’ likes and preferences. One relative told us, “To be honest I do not think they do know Mum’s likes. [Staff] did not even know my mum was a [previous profession] or what she did. The bedroom is such a horrible environment for my mum.” Another relative told us staff did not know their loved one as a person. They told us, “We had a meeting at the start to discuss things, I don’t think they [staff] know dad.” Relatives told us they had not seen their loved ones participate in any activities. Relatives told us, “There aren’t any [activities]. When I go, I get people talking and play music they like and get them singing and their faces light up, I have brought things for people to do, but this should be done by the manager, not me, it’s not the staff’s fault it’s the people above.” Another relative told us, “In all the time my mum has been there, which has been over 2 years, I have never seen any activities. I was told there used to be two activities staff.”

Staff told us people did not receive person-centred care because there were not enough staff. They told us they tried their best, but care was focused on tasks that needed to be completed that showed up on their phones and this left no time to offer person-centred care. All staff we spoke with raised concerns regarding having no time to even have a chat with people.

We observed care was task-orientated and staff-focused instead of person-led. We reviewed people’s daily records that demonstrated task-focused care. People were not provided with care and treatment when they wanted their care instead it was when staff could provide the care. The management team did not provide staff with clear information and guidance on how people wanted to be supported in line with their likes, choices, consent and preferences. This meant people were at risk of institutional care. We observed people did not experience positive outcomes because people had nothing to do for long periods of time. This meant people were at risk of boredom, inactivity and social isolation due to the lack of person-centred activity.

People’s care was not joined-up or flexible because people or relatives were not involved in any care planning or decision-making. People told us they wanted to see other health professionals such as dentists or have their hearing checked and were not offered this support or information on how they could access these services. Relatives and people did not have access to their own care plans, assessment and risk assessments to ensure their rights and choices had been respected. Relatives were not sure if people had access to other health services. One relative told us, “My mum’s teeth were perfect, and used to be nice and now they have gone disgusting and brown in colour. I don’t know if my mum has had a dentist or optician. I have not been told.”

The registered manager told us they did have a dentist booked to visit the service, however the dentist cancelled, and no other visit had been booked. People and relatives had not been informed of any other options available to access other health services for people to make an informed decision. For example, a visit to a dentist with family support.

A partner told us that people who required support due to their mental health had been referred to them. However, they told us that distressed behaviour records were not completed in detail and staff verbal feedback to the partner also contradicted what records had demonstrated.

Staff and management did ensure a doctor was involved in people’s care and support if required. However, we were not assured there was a clear process or system to ensure people were offered a range of health services to meet their needs.

We were not assured people were provided with information that was accurate and up-to-date in a way they could understand. For example, a person living at the service responded better to their native language Italian. Words had been put together for staff; however, these had gone missing. The provider shared with us an activity timetable in Italian. However, we were not assured this was used because their daily notes did not demonstrate the person participated in any activities. Furthermore, we were not assured their care plan had been offered to them in a way that they could get a better understanding to ensure the information regarding them was correct. Relatives told us they had not been provided with information such as how to make a complaint or raise concerns. Relatives told us there was no effective process where the management team engaged with people and relatives to provide information. One relative told us, “There has been no meeting, never. Families have raised to get the relatives together such as a coffee morning or a weekend morning come together every 3 months so we can get updated. We are not made aware of any changes. Even when they made the extra room. There is no consultation when changes are made and it is not even considered how this will affect my mum. Poor communication.”

Staff told us they were not always provided with clear information and guidance on how to best support people with their communication. One staff member told us, “I feel we were not provided with clear guidance on how to communicate with people or support people, but we learn it on the job.” This meant staff were not provided with clear guidance on how to best provide people with information.

There was not an effective process or system in place to provide people and relatives with information. We were not assured that the accessible information standards were met such as providing information in a different language or different size print to people where needed. People’s information was securely stored.

People and relatives told us they did not have much contact from the management team. One person told us, “The [manager] hides in the office.” Another person told us, “I don’t know who the manager is here.” Relatives wanted more contact with each other and to be more involved. Relatives told us they had requested resident and relatives’ meetings, but this had not been actioned by the registered manager. A relative told us, “We asked to get relatives group together and then the manager said no one responded to an email but I wasn’t sure because relatives want to get together. I have not had emails from [management].” Relatives told us they had not been asked but had raised concerns regarding the garden as it was not safe or welcoming. The registered manager had told them there was a plan to develop the area however this had not happened. One relative told us, “Yes, I feel listened to by the manager, but I think [the manager] only has so much control so needs to go above and then can’t made the decision. Garden, for example, the residents do not have any access, it’s so uneven. I was told the back garden was going to be done with soft foam so it’s safe. So, I stopped the gardening, 9 months ago as i was told it would be done. But it’s not been done and just excuses. I did the gardening with other relatives because it was horrible and they would not do it, we would put our money together and buy flowers and get deals from work. They have had new furniture, but they can’t go out because it’s not safe.” Another relative told us, “Due to lack of action we use to volunteer to do the garden and we were promised equipment and money to make it better but again that didn’t happen. We brought our own plants to try and make it a little better because it’s horrible.”

There were ineffective ways to engage with and involve staff. For example, staff told us staff meetings were cancelled, and they did not always have the opportunity to have one-to-one meetings. Staff were not empowered or confident that their concerns and ideas resulted in positive change to shape services to create a more equitable and inclusive organisation. The management team told us they produced a newsletter to provide relatives with information. The registered manager told us they had not received any complaints this year. However, relatives feedback demonstrated that relatives had made complaints regarding the quality of care and service their loved ones were receiving and these complaints were not logged. This meant there was a risk people and relatives’ complaints were not always logged, monitored or investigated.

We found no records to demonstrate the management team had a process where people and relatives were involved or asked for their feedback regarding the quality of care. There were no effective ways to engage with or involve staff, to ensure they had the opportunity to be listened to or be involved. Meeting records demonstrated staff did not have regular staff meetings, the records demonstrated two staff meetings, one in January and one in June. Peoples, relatives and staff feedback demonstrated there was not a listening and involving people culture within the service, to make the necessary improvements to ensure people received the care and support that was tailored for them.

People did not always have access to the care, support and treatment they needed or wanted. For example, people told us they did not have access to a dentist. One person told us they had not been supported to ensure they had their well woman checks they were entitled to and another person told us they were not offered support to have their hearing tested.

The management team told us they had a weekly contact with a GP to discuss people’s health needs and raise any concerns. Staff told us people had access to a chiropodist. One staff member told us, “Everyone is with the same GP and has a GP walk round. They do have someone to come out for footcare, every three months. The hairdresser works in the laundry and will do the hair for the people who have the money.” However, our observations and photos of people’s foot/leg wounds showed people had overgrown toenails.

People living with dementia who showed signs of distress did have access to the dementia outreach team. However, we were not assured that the dementia outreach team could support people effectively due to the poor record keeping from the staff when incidents had occurred. This meant it was difficult for the dementia outreach team to review information and provide effective strategies.

There was a process to have access to people’s GP and pharmacy when people required support for when they were not feeling well. Care plans did not always clearly demonstrate what access people had to support with their oral, foot and hearing healthcare needs.

People were not always informed or empowered to give their views and understand their rights to have access to all healthcare services to ensure there was no barriers because they were living in a care home. This meant we were not assured people and relatives were aware of their rights under the Equality Act 2010. A relative told us, their relative speaks Italian, they can speak English but finds it easier to understand Italian. The relative told us, “There had been attached to the wardrobe door a list of phrases in Italian to assist others to speak to [person] but this had now gone. I did ask staff about this who also said they didn’t know where it was.” The registered manager confirmed these had gone missing but failed to take any action to replace them to support the person with better communication.

Staff told us everyone was treated equally within the service and people were not discriminated on the basis of their gender, age or ethnicity. However, some staff did raise more needed to be done to meet people’s cultural needs. Staff told us of people living at the service who had raised they would like foods in line with their cultural needs and this had not always been offered.

People’s unique needs and identity was recorded in their care plans. However, staff were not given guidance on how to support the person’s needs to ensure positive outcomes. For example, staff were able to clearly tell us people’s cultural needs and wants especially around food, however these were not included in people’s care plans. We were not assured there was an effective process or system to allow people to have choices and control over the care they received. People or relatives had not been involved in care planning meaning people were not involved in making informed decisions. People’s communication needs were not always clearly recorded in their care plans. Staff were not provided with the resources to communicate with people and understand their needs and wishes. Staff had completed equality, diversity and inclusion training.

People or relatives had not always been provided with an opportunity to discuss end of life care wishes and choices.

The management team shared their end of life strategy. However, we were not assured that of the effectiveness of this strategy because people’s care plans did not demonstrate the strategy had been followed. Staff were not able to explain people’s wishes and were not sure where they would get this information. One staff member told us, “I do not know about people’s end of life care. I did online training and maybe the care plan.”

Care plan records had a section called last wishes. However, we found this had not been completed. Where people lacked capacity to express their wishes, we found relatives’ feedback had not always been obtained. There was an end of life policy however we were not assured that this could be followed if people and/or their families were not part of the care planning for end of life care. Some people had completed ReSPECT forms where appropriate. This form creates a process for personalised recommendations in the event of an emergency or where people are unable to decide or express their wishes. Staff had completed end of life training.