Kimwick Care Home

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 Requires Improvement. At this assessment the rating has remained Requires Improvement.

Requires Improvement: This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider had not ensured people’s needs were properly assessed before they were admitted to the home and people’s health concerns were not always followed up in a timely manner. People told us staff asked for their consent before providing care and support, however the processes in place did not always support compliance with the Mental Capacity Act 2005 (MCA).

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.

The provider did not make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

The provider had not ensured people’s pre-assessments considered whether the people living in the home had compatible needs. Prior to the assessment we were aware of concerns held by commissioners about the compatibility of people living in the home. People’s relatives told us they had also been concerned about the mix of people living in the service. At the time of the assessment commissioners had acted to support 1 person to cease using the service.

The manager and staff told us people’s needs were assessed before it was agreed the service could meet their needs. We asked to view records of people’s pre-assessments as part of this assessment, but these were not available.

We could not be assured appropriate assessments were carried out to ensure the service was able to meet people’s needs appropriately as people's pre assessments were not available at the time of assessment.

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.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People’s relatives told us staff did not always follow up health concerns in a timely manner and that health appointments had sometimes been missed. One person’s relative described 2 incidents that required follow up from staff, but appointments were not made until family intervened. There was a risk people would experience a deterioration in their health due to a delay in receiving appropriate treatment.

Staff told us how they supported people to live healthier lives, including eating a healthy diet. However, some of the information they provided about people’s health needs was not reflected in their care plan. For example, staff told us 1 person did not always tell staff the truth about their health needs, this was not reflected in the person’s care plan. This meant staff did not have access to the information they required to provide appropriate support to people.

Daily handover meetings were in place for staff to share information about changes to people’s health. However, we found information about acute changes to people’s needs or appointments that were due that day was not always shared effectively, and health appointments were not made or were missed as a result.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

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 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 MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

We were able to gain limited feedback from people. However, 1 person told us staff always asked for their consent before providing support.

Staff told us they had received training in MCA and DoLs and were able to describe their responsibilities under this legislation, they were aware of people’s mental capacity assessments and who had a DoLs in place. However, during the onsite visit we found the front door was unlocked, this demonstrated staff did not always implement their training and knowledge in practice.

Prior to the assessment we were aware that the provider had not always complied with the legal framework in relation to applying for DoLs for people living at the service in a timely manner. This had been identified by commissioners and at the time of the assessment the provider had taken the necessary action to ensure compliance. However, they had not considered how they would prevent a similar occurrence in the future.