Kitwood House Care Residence Also known as 1-11337159380

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question good at this inspection the rating has changed to requires improvement. The provider was in breach of legal regulation 17 in relation to the governance of the service.

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 had core values which was evidenced on their website. However, these were not always embedded into the service delivery or based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities. The provider utilised PRICE (Protecting Rights in a Caring Environment)) training to help staff manage behaviours that may challenge with minimal restraint, focusing on de-escalation. However, the care was not person-centred. Staff report using restraint mainly for safety without considering its potential negative effect on the wellbeing of people being restrained. One staff member told us, “PRICE is for the safety of other residents and if they are in a certain mood or chasing other residents, we will use a PRICE hold.” PRICE hold is a physical form of intervention. There was little evidence to demonstrate least restrictive options were utilised prior to people being restrained. One staff member told us they had raised concerns with the management team about other staff members, however, did not feel the issue had been addressed. Another staff member told us they had raised concerns about staffing levels and the impact this had on their ability to do their job. They were told there was enough staffing and therefore the staff member did not feel listened to and felt their opinion was dismissed. The provider had core values which was evidenced on their website and within their Dementia strategy 2023-2026. These values were respect, compassion, dignity and choice. The provider had a clear vision on what they wanted to achieve. However, these were not always embedded into the service delivery.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

There was mixed feedback in relation to the quality of support and supervision the staff received from the manager. One staff member told us, “I don’t have one to ones with management and haven’t since I worked here.” Another staff member told us, “I had supervision 2 months ago when I was late back from my break.” Without access to regular supervision staff were not provided with the opportunity to reflect on their practice and to raise any concerns.

Some staff told us they felt supported by the registered manager. One staff member stated, “The management is very helpful, and [registered manager] is lovely to us all.” Another staff member stated, “I love my job at Kitwood I feel very supported by management.”

The operational management team met weekly to identify any outstanding actions and to discuss any concerns that had arisen that week. Where there was an outstanding action identified, these did not always formulate part of the meeting actions and were not always completed.

Staff did not always feel they could speak up or their voice would be heard. When staff raised concerns, they were not always informed of the outcome therefore, they did not know whether any action had been taken following them raising their concern. Not all staff were aware of the whistle blowing policy. One staff member said, “I am sorry I don’t know what that is.” There were mixed opinions from staff as to whether they were confident in speaking up. Some staff told us they were confident in speaking up if they needed to and were able to demonstrate the steps they would take if they felt they weren’t being listened too. One staff member said, “I would always go to the nurse on duty, if unsatisfied I would go to management, if not happy go to CQC.”

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them. The provider did not always provide accessible communication tools for people who required them. One staff member told us, some staff were scared to speak up in case they had their sponsorship removed.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. Despite the provider holding weekly operations meetings, which was attended by senior leadership we found they did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. Governance systems in place were not always effective, when audits were being completed, identified actions were not always followed up on. Staff did not receive regular supervision; some staff told us the only supervision they had, was when there had been an incident. All staff had access to policies however, we found the provider was not adhering to some of their own policies, this included, restrictive practice and covert medication. Some staff were happy with support from the registered manager and found them approachable. There was evidence out of hour spot checks visits had been undertaken by the management team. The provider notified Care Quality Commission when required, this included allegations of abuse, serious incidents and when a person was being deprived of their liberty. This was a legal requirement.

The provider understood their duty to collaborate and work in partnership, however, there were some occasions when they did not do this, this included not requesting GP reviews for people when required. The provider encouraged engagement with the local community. The local school had attended the service and provided entertainment. The provider had ‘dementia bus’ which enabled people to experience what life could be like for people living with dementia. The provider utilises local singers to provide entertainment for people living in the service.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice. We reviewed the training matrix and identified most staff had completed all their allocated training. However, we found specific training in relation to supporting people with a health condition had not been completed for example, catheter care. Staff told us they were provided with a lot of training, one staff told us, “I always get training and am pointed in the right direction.”