King Street - Care Home Physical Disabilities

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

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 rated inspection, we rated this key question Requires improvement. At this inspection the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider had effective processes in place for assessing people’s needs to ensure care was safe, personalised and responsive. Assessments were comprehensive and considered all aspects of people’s health, wellbeing and support requirements. People who required complex support, including those with significant physical mobility needs and those receiving acute delegated healthcare tasks, had detailed and robust assessments in place which clearly guided staff practice.

The interim manager, who had a nursing background, demonstrated strong clinical oversight and worked collaboratively with community nursing teams and other health professionals to ensure staff were equipped with the necessary skills, knowledge and competencies to meet people’s needs safely. This included ensuring appropriate training, competency checks and ongoing support were in place. Assessments were regularly reviewed and updated to reflect any changes, ensuring care delivery remained effective and aligned with best practice. This approach promoted safe, consistent and high-quality care for people with complex needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The provider ensured care and treatment was delivered in line with current evidence-based guidance and best practice. The interim manager, who had a strong clinical background, had implemented a range of nationally recognised assessment and monitoring tools to support the effective identification and mitigation of emerging risks associated with people’s needs and presentations. For example, tools such as MUST (Malnutrition Universal Screening Tool) were used to monitor nutritional risk, Waterlow or similar assessments to reduce the risk of pressure damage, and recognised falls risk and dependency assessments to inform safe care planning. These tools were used consistently and were embedded into practice, enabling staff to identify early signs of deterioration and respond promptly.

Where risks were identified, appropriate referrals were made to external professionals, including GPs, dietitians and community nursing teams. Care plans reflected evidence-based interventions were regularly reviewed to ensure they remained current and effective. This structured and proactive approach supported improved outcomes for people and demonstrated a clear commitment to delivering evidence-based care.

People received good, evidence-based care and treatment in relation to their nutrition and hydration needs. Staff supported people with complex dietary requirements and swallowing difficulties through well-developed, comprehensive care plans that clearly reflected their individual needs. These plans were aligned with IDDSI (International Dysphagia Diet Standardisation Initiative) guidance, ensuring consistency and safety in the preparation and delivery of food and drink. The provider had also developed person-centred placemats which gave clear, accessible prompts for staff, highlighting key information about people’s preferences, support needs and risks. This supported staff to deliver safe, personalised care and promoted positive outcomes. Staff demonstrated a good understanding of these approaches and used the information effectively in practice to reduce risks and enhance people’s mealtime experiences.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff across the service worked together effectively to deliver coordinated care. The provider had well-established systems in place to ensure information was shared in a timely and consistent way. This included daily ‘flash’ meetings attended by leads from each service area, such as kitchen, domestic, laundry, senior care staff and management. These meetings enabled swift communication of key updates, risks and priorities, ensuring all departments were aligned and able to respond to people’s needs. Staff described a positive, team-focused approach and told us there was a clear understanding of each other’s roles, which supported seamless working across the service.

Health and social care professionals we spoke with were positive about communication and collaboration, noting there had been clear improvements in joint working, responsiveness and information sharing. They told us staff engaged proactively, acted on professional advice and worked in partnership to achieve positive outcomes for people. This demonstrated a strong, cohesive approach to multidisciplinary working and continuous improvement.

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.

The provider did not consistently support people to live healthier lives and improvements were required in this area. While people’s basic health needs were met, there were limited opportunities for individuals to engage in meaningful activities, hobbies or pursue personal aspirations that promoted their overall wellbeing. Care records did not always clearly reflect people’s interests or how these were supported in daily practice.

Some people experienced limited stimulation, and activities were not always tailored to individual preferences, abilities or goals. This meant opportunities to enhance physical health, emotional wellbeing and social engagement were sometimes missed. Staff spoke about the importance of person-centred care; however, this was not always fully embedded in practice. The provider recognised this as an area for development, and further work was required to ensure people were consistently supported to lead active, fulfilling lives aligned with their interests and choices.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

There were noted improvements in people’s health outcomes; for example, one person was supported to transition from a PEG (enteral feeding tube directly into the stomach) to a RIG (Radiologically Inserted Gastrostomy), which reduced the risk of infection, improved comfort and enabled them to remain living safely in their home. However, the provider did not consistently demonstrate effective or embedded systems to monitor, develop and sustain improvements in relation to wellbeing and quality of life, and this required further development.

People did not consistently have clearly defined, person-centred progression plans or individualised goals in place to support their development, independence or wellbeing. This meant opportunities to promote personal growth, enhance quality of life and support meaningful engagement were not always fully explored or realised. Opportunities to identify trends, review progress against individual goals and proactively enhance people’s lived experiences were not maximised. As a result, a more systematic and outcome-focused approach was needed to ensure improvements were sustained, clearly evidenced and consistently built upon.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The provider demonstrated a strong commitment to ensuring people’s rights were upheld in relation to consent to care and treatment. Staff had a clear understanding of the principles of the Mental Capacity Act 2005 and were able to describe how they supported people to make their own decisions wherever possible. Capacity assessments were completed appropriately and were decision-specific, with best interest decisions made in line with legislation when people lacked capacity. We observed staff gaining consent before they moved people and offering choice throughout the mealtime experience.

Care records reflected that people were consulted and involved in decisions about their care, and their preferences were respected. Where restrictions were in place, these were lawfully authorised and regularly reviewed. Staff sought consent before providing care and supported people in a respectful and empowering way.