King Street - Care Home Physical Disabilities

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

This means we looked for evidence that the provider met people’s needs. At our last rated inspection, we rated this key question Requires improvement. At this inspection the rating has remained Requires improvement. This meant people’s needs were not always met.

This service scored 50 (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 always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People generally experienced caring and respectful interactions, and during our visit we observed staff supporting individuals in a person‑centred and meaningful way. However, this was not always consistent. Although care plans were in place, they were not always fully reflected in day‑to‑day practice, and staff did not always demonstrate the flexibility needed to respond to people’s individual preferences, routines and choices. On some occasions, care was delivered in a task‑focused manner, which reduced opportunities for people to direct how and when they received support. Strengthening the link between care planning and practice would help ensure person‑centred approaches are embedded consistently across the service.

The introduction of new staff, alongside ongoing training and deployment challenges, meant people’s choices about how they spent their time were not always fully maximised. At times, this affected people’s ability to participate in meaningful activities or access their local community in line with their preferences. This limited opportunities for people to maintain independence and pursue personal interests.

The service had not yet achieved a consistently personalised approach to care delivery. Further improvements were needed to ensure the principles of Right Support, Right Care, Right Culturewere fully embedded, so people have maximum choice, control and involvement in their daily lives, and are supported to live in a way that reflects their wishes, aspirations and potential.

The provider did not always understand the diverse health and care needs of people and their local communities, to ensure care was joined-up, flexible and supported choice and continuity.

Care provision was generally organised to support continuity; however, this was not always consistently achieved. Systems were in place to support information sharing across the service, and staff demonstrated an understanding of the importance of maintaining consistent care. However, these systems were not always fully effective in practice, particularly during shift handovers or busier periods, which occasionally led to variations in how care was delivered.

Some records required updating to ensure they accurately reflected people’s current needs and preferences, so staff could provide fully aligned support. The integration of new staff into the team also presented some short-term challenges, as they developed their knowledge and confidence in understanding people’s individual routines. Despite this, staff were committed to working together to meet people’s needs, and there was a clear recognition from the management team of where improvements were required. This demonstrated a service that was taking steps to strengthen coordination and continuity to achieve more consistent, joined-up care experiences for people.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information was not always provided to people in a way that met their individual needs and supported their understanding. Whilst some information was available, it was not consistently tailored to people’s preferred communication styles, such as accessible formats, visual aids or simplified language. This meant some people were not fully supported to understand important aspects of their care, daily routines or the choices available to them, limiting their ability to make informed decisions and exercise control.

In addition, some staff lacked the training and confidence to effectively use Makaton, a form of sign language that uses signs and symbols alongside speech to support communication, which some people relied upon to express their needs and preferences. Inconsistent use of this communication method meant people could not always convey their views or receive information in a way they understood. Approaches to sharing information varied across the staff team, and systems to support consistent, inclusive communication were not fully embedded. The provider recognised the importance of accessible information; however, improvements were required to ensure all staff had the necessary skills and confidence, and that people were consistently supported to receive clear, personalised and meaningful information.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

People were not always fully supported to be listened to and involved in decisions about their care. The provider had systems in place to manage complaints and compliments in line with their policy, and records demonstrated these were logged, responded to, and actions were taken where necessary. People and their representatives told us the management team had improved their communication when concerns were raised, which had led to more timely responses in some cases.

However, this was not consistent, and further improvement was needed. Some people continued to feel their feedback was not always acted upon effectively. One person told us, “Yes, I’m aware how to make a complaint or raise a concern but when I do it’s not always addressed. I need to know who to escalate them to.”

The provider recognised the importance of engaging people but needed to strengthen their systems and processes to ensure everyone had regular and meaningful opportunities to share feedback, contribute to decisions, and help shape the service and their care.

The provider did not always ensure that people could access the care, support and treatment they needed when they needed it.

The provider did not always ensure equitable access to services, and this required improvement. While people received care and support within the home in an accessible way, challenges arose when individuals needed to attend external health appointments. There was not always sufficient access to appropriate transport or available staff to support people to travel safely, despite the service having transport available onsite.

This meant alternative arrangements had to be made, which could result in delays or the need to rearrange appointments, potentially impacting people’s timely access to healthcare. Although staff demonstrated an understanding of the importance of attending appointments, systems were not consistently effective in ensuring people could access external services without disruption. Further improvements were needed to ensure access to healthcare was consistently equitable and responsive to people’s needs.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People did not always experience equitable care and outcomes. Whilst staff were kind and committed, those who relied on staff to interpret or advocate for their needs were not consistently supported in a way that ensured their views were fully understood, represented and acted upon. This placed them at a disadvantage compared to people who were able to communicate their wishes more independently. In addition, there were limited opportunities for some people to access the community and engage in meaningful activities outside the home, largely due to staffing constraints and the availability of suitable support, such as staff who can drive the provider’s transport. One person told us, “I have 1:1 support on a Monday, but I can’t go out as my 1:1 doesn’t drive.”

This further contributed to inequalities in people’s experiences and reduced opportunities to achieve positive outcomes, develop independence and maintain social connections. Although some systems were in place to support inclusive communication and engagement, these were not applied consistently, and staff confidence varied. The provider recognised these challenges; however, further improvements were required to ensure all people had equal access to opportunities, were enabled to express their preferences effectively, and experience consistently fair and person-centred outcomes.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Planning for people’s future was not always sufficiently developed to support meaningful progression and positive long-term outcomes. People did not consistently have clear progression plans in place to outline how they would be supported to develop skills, increase independence or achieve their personal goals. This meant opportunities for growth were not always identified, monitored or actively promoted, which limited people’s ability to move forward in line with their aspirations and potential. Where plans were in place, these were not always detailed or regularly reviewed to ensure they remained relevant and outcome focused.

Where appropriate, people had been supported to consider and record their wishes and preferences for end-of-life care, which demonstrated some recognition of the importance of future planning. Despite this, the overall approach to planning for the future was not holistic or consistently embedded in practice. Improvements were required to ensure all people had clear, person-centred plans that promoted development, independence and meaningful outcomes, enabling them to plan confidently for all stages of their lives.