Kynance Residential 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

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment this key question has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 choices. Care was not always delivered in a way that reflected people’s individual choices or routines. Records showed that full personal care, such as bed-based washes, was primarily undertaken overnight and did not demonstrate that this care was offered at alternative times to reflect people’s preferences. This suggested that care was being delivered according to established routines, rather than consistently being planned and delivered around the person’s individual preferences.

We also identified a person who had not had their hair washed for two weeks. We were told this was because they had been asleep at the time this was scheduled, and staff had not returned at another time to provide this support.

The provider understood the health and care needs of people and worked to ensure care was joined up and supported continuity. People and family members told us there was continuity in care staff, and some staff had worked at the home for many years, which supported consistent relationships and a good understanding of people’s needs.

Processes were in place to support continuity of care when people were admitted to the service, including pre-admission assessments undertaken by the registered manager. Information about people’s needs was also available to support continuity of care if people required hospital treatment or input from external services.

External health and social care professionals told us they were contacted appropriately when required, which supported joined up working to meet people’s needs.

The provider supplied appropriate, accurate and up-to-date information in formats which reflected people’s individual needs. Care records included information about people’s communication needs and any equipment required to support this, such as hearing aids or eyeglasses.

The management team told us that people and their family members were provided with written information about the service, including how to raise concerns or make a complaint. This was supported by feedback from people and relatives, who told us they felt well informed and knew how to raise concerns if required.

The management team made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. People and family members told us they felt able to raise issues with staff or the management team.

Staff involved people in decisions about their care and sought their views about aspects of the service. For example, people told us they were asked for their ideas about meals, and that their feedback was acted upon, demonstrating that people’s views were considered in the running of the service.

The provider had a complaints procedure in place and, although there had been few complaints, records showed these were recorded and investigated appropriately.

The provider took steps to support people to access the care, support and treatment they needed. Discussions with the management team showed they understood how to access specialist health or social care support when required. Staff were available to support people to attend hospital appointments where they were unable to do so independently, which helped remove barriers to accessing care.

Staff demonstrated an awareness of people’s individual needs and made reasonable adjustments to support access. For example, where people had communication needs, such as hearing impairment, staff described how they adapted their approach, including writing information down and supporting communication in ways that met the person’s needs.

However, we identified that people did not always receive care in a timely way or in line with their planned support, which meant access to aspects of care was not always consistent. This included delays in care being provided in line with people’s preferences and some aspects of personal care not being delivered as expected.

These findings indicate that, although systems were in place to support equitable access, these were not consistently embedded in practice.

Staff and leaders demonstrated an understanding of equality, diversity and inclusion and aimed to ensure people received equitable care and support. Care staff had undertaken equality and diversity training, which supported their awareness of people’s diverse needs.

Staff adapted their approach to meet individual needs and help reduce barriers to care. For example, where people had communication needs, staff described how they adjusted their approach, supporting communication in ways that met the person’s needs.

Staff, people and family members did not raise concerns about discrimination, which indicated that people were generally treated with respect.

However, we identified that the outcomes people experienced were not always equitable. Some people did not consistently receive care in line with their needs and preferences, including where aspects of personal care were not delivered as expected or care was provided at times that did not reflect individual choice. This had a greater impact on people who were less able to understand, express or consent to their care, meaning their experiences were not always equal to others.

These findings show that, although there was an intention to provide equitable care, this was not consistently achieved in practice.

The provider took steps to plan for people’s future care needs and ensure continuity of support. Processes were in place to support people when their needs changed, including seeking input from external health and social care professionals where required.

People were also supported to plan for important life changes and make informed decisions about their future, including at the end of life. Care plans included information about people’s wishes and preferences, such as advance decisions and Do Not Attempt Resuscitation (DNAR) information where applicable. Staff worked with external professionals, including hospice teams and district nurses, to ensure coordinated end of life care and support.