Kite Hill 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 good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to the need for consent.

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

People’s needs were assessed before they moved into the service and reviewed regularly. However, some assessments and care plans lacked sufficient detail to fully inform staff about people’s individual needs.

For example, safety risks in relation to diabetes were not comprehensively assessed and care plans lacked important information about the condition. Guidance did not contain sufficient information in recognising signs of hypoglycaemia or hyperglycaemia or seeking timely medical support. The provider’s training matrix demonstrated that out of 25 care staff, 24 had not received diabetes training.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Nationally recognised tools to assess people’s risks and support needs were used. However, these were not always used correctly to accurately identify the level of risk for each person. For example, a tool designed to identify a person’s risk level of developing pressure ulcers contained information that contradicted the person’s care records. This meant information to guide staff on people’s assessed risk levels was inconsistent, which placed the person’s skin at risk of further deterioration.

The provider worked with healthcare professionals to support people’s health needs.

During our inspection we saw district nurses visiting the service. An external health professional told us they visited the service weekly to review people’s healthcare needs.

People and their relatives told us they had access to healthcare professionals when they needed them.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People's dietary requirements and professional recommendations were followed in practice, although these were not always clearly documented in their risk management plans.

People and relatives made positive comments about the food. Comments included, “The food is very good, but I get too much of it, there is always a choice and if you don’t fancy what’s on offer you can always ask for something else, they are very good,” “The food is lovely, they give me plenty of choice” and “I definitely get enough to eat.”

Relatives told us people enjoyed their meals, had choices, and were supported with drinks. Some gave examples of smaller meals being provided when large meals felt daunting, diabetic diet being considered, and pureed food being presented separately so the person could taste individual flavours.

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 and consistent, or that they met both clinical expectations and the expectations of people themselves.

The provider told us they used nationally recognised tools called RESTORE2 and NEWS2 scoring which are assessment tools to detect early signs of deterioration in people. However, records showed that these tools were not consistently followed when people became unwell. This meant staff did not always identify and respond appropriately to signs of deterioration. Furthermore, the provider did not provide evidence that staff had received training in using RESTORE2 or had been assessed as competent to undertake clinical observations.

We found some monitoring records to support people's everyday needs were not always consistently completed. For example, some people required support to reposition to maintain or improve their skin health, however, records showed that support was not always provided in line with their assessed needs. Risk management plans were also absent or insufficient where people were at risk of constipation. For example, a person had a history of serious complications and required prescribed treatment, however, there was no guidance in place to support monitoring and escalation.

Some relatives spoke positively about the level of care provided, however, some felt care was not always delivered consistently. Comments included, “[Person] needs to be assisted more with drinking. Sometimes their mid-morning drink is left as [they are] asleep,” and “I'd like [person’s] care to be less of a lottery and more consistent in terms of toileting, preventing sores and making sure [they] have their drinks.”

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

The provider failed to ensure the correct procedure was followed in relation to the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for supporting people who may lack the ability to make certain decisions for themselves.

The provider did not always assess people’s mental capacity to make specific decisions in line with the MCA. This included decisions such as modification to diets, having photographs taken, living in a care home and the use of restrictive or intrusive measures, such as bedrails, sensor mats and regular checks throughout the night.

Practice in relation to best interest decisions did not meet MCA requirements. The provider failed to show they had considered least restrictive practices when they were making best interest decisions in relation to restrictions on people. Therefore, the decisions made may not have been proportionate and the least restrictive option which could impact on people’s freedom.

A person with full capacity had bedrails in place; however, they told us they did not want them. There was no evidence to demonstrate the provider had gained the person’s consent to bedrails being used.