Kingdom House

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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 support was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s assessments considered their health, care, wellbeing, and communication needs, to enable them to receive care and support that had the best possible outcomes. Staff understand people’s current needs. People’s views and opinions were captured, respected, listened to and implemented as part of their day-to-day support.

People’s care plans and risk assessments were detailed and included individual outcomes. People’s past history and exposure to trauma was considered in their care planning.

We asked people’s close relatives if they had the opportunity to be involved in planning their family members’ care and support, and in their reviews. One relative told us they had recently received a copy of their family member’s care plan for the first time, so they could be more involved in their reviews. Another relative said, “I am happy for Kingdom House to manage my loved one’s care plans. I am always kept informed of any changes and I can voice my views and opinions on the changes.”

The team planned and delivered people’s care and treatment with them, including what was important and mattered to them. People received care and support that was evidence-based and in line with good practice guidance.

People’s needs were assessed using a range of assessment tools to make sure their needs were reflected and understood. People’s communication needs were assessed and met to maximise the effectiveness of their care and support. We saw some people were supported to make their own drinks and access snacks, promoting their independence.

People’s nutrition and hydration needs were met in line with current guidance. Where health professionals were involved with people’s care and support, their advice was included in people’s care plans.

Where people were living a long way away from family or the area they grew up in, the team facilitated visits to support important relationships.

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.

We asked relatives if they felt the staff team were well trained and knew how best to support their family members. One relative said, “I feel the staff team are very well trained. They know [family member’s] likes and dislikes and support them to make as many daily choices as possible. They are very quick to adapt to any changes to [family member’s] needs.”

Overall, staff had access to the information they needed to appropriately assess, plan and deliver people’s care and support. Plans for transition, referral and discharge considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. Information was shared between teams and services to help make sure there was continuity of care. When people received care from a range of different staff, teams or services relevant staff, teams and services were involved in assessing, planning and delivering people's care and support and staff worked collaboratively to understand and meet people's needs.

We asked people’s relatives if they were involved in planning their family members’ care and support, and their reviews. One relative told us they had recently received a copy of their family member’s care plan, so they could be more involved in their review. Another relative said “I am happy for Kingdom House to manage my loved one’s care plans. I am always kept informed of any changes and I can voice my views and opinions on the changes.”

We spoke with 1 person who was very clear about what they liked and did not like to do and who self-limited their own activities and stimulation. Members of the management team told us of the ways they were supporting the person to encourage them to engage in different activities.

The person’s advocate told us the person appeared fine and wanted to continue to live at Kingdom House. However, they expressed concern that the person engaged in very limited activities, both at home and in their local community. The person’s advocate had discussed with them, setting up a resident’s council, to decide what they wanted to do for events such as Halloween and Christmas.

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 health needs were clearly recorded, and evidence showed people had attended appointments with a range of health professionals, whose input was referenced in people’s care documentation.

People were supported to make healthy choices to help promote and maintain their health and wellbeing. The service identified risks to people’s health and wellbeing early and on how to support people to prevent deterioration.

People were involved in regularly monitoring their health, including health assessments and checks with health and care professionals. Changes in people’s presentation, emotional state or distress, which might show a deterioration in their health or wellbeing, were recognised. Reasonable adjustments were identified, planned for and communicated so people could attend planned and unplanned appointments. People were supported to access emergency health care when needed, and information about them was made available to help make sure people’s disability would not prevent them from accessing prompt care and support.

The provider had systems to monitor people’s care and support to continuously improve it. However, this was sometimes made difficult due to a lack of detail, and occasional gaps in people’s day to day records.

The social workers and advocate we spoke with told us they had raised concerns with the management team about a lack of detail in people’s day to day records. It was clear that the home’s management team were aware of these shortfalls and were taking action to address them.

We reviewed 1 person’s day to day records in detail and saw there had been improvement made recently; in the way staff recorded their care and support. However, there remained a need for further improvement to provide a more comprehensive picture of people’s day to day lives and wellbeing. This would better enable managers and partner professionals to monitor the support provided, and the choices and activities offered to people.

People’s skills, life experience and strengths were discussed with them and those involved in their care, to understand how people’s short, mid and long term life choices, goals, ambitions and outcomes could be planned for and achieved.

Staff interactions with people were consistently respectful and caring, and people appeared happy and relaxed. People were observed taking part in activities they enjoyed, although there was limited opportunity available during the early part of the morning.

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

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.

People’s communication needs were assessed and met. This helped to maximise the effectiveness of their care and support. Staff communicated well with people about their choices. People’s records included how they were able to give consent or refuse in relation to specific decisions, either through verbal or non-verbal means.

Staff showed a good understanding of the principles of consent and the MCA. They explained to people and sought their consent prior to providing care and support.

Mental capacity assessments, best interest decisions and DoLS authorisations were appropriately recorded in people’s care plans. People’s care plans reflected their preferences and choices. Where people lacked capacity to make certain decisions, the provider recognised this, and appropriate best interest decisions were made in line with the MCA, involving people’s close family members and representatives, where needed.