KYN Bickley

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. This was the first assessment since the service was registered with CQC. This key question has been rated good.

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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The quality of information in the care plans and risk assessment needed to improve. Overall documents contained lots of information, some of which was well written and described people’s vulnerabilities and risks in a respectful and dignified way. However, there was so much information, the levels of support and supervision, and reasons for these, was unclear. Some information was repeated several times, leading to a lot of incorrect statements throughout the file. Contradictions in information were noted from document to document, section to section and even within the same document. This made the documents difficult to follow and it was unclear which piece of information was correct, which could lead to unsafe and/or incorrect care being delivered.

A manager was able to clarify some of the information as incorrectly recorded but also had to seek clarification from other staff to determine the correct information. Some amendments were made on the day, and missing documents were obtained. However, the manager said other information and systems would be reviewed and corrected/implemented as soon as possible.

People talked about how welcome they were to come and join in with any of the activities and how families and children were all welcomed.

A family member said “My [Relative] does like to do the exercise classes and the flower arranging, she’s quite keen to look smart and presentable, she likes the hair and to get a manicure. They have a good program of music; Mum likes the harp that comes in and a guitarist and singer.”

The provider assessed and reviewed people’s health, care, wellbeing and communication needs as part of care planning. Care plans were personalised and reflected people’s choices, such as preferred meals, routines, and communication styles. Staff knew people well and were able to describe their individual needs. One person said, “They discuss my needs and care with me.”

Relatives told us that the assessment and reviewing processes were consistent. Relatives told us that they were involved in reviews. “

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.

People were provided with meals to meet their nutritional needs and where people required special diet such as, soft, fortified food and low sugar diet it was provided. People were offered snacks, drinks and fruits throughout the day. The staff have dementia training and knowledge, about best practice and their guidance in this area.

A range of assessment tools were used, to understand people’s needs and how best to support them. For example, the malnutrition universal screening tool (MUST) was used for the management of weight loss and nutritional intake assess needs. Staff followed advice from professionals such as Speech and Language Teams (SALT) and dietitians, and care plans included recommendations for positioning during meals and supervision needs. They routinely tracked people’s weight and documented their dietary and fluid consumption.

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 worked well together and with external professionals to meet people’s needs. There was evidence of collaboration with GPs, nurse practitioners, and other health services. People told us the staff made referrals to health practitioners when needed, and staff supported them to attend appointments. Care records were detailed and ensured continuity of care. Staff described good teamwork and said they felt supported by colleagues and management.

The provider had access to an on-site physiotherapist and occupational therapist for people to access and there was regular communication between the teams.

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.

Dietary needs and preferences were documented, and staff encouraged people to eat and drink regularly. One person said, “I get enough to eat and am offered more if I want it.” Life enrichment activities were varied and included community outings, yoga, flower ranging music and therapy dogs. Staff monitored health conditions and responded to changes, although some care records needed more consistent documentation about oral health and pressure care. The provider had already identified this themselves and were making the required improvements.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People received support from a variety of staff including therapists.. People’s outcomes were achieved through collaboration between professional and clinical staff. A staff member told us, “People have different needs; we observe, monitor people so we can identify any changes and stay on top giving them the best care.”

Records were kept of care provided so that it was possible to monitor the care had been provided in line with assessed needs and clinical care .

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

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, the quality of detail in mental capacity assessments and best interest decisions was inconsistent and included contradictory information .Records showed that some relatives were making decisions about consent without legal authority or Best Interest decisions being made. We discussed this with the registered manager who agreed to take action to address this.