Kingly Terrace

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 remained Good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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

People and their relatives told us they were involved in planning and reviewing care. This helped ensure support was tailored to each person.People’s needs were assessed before they moved into the home. Pre-admission assessments were completed to confirm the service could meet their needs and to gather information for care planning. Assessments included people's physical health, mental health, mobility, nutrition, skin integrity and risks associated with their individual needs.The provider told us they would consider whether the environment and staffing arrangements could safely meet people's assessed needs before admission.

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.

The provider used recognised assessment tools to review people’s needs, including the Malnutrition Universal Screening Tool (MUST) and the Waterlow tool for assessing the risk of pressure ulcers. These were completed as part of people’s care assessments.

Care plans were tailored to people's individual assessed needs and reflected their current health conditions and identified risks. Risk assessments were regularly reviewed and updated to ensure they remained relevant and supported the delivery of safe care. Where healthcare professionals made recommendations, these were clearly documented within care plans and implemented by staff.

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.

The provider worked collaboratively with a range of healthcare professionals, including GPs, district nurses, and phlebotomists, to help ensure people receive coordinated and joined-up care.Staff told us that handovers took place at every shift change, providing an opportunity to share important updates about people's wellbeing and any changes in their support needs.A relative told us, “I do not know the difference between the agency training and the regular staff training. They seem like a good team.”

Staff also described communication within the home as effective, with information shared promptly between team members and, where appropriate, with external professionals. They spoke positively about the support they received from colleagues and managers and described a positive team culture.

The provider generally supported people to manage their health and wellbeing. However, staff did not always support people to live healthier lives by providing meaningful opportunities for activity, occupation and community involvement.

People did not always have enough opportunities to take part in meaningful activities or engage in purposeful occupation. People told us they would like more opportunities to take part in activities, particularly outings and activities in the local community. Although activities were available, people's experiences showed they did not always have meaningful opportunities for community involvement. This had also been identified during a previous local authority quality monitoring visit. The provider acknowledged this and told us they would review the activities programme to provide more meaningful opportunities for people.

People were supported to access healthcare services when needed. Staff worked well with healthcare professionals to ensure people attended appointments and received the support they needed to maintain their health and wellbeing.

People enjoyed their meals and were supported to eat and drink safely while maintaining their independence. The provider met people's nutritional and hydration needs, including providing modified diets where required. One person told us, "The food is amazing. It's freshly cooked here."

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's health and wellbeing were monitored regularly. Staff understood people's needs, identified changes in their condition, and recorded these appropriately. Vital signs and weight were monitored in line with people's assessed needs, and any concerns were acted upon promptly, including referrals to relevant healthcare professionals where required.

The provider monitored people's outcomes and responded appropriately when their needs changed. For example, where people had experienced falls, referrals were made to the falls team, and additional measures, such as sensor mats, were introduced to reduce the risk of further falls.

Records demonstrated that people's outcomes were reviewed regularly, and care and risk management plans were updated to reflect changes in their needs. This helped to ensure people continued to receive safe, effective, and person-centred care.

We found some gaps in fluid intake records. However, staff continued to monitor people's health and wellbeing, and we found no evidence that this had affected people's care or outcomes. This has been considered under the Governance quality statement.

The provider generally supported people to make decisions about their care and treatment and respected their rights. However, they did not always ensure Mental Capacity Act documentation was complete and up to date.

People told us staff always asked for consent before providing care. People and relatives told us staff are very kind and respectful. Staff had received training on the Mental Capacity Act (MCA) and understood the importance of gaining consent.During the assessment, we observed staff seeking consent before providing care. Staff took time to explain what they were doing and respected people's responses before continuing with care.

We saw good examples of MCA assessments for some people; however, there was no evidence of best interest meeting discussions or records within the MCA documentation we reviewed during the assessment. Deprivation of Liberty Safeguards (DoLS) applications were being made and tracked appropriately. We also found that some decisions, such as information sharing, photography and the use of locked doors, did not always have a recorded capacity assessment. We did not observe any inappropriate restrictions or evidence that people had been adversely affected. However, the provider could not demonstrate that these decisions had been supported by appropriate Mental Capacity Act documentation. We raised this with the provider, who confirmed action would be taken to address the gaps.