Kenilworth Grange Care 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 the rating has remained good.

This service scored 68 (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 treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Whilst we saw some positive interactions between staff and people, there were many missed opportunities to create connections and engagement with people, and some people told us they were not always spoken to during the delivery of care. One person said, “Most of the time they have the time to speak to me.” Another person said, “Some of them haven’t got social graces, they never tell me what their name is.” A relative told us, “[Name] thinks they don’t like her because she’s not the same as them. Maybe there’s a language barrier too. I don’t know the reason they don’t interact with her.”

We observed 1 person who had experienced distressed behaviours. The care plan to mitigate the person’s distress was very detailed and gave staff clear advice on how to support the person in the moment. However, there was limited information about ways to engage and occupy the person during their day to day life to possibly prevent the behaviours from occurring.

One staff member explained how they worked to meet people’s individual needs. They told us, “It is all about providing specific care, according to people’s specific needs and how they want to be taken care of. It cannot be an umbrella approach; it should be specific to the person because everyone is different." However, we saw occasions when staff were unable to provide person-centred care. For example, 1 staff member was assisting a person to eat their lunch. This became more task focused because they were having to provide physical and emotional support to 2 other people sitting at the table.

Other people and their relatives were more positive about their care and told us about individuals across teams who had worked in partnership with people to create positive outcomes.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The provider considered local healthcare needs as part of their governance. For example, the service had increased its provision of ‘discharge to assess’ beds to support speedy discharges from hospital during winter pressures. One healthcare professional, involved in the scheme told us, “Kenilworth Grange has consistently demonstrated flexibility and responsiveness, particularly during periods of increased pressure within the acute hospital. When the Trust has escalated to higher operational levels due to increased admissions, the home has supported the service by flexing bed capacity where possible to help facilitate safe and timely discharges.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communication needs were assessed. Where people had complex needs, care plans informed staff how to communicate through facial expressions, touch and other sensory input. We saw staff positioned themselves on the same level as people when speaking to them.

Due to their health condition, 1 person had reverted to speaking in their first language which was not English. Their care plan detailed the best ways for staff to communicate with the person and listed those staff who could speak in their language. The registered manager ensured one of those staff were present each day.

We observed that some information in the home, such as minutes of meetings and written text, would benefit from being available in formats that were more accessible to people. The provider’s representative gave us assurances this was something they were working towards.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

We found complaints made to the provider or the registered manager, were investigated and responded to according to the provider’s policy. However, we were told of circumstances where relatives had raised concerns, and these had not been consistently recorded or responded to. This meant themes and trends around concerns were not always monitored and lessons could not always be learnt to improve outcomes for people.

Residents and their relatives had opportunities to meet with the registered manager monthly in ‘residents’ meetings’ which were chaired by a representative from outside of the provider. Minutes from these meetings did not always demonstrate how people had been listened to or how they had been given opportunity to influence future plans and developments in the home.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Staff monitored people's health and made sure people accessed other services in cases of emergency or when their physical or mental health changed. The provider used an observational tool to assess pain in people with advanced dementia or those unable to verbalise their needs.

The registered manager and deputy manager provided out of hours cover to ensure staff always had access to support. The provider had systems to give advice and support to the managers if needed.

Lift access was available to the lower and upper floors of the building, and all areas of the home were accessible to people in wheelchairs. When people needed to attend medical appointments out of the home, specialist transport was arranged to meet their mobility needs.

The maintenance person had made adaptations to areas of the garden to enable people to grow plants and vegetables.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider promoted Namaste Care at Kenilworth Grange. This is a specialised, person-centred programme for people with advanced dementia or end-of-life needs, focusing on sensory stimulation and touch. It aims to provide comfort and reduce agitation. One member of staff explained how this approach had a positive impact on people and had, in some cases, reduced the need for anti-psychotic medication. Another staff member told us, “Namaste is different with every single person. If I am doing it with someone who does not normally talk or react, during Namaste, because there is that sense of touch and closeness, people will open up, that is the deepest level of connection.”

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

We saw people’s choices about their future care needs had been discussed and planned for with their involvement. Care records provided detailed information about what was important to people and included details about religious, spiritual and holistic needs as well as their preferred clinical and medical interventions.

Kenilworth Grange was accredited under the Gold Standards Framework (GSF) which is a national framework of tools and tasks that aims to deliver a ‘gold standard of care’ for all people nearing the end of their lives.

Healthcare professionals told us how staff ensured people had access to medication in a timely way to ensure they were comfortable at the end of their life.

During our inspection, we observed how staff, after the death of 1 person, acted in a way that reflected the person’s spiritual preferences. The registered manager supported staff at various times throughout the day.