Kineton Manor Nursing 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 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’s needs were assessed before they moved to Kineton Manor Nursing Home, including their medical history and what physical assistance and well-being support they needed. Assessments were robust and generally completed face to face to ensure the service could safely meet people’s needs and expectations.

Assessments were used as a basis to develop personalised care plans that reflected people’s preferences, likes and dislikes. The registered manager explained, “Care plans are a work in progress because when people come in, they may be different from when they were assessed. It is a live document we update as we get to know the resident."

Care plans were reviewed monthly or when there was a change in need to ensure they remained relevant and effective and promoted positive outcomes. One relative told us they had been involved in a review of their family member’s care and commented, “The care plan evolves.”

The provider followed legislation and current evidence-based good practice and standards. However, this was not always reflected in staff knowledge.

The provider used recognised tools to assess and identify risks to providing people’s care and support. This included the International Dysphagia Diet Standardisation Initiative (IDDSI). IDDSI is a standard for describing food textures and drink thicknesses for people with swallowing difficulties. We saw dietician and speech and language therapists’ advice had been obtained and care plans clearly identified how people needed their food prepared or drinks thickened to reduce their risks of choking. However, we found a lack of knowledge and understanding across the staff team on how to deliver nutritional support in line with the IDDSI standards. Supplementary food and fluids chart records and daily records, did not always evidence people had been given their foods modified and fluids thickened as required.

The registered manager had recognised IDDSI standards were an area for development and improvement in the home. A chef experienced in modified diets had been appointed and extra face to face training was planned to improve staff knowledge and confidence in this area. On the second day of our inspection, improved processes and extra checks had been implemented to ensure people received the correct modified diet to mitigate their identified nutritional risks.

People told us there had been several different chefs in recent times that had impacted on the quality and variety of meals available to them. However, people were encouraged by the appointment of the new chef and improvements in food standards. One person told us, “It has improved recently, and I eat everything that I am given now.”

A member of catering staff told us how improvements had very recently been implemented to enhance people’s dining experience. They described improved communication around people’s nutritional risks. Where people were at risk of losing weight, meals and drinks were fortified with extra calories to promote their health.

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, registered manager and staff told us they worked together to achieve positive and good outcomes for people. We saw staff communicating well to support people across all parts of the home. One staff member told us, “There is very transparent communication, especially between the clinical team and the non-clinical team." Another staff member told us the handover between shifts was detailed and gave them the information they needed to provide effective care. A third staff member commented, “We do handovers in the morning and if there are any issues, they bring it up in handover and we will talk it through and sort it out."

A visiting healthcare professional described effective communication channels between them, the manager and the clinical staff to ensure people’s needs were met. They told us, “I know [manager’s] clinical knowledge and prioritisation is great and I have great confidence in her."

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 were supported by staff to maintain their health and wellbeing. For example, care plans described the assistance people needed to maintain their oral health to support their ability to eat and drink well and verbally communicate. Where a need was identified, people were referred to other healthcare professionals for assessment, advice and support. A visiting healthcare professional told us referrals were appropriate and timely.

The registered manager gave examples of how the support people received had helped them maintain independence in their mobility and attend external health care appointments.

The provider monitored people’s care and treatment, but accurate records were not consistently maintained.

We identified some inconsistencies in the records maintained when people needed to be regularly repositioned to maintain their skin integrity. Accurate recording helps determine if the repositioning regime needs to be reviewed to meet the person’s needs. However, the registered manager and clinical staff monitored people’s skin, thereby minimising the risk of deterioration. One relative told us, “[Name] came here with horrendous bed sores, but these people cared for them, and they haven’t got any now."

We also found some daily records did not always accurately reflect risk management strategies were being met. The importance of accurate record keeping to evidence good outcomes for people was being addressed through staff meetings and increased checks by senior staff.

Relatives told us staff were proactive in increasing the monitoring and checks on people when there was a deterioration in health. One relative told us, “If [Name] is wheezy, they instantly check their oxygen and bloods.”

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

Our observations showed staff asked people for their consent in what they wanted to do or where they wanted to go. Staff were gentle in their approach and did not compel people to do things they did not want to do. Staff understood the importance of people being encouraged to make as many day-to-day decisions as possible and respected people’s right to decline support in that moment.

Where it was identified people may not have capacity to make a specific decision, an assessment was completed in accordance with the requirements of the Mental Capacity Act 2005. Where people had fluctuating capacity, staff considered advanced care planning to promote people’s involvement in making decisions about their future care. Staff consulted with others involved in people’s care to ensure any decisions made were in the person’s best interests.