Kineton Manor Nursing Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff and the provider described recent challenges due to management changes in the home and issues around the provider’s overseas sponsorship licence for employees. Whilst these issues had been resolved, and a new registered manager had been appointed; the provider recognised the impact on staff morale. The provider had been open and transparent with everyone during this period and staff, people, relatives and visiting health and social care professionals described a return to the high standards previously demonstrated at Kineton Manor Nursing Home. A visiting healthcare professional commented, “It has gone back to the top in terms of morale, quality of service and opportunities to deliver great care."

The provider’s vision was to provide a ‘family home with a little bit extra.” This was reflected by staff who consistently used the words ‘homely, family and teamwork’ when describing why they enjoyed working at Kineton Manor Nursing Home. Comments included: "It is a very happy, family environment. The staff, the residents and the management are really welcoming”, "It is just very homely, and everyone gets on. It is nice coming to work because we all help each other" and "It is such a nice family orientated place. I have never worked in a place like this where everyone pulls together and works as a team. If something needs doing, everyone will get on and do it."

People and relatives were positive about the culture of the home. One relative told us, “I like the family atmosphere here, all the staff are happy and smiling. If the staff are happy the residents are happy too.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The provider had appointed a new manager at Kineton Manor Nursing Home whose registration with CQC was completed during our inspection visit. The new registered manager had previously been the registered manager at Kineton Manor Nursing Home and knew the service very well. They had already identified and prioritised improvements that needed to be made and demonstrated a commitment to improving standards within the home.

Staff spoke extremely positively about the new registered manager and the senior management team. One staff member told us, “I am glad we have [registered manager] because she cares about everyone and the staff. If you have got happy staff, it does make a difference.” Other comments included: “I think [registered manager] really does care about the residents, she goes round and speaks to them, and she does get involved" and “If I need to talk to [registered and deputy manager] I could. I think they genuinely have the needs of the residents at their heart and if you have got that at the top, that is good."

People, relatives and external healthcare professionals also demonstrated confidence in the provider and the registered manager. One relative told us, “The new manager has evident empathy with her staff, relatives and residents; she is noticeably very supportive of staff.” A healthcare professional commented, “[Registered manager] is great, and she is incredible in relation to her clinical knowledge.”

The registered manager understood their obligation under the duty of candour to be open and transparent with people and their relatives when things had gone wrong or accidents occurred. They told us, “We have a very open relationship with the families, and we always inform them about anything, any falls or any incidents. It gives them the confidence we are open and not hiding anything.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff felt confident to raise any concerns and whistle blow if it meant they protected the people living at Kineton Manor Nursing Home. Where staff had shared concerns, these had been acted upon or acknowledged by the registered manager who had given assurance they would address the issues raised. One staff member told us, “I have felt able to raise concerns with [registered manager] and although she wasn’t able to action everything, she did acknowledge it.” Another staff member explained, “If you have got a problem you can go to your manager, and it is resolved in minutes. You never feel like you are asking a silly question." Staff told us the provider’s representatives were visible in the home, and they could freely approach them if they needed to.

The provider had processes to support staff to speak up. This included supervision meetings, handovers, staff meetings and a whistleblowing policy. We saw examples where concerns had been shared, and actions were taken to improve practice and people’s experiences.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

There was a diverse staff team at Kineton Manor Nursing Home who told us they had not witnessed any inequalities or discrimination. Comments included: “We have got lots of different cultures, but everyone is treated the same" and “Whether you work in the laundry, a cleaner or the highest nurse, everybody is respected and it is a level playing field."

The registered manager celebrated the diversity of the staff team and promoted integration through careful management of staff rotas. Staff were given flexibility in working patterns to meet any cultural needs, health issues or caring responsibilities outside the home.

The provider had clear responsibilities, roles and systems of accountability. However, the provider’s oversight of the service needed to improve to ensure any failures to meet their own policies and procedures were promptly identified to ensure standards were maintained.

The new registered manager had identified some audits and checks had not been consistently completed in line with the provider’s expectations. This included in relation to care plan reviews, analysis of accidents and incidents and clinical oversight. Immediate action had been taken to address these deficiencies, and we saw positive outcomes from the newly implemented checks and audits. The management team demonstrated a commitment to ensure the improvements made were sustained to ensure people consistently received good care and achieved good outcomes. However, checks of daily records needed to be more robust to ensure they were completed accurately and consistently to evidence people’s risk management plans were followed.

The provider acknowledged their oversight was an area for improvement and were recruiting an external consultant to complete quarterly quality audits. The impact of the external audits was yet to be assessed.

Monthly governance meetings with managers and clinical staff were used to monitor the standards of clinical care, quality and safety and ensured action had been taken to address any shortfalls identified.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Relatives described some challenges in partnership working over recent months. However, they felt these challenges had been addressed by the appointment of the new registered manager who wanted to work with them to achieve good outcomes. The registered manager told us that rebuilding trusting relationships had been a priority and commented, “The first month I stayed down in the nurse’s office by reception so I could greet any family coming in and introduce myself. They appreciated there was an effort by me in trying to build a relationship with them." This was reflected by a relative who told us, “The new manager rang me the first day she was appointed to introduce herself. She has made an effort to get to know everybody, she is brilliant."

The provider had maintained close links with the local community to benefit people's lives. On the first day of our inspection children from a local school entertained people by going round the home and singing. Some people enjoyed attending community events such as coffee mornings and church services. One relative told us the home was, “Respected and an integral institution in Kineton’s daily life.”

The manager had recognised that staff would benefit from more practical face to face training and was working with other organisations to arrange this. An external healthcare professional told us that by working in partnership with managers and staff, they could ensure people’s clinical and health needs were met.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider offered training opportunities and work experience for nurses, university and school age students. This encouraged learning within the home and provided real life experience for students to learn more about a career in social care. Staff were encouraged to develop a career pathway in care through funding to complete apprenticeships and training for further qualifications. Some staff had taken on ‘champion’ roles in areas such as dignity, end of life care and infection control to share and embed good practice in those areas. The registered manager planned to expand the ‘champion’ roles to promote best practice in other areas of care provision.

The registered manager recognised the importance of participating in research to benefit people living at Kineton Manor Nursing Home and improve the provision of social care in the wider community. They had joined a care home research advisory group, were participating in a project reviewing nutritional care in older people and had applied for a scheme leading towards a recognised accreditation in dementia care.

The provider demonstrated a commitment to learning and improving but acknowledged their oversight had not always been effective in assessing performance and ensuring continuous development. They assured us lessons had been learnt and action taken to evidence their effective monitoring of the service to ensure improvements were sustained and embedded in the practice of the home. A healthcare professional told us, “The provider is genuinely keen to provide high standards.”