Archived: Kettlewell House Nursing Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.
 

This service scored 40 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.
We observed people were not always treated with kindness and compassion. For example, we observed one person kept shouting, “Hello, hello, talk to me” to staff, yet was ignored and the staff walked away. On another occasion we observed staff acknowledged this person, but they did not stop to engage in any further conversation.
Relatives told us, “The carers now are very patient with [relative] and respect [their] dignity and privacy and always talk to [person]. The [staff] who left, hit [person] around the back of the head.”
We reviewed people’s care records and found 1 person said, “I commit suicide.” The staff “Told [person] that committing suicide is a crime.” The information failed to demonstrate appropriate action was taken without delay to ensure this person was supported and treated with compassion whilst displaying these thoughts. We also found this was not updated in this person’s care plan, meaning a lack of oversight and monitoring of this risk.
 

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.
We asked the leadership team if there were any people within the service with any religious needs. The leadership team confirmed one person. However, we observed throughout our site visit there were multiple people with religious needs, yet the provider was unable to relay this information to inspectors.
One person told us, “I would like to go to church because I did every Sunday. I don’t know if they are all non-Catholics here, but I went to a convent school and was taught by nuns .” We found this person was not supported with their individual need.
Furthermore, staff told us although care plans were accessible on their electronic system, they relied a lot on handover meetings for up-to-date information on a person. This meant not all staff knew about people’s backgrounds, interests and other person-centred information.
 

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.
We received mixed feedback from people. One person told us, “I think they are so busy, but they are very loving.” Another person said, “They take their time but sometimes they do rush but you can’t in this job. My privacy is ok and respected.”
The service had an activity planner in place, and we observed some activities throughout our visit. However, one morning activity appeared to involve a member of staff tapping a balloon around the room for people to tap back. The activity did not seem to be engaging for any of the people. The interim manager confirmed more hours were needed from the activities team to improve this area of care delivery.
We observed one person requested to go to the lounge, however the staff discouraged this due to the person previously not enjoying being in the lounge. This did not demonstrate people were always empowered by staff, and their independence, choice and control were promoted to enhance their autonomy and engage them in meaningful activities.
 

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.
As part of our assessment, we observed mealtimes within the service. We observed 1 staff member did not inform a person what they were about to do and proceeded to remove their pillow, hold their head up and wipe their mouth. The staff member told the person they had soup but did not inform the person what flavour it was. We also observed staff shouted to a person to wake up and then moved a spoon of food in front of their mouth. These observations failed to demonstrate staff always listened to, respected and understood people’s needs and preferences.
Some staff also told us about the impact of their staffing levels when delivering care. One staff said, “When I work at night, we need more staff as it’s too heavy for just the 3 of us.” This meant people’s immediate needs were at risk of being unmet, as the complex and diverse needs of people within the service were greater than staffing levels at nighttime.
 

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them.
We received mixed feedback from staff. Some staff told us they felt supported by management, however other staff told us, “Lots of different managers. It is ridiculous, you have to keep getting to know managers. They keep wanting to change things, so it keeps changing” and “Many agency staff, that is ridiculous, different people. They don’t know how to do things it is really bad. Yes, it is a good staff team, but when agency [used] it is bad.” This did not demonstrate all staff felt supported by the management team and always felt supported to deliver care.
We also reviewed staff meeting minutes where staff expressed concern over the high turnover of management, and the impact of this on care delivery and decision making. Staff told us, “The latest manager; I have hardly seen.”