Kirklands

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to the need for consent. The service did not always ensure people’s consent was gained or recorded where required. The service did not always ensure the principles of the Mental Capacity Act 2005 were followed.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always have effective procedures in place to ensure people's care plans included detailed and consistent information.

Care plans were generally person centred and included information about people’s social histories and preferences. However, some lacked information about people’s care needs and health risks and how staff should manage these. Some care plans included inconsistent information about people’s care needs.

We discussed with the management team the need to ensure information about people’s oral health care is included in their care plans with guidance about their preferences and support needs.

People and relatives had been involved in care planning and reviews.

The service 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.

Staff supported people to have enough to eat and drink to prevent malnutrition or dehydration. Where required, staff recorded people’s food and fluid intake. We observed people were supported according to their needs and were offered plenty of choice around food and drink. One person told us, “The food is very good, plentiful and there is choice.” One professional visiting the service told us, “Staff support people appropriately with their dietary needs and are quick to spot any issues.”

People had adapted cutlery and cups where required to help maintain their independence around eating and drinking.

The service worked well across teams and services to support people.

Staff told us they generally worked well together. One person told us, “My colleagues are flexible, and we work well as a team.” Another staff member told us, “We are like a family. We help each other out.”

Staff shared information about changes in people’s needs through handover meetings.

The staff team worked well with external services. One professional visiting the service told us, “The home wants to work collaboratively with us. The manager even requested a meeting with our district lead to improve how they work with us.” Another professional visiting the service told us, “Staff know what they are doing and come back to me if they don’t know something or can’t find something.”

The service supported people to manage their health and wellbeing to maximise their independence. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

We saw evidence the service sought support from healthcare professionals when they identified people could benefit from this. When people were unwell, records showed that staff facilitated access to the GP or other health partners quickly. One visiting professional told us, “Staff are very proactive and quick to identify concerns and tell us about them.”

We observed various health professionals visiting people over the course of our onsite inspection and records showed staff following up actions or acting on recommendations.

The service did not always routinely monitor people’s care and treatment to continuously improve it.

The care home staff and visiting professionals we spoke to generally expressed people were monitored where required and had good outcomes. However, we found systems in place to monitor people’s care and identify issues were not always effective. For example, where people had issues relating to their skin, this was not always documented in records or on body maps.

Where people required thickener to be added to their drinks, staff did not always record how much thickener was added and when. Where people required their meals to be fortified, staff did not always record how this was done.

The service did not tell people about their rights around consent or respect these when delivering care and treatment.

Closed-Circuit Television (CCTV), which recorded both images and audio, was in operation in the communal areas of the care home. However, the service could not evidence how they had obtained consent from service users about this. Visitors, including professionals from partner agencies, were not routinely informed audio was being recorded in communal areas and there was no information displayed about this. This meant there was a risk people’s privacy was not protected. Following feedback from the inspection team about this, the management team took the decision to suspend use of the CCTV while they reviewed its purpose and put the required processes in place to obtain people’s consent or to ensure best interest procedures were followed, where required.

Where consent was required for other decisions such as restrictions in place to reduce people’s falls risks, consent forms had not always been signed. The principles of the Mental Capacity Act 2005 had not always been followed. For example, it was not always clear why some decisions had been made in people’s best interest and what least restrictive options had been considered.

Where mental capacity assessments had been completed, it was not always clear what information had been given to people to determine whether they had mental capacity or not.