Knightingles Healthcare Bedfordshire Limited

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

As part of this assessment, we looked at 5 quality statements for the key question of caring. These were ‘kindness, compassion, and dignity, treating people as individuals, independence, choice and control, responding to people’s immediate needs and workforce wellbeing and enablement’. People were treated with great kindness, empathy and compassion and their privacy and dignity was always maintained. Staff treated people as individuals and made sure their care and support fully met their individual needs in line with their preferences. People’s independence was always encouraged and promoted ensuring they had choice and control over their care and support. Staff knew people very well and took time to observe, communicate and engage people in discussions about their immediate care needs. The support and wellbeing of staff was promoted to enable them to always deliver person centred care.

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

People and relatives told us they received compassionate care, and that staff were kind and went over and above their roles. For example, staff had carried out welfare checks on the spouse of a person using the service, whilst the person recovered from hospital treatment in a setting away from home. This had reassured both people and relieved their anxieties. Other examples included the purchase of an inflatable sink so that people who were cared for in bed could have their hair washed and staff arranged a hairdresser to conduct home visits for people unable to visit the salons. A relative commented, “The carers are such lovely people, not only to [family member] but to us as well. They are so lovely and laugh and chat away and nothing is too much trouble. They ask [family member] what they want to wear and things like that, it’s not just ‘do this do that’. They are very kind.”

The provider’s core values were to be Kind, Respectful, Professional, Caring and Attentive. Staff were fully aware of the core values of the service and were passionate about their jobs. One staff member told us, “I love coming to work. Knowing I can make a difference to people is so rewarding.” The management team were proud of the staff team and gave us numerous examples of how staff had supported people over and above their roles. For example, staff collected people’s prescriptions when family members were unable to do this, especially when people had been prescribed antibiotics that need to be started quickly. Staff had supported 1 person to have a look at a care facility because their family had not been available to facilitate the visit. The provider had purchased a safer hot water bottle cover for 1 person to use because the 1 they were using was not safe and, the provider purchased ingredients for Christmas dinner for 1 person receiving live-in care, so they felt included in the Christmas festivities and religious celebrations.

Feedback from health and social care professionals was positive. One said, “I have no concerns with the care being given to people. Knightingles Healthcare are professional, and very responsive. They work collaboratively with families in care planning and putting individuals at the centre of their care. They have been proactive in supporting the physical health needs of the individuals they support for us.”

People told us that staff treated them as individuals and said their care had been discussed with them and delivered in line with their preferences. For example, 1 relative told us how staff had completed specific training around their family members health condition so they could support them safely and fully meet their needs. One person who received live-in care liked to have regular staff changes, so in line with their wishes the provider had a flexible approach and did not have staff living-in for long periods. This meant the person had been empowered to make decisions about the staffing of their care package, their choices had been respected and their voice was heard. We saw that staff had arranged a fish and chip supper for 1 person every Friday in line with their preferences.

Staff fully understood the importance of promoting equality and diversity. Care plans contained comprehensive information about people's cultural and religious beliefs and their personal relationships with their circle of support. For example, the management team informed us that staff had supported a person to continue to practice their faith when they were no longer able to visit their place of worship. The staff facilitated weekly attendance via zoom and the provider specifically recruited a staff member of the same faith to support the person with their religious beliefs. This meant the person had been able to continue to practice their faith, so their spiritual needs were met.

Detailed care plans were focused solely on the individual with person centred care being the main emphasis, ensuring that people were treated as individuals. Topics of interests were a big part of the initial assessment and re-assessment process which were discussed face to face with people and families. Information was sought in relation to people’s preferred lifestyles, their cultural and unique backgrounds, the people that were important to them and the different hobbies and interests they enjoyed. Information was also sought about people’s preferred routines and the ways in which their care would fit into their lives rather than their lives having to change because they now required care and support. This meant people’s care was delivered in a holistic and person-centred way.

People were fully encouraged to maintain their independence and confirmed they were supported to do as much as they could for themselves and were fully involved in their care. A relative told us how their family member, who they said had been heavily medicated, had been supported to discontinue the use of medicines. The relative said, “They have really turned [family member] around. We have weekly meetings online with the company, the carers and me and we discuss all areas of the care provided. I am really happy with the care, [family member] is doing more for themselves and has a better quality of life.” Another relative commented, “The carers supported [family member] to be as independent as they could be, which was lovely.” Where people requested a particular gender of staff, this was facilitated even if staff teams had to be reconfigured, so the choices of people were respected and ensured people felt they were listened to.

Staff had an exceptional understanding of protecting and respecting people's human rights ensuring they were able to make decisions about their care, treatment, and wellbeing. Staff received training about equality and diversity. One staff member told us, “I support individuals in maintaining or increasing their independence by encouraging autonomy, providing choices in their care and treatment, and promoting self-advocacy. I follow the personalised care plan and always respect the choices of the people we support. If an individual cannot wash their body, sometimes they will be able to wash their face only. Families are always involved and invited to the meetings. Families and relatives are encouraged to be actively involved in the care planning process, as their input is valuable in understanding the individual's needs and wishes.” The management team informed us that they adjusted care calls to respond to urgent needs and also when people had to attend health appointments. For example, they had to adjust 1 person’s call times to make sure they were ready to attend their necessary health appointment. They said, “We adjust the call to an earlier time to make sure [person] is dressed and ready by the time the transport arrives. This means the person is calm and ready to attend their appointment without feeling anxious. This also means they are able to maintain their independence without having to be admitted to long-term care facilities.”

Promoting independence and maintaining skills was at the centre of the care delivery. The care plans focused on what people could do well and the support needed from staff. Staff met with people, their relatives and other external professionals to discuss their support and any changes required and these were reviewed regularly and updated when a person’s care requirements changed. In the customer information guide given to people when they commenced a care package the provider has shared their objectives. One of these was ‘to maintain and promote the dignity, independence, choice, and rights of customers while providing care at home’ and they had a code of conduct to ensure staff worked to meet the providers objectives.

People felt that staff knew them well and were able to engage people in discussions about their immediate needs. One relative told us, "Communication is excellent. If [family member] is unwell or out of sorts the staff will always call me and make contact with the doctor. I have confidence that the carers will deal with any emergencies quickly and professionally.”

The registered manager informed us that as part of the induction training and refresher training, staff covered recognising and minimising discomfort and distress. One staff member told us, "We are given training on how to deal with emergencies such as falls so that we are confident and prepared to deal with emergencies.” The service employed 3 nurses who helped to direct the care and were always involved in the creation and checking of people’s care plans. Their advice was also useful in making sure that medical emergencies were dealt with in the most appropriate way. For example, sometimes staff needed to seek advice when they were concerned about a person’s wellbeing, so they knew what steps to take next. The nurses had also played an important role in the medication audit process. The provider also employed a Nutritionists who had been out to visit people, helping with meal plans. This had helped 1 person to better manage food being bought and potentially thrown out when not used. There was a Pharmacy Technician employed who was able to give advice about reactions to medications, especially when new medications were started. When a fall or accident occurred, the staff would notify the on-call out of hours staff and would either stay with the person until the ambulance arrived or the on-call would arrange someone to relieve them. The provider gave us an example where they had to alter the rota for 1 staff member for the remaining day by assigning care calls to other staff because one of the team was waiting with a person until the paramedics arrived.

People benefited from staff who had regular opportunities to provide feedback about the service, raise any concerns and give their views about how to improve the service. For example, there were regular staff meetings and 1-1 supervision meetings where staff were able to provide feedback and give their views about the service. One staff member said, "We are well supported, and the managers are very approachable. We can talk with them anytime if we have a problem or any worries.” The management team gave us examples of how they ensured staff were valued and supported. For example, staff of different faiths were given time off during religious festivals and the provider also adjusted staff rotas to enable them to take part in fasting periods. The provider had also purchased plane tickets for staff when they had suffered a bereavement in their family and needed to travel to their country of origin immediately. Staff and managers had also pooled money (donations) to assist staff with funeral arrangements and bereaved staff members were visited with flowers and cards. The provider always celebrated staff members birthdays, weddings and graduations etc so that staff felt appreciated and valued.

There was a strong organisational commitment and effective action to ensure there was equality and inclusion across the workforce. The provider had a workforce app that had an employee assist program, medical advice through an on-demand GP, access to counselling services, interactive groups and discounts from various retailers. The provider had implemented a menopause policy and there were numerous reasonable adjustment policies in place. Staff had a number of WhatsApp groups that they could belong to. There was an on-call group used only in emergencies and when changes to schedules had been made. If a call had been cancelled in a very short timeframe the message would go out and direct calls would be attempted for the affected staff members. The impact of these services was that the staff wellbeing was always a priority and the staff felt appreciated and valued.