Kings Court

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

The provider had effective systems and processes in place to recognise people's changing health and care needs and act on these in a timely manner to keep people safe. Other healthcare professionals were consulted when needed about people’s care. Staff told us how important it was to them to support people to live their lives as independently as possible. Staff told us they took time and spoke to people. While there were some warm interactions between staff and people, there were also times that staff did not acknowledge people, and staff did not knock before entering people’s rooms. This was more noticeable on floors of the home where people with more advanced dementia were living. People told us they wanted more activities at the home, and some people said they were not spoken to by staff very often. One person told us, “No- one comes in and asks me how I am”. The registered manager told us he was working with the staff team to address communication and culture.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Signs around the home were clear, colourful and helpful to orientate people around the home. People’s support needs were assessed and they received care in line with these. People and their relatives were involved in creating care plans and ‘about me’ statements to help staff know people better.

The registered manager told us how they carried out assessments with the local authority placement teams or the hospital before people arrived at the home. The registered manager also told us how people were shown photographs of the home or were able to look at posts on social media to get a feel for the home before admission. Staff told us they understood people’s communication needs and took time to speak with them.

The pre-admission policy included advice to remind people there were other homes available and to encourage people to look around before ensuring King’s Court was the best place for them to live. This policy also referenced assessing the person and their needs, although there was no emphasis on including the person in decisions about their care. The pre-admission care planning mentioned looking at previous paperwork from other healthcare professionals, and informing the person of the named staff member who would oversee the plan. Care plans were detailed and robust.

People received care and support in line with good practice. There were some warm interactions between staff and people. People’s nutrition and hydration needs were met. One person said, “The meals here are pretty good.” The chef was aware of people’s preferences and met with people to discuss their menu choices every day.

The registered manager said he had frequent meetings with head office and with the regional directors, who sent him links for all the latest legislation, policies and procedures. He said the local authority sent him relevant information. Staff told us digital care records were easier than written notes and provided good information.

Care plans were thorough and had space to record physical and emotional needs as well as guidance for staff in how to best care for a person. Care plans contained detailed information and good practice.

Staff were very responsive to people’s care needs. For example, one person had become quite unwell. The deputy manager immediately phoned for an ambulance. They were very response to this person’s change in medical presentation and deterioration of oxygen saturation levels. The situation was managed well and the person was transferred to hospital.

Staff worked effectively both in the team at the home and across external teams such as Speech and Language Therapists, the local GP surgery and community matrons. For example when a person moved from the home to a nursing home for more specialist care staff worked with a range of professionals to ensure a smooth transition of care for the person.

The local authority contracts team and safeguarding teams were notified as necessary of people’s changing needs to ensure care was consistent across services.

People had care plans spanning all their needs from physical and clinical to emotional. Other health care professionals worked with staff to ensure continuity of care and this could be seen in the plans. Pre admission and hospital admission packs ensured staff were guided to share information with relevant teams and services.

People had access to a weekly visit from a GP or healthcare professional. Other healthcare professionals regularly visited the home, e.g. community matrons, district nurses. A relative said, “I was very pleased that a dentist came to visit in the home just last week.” She added, “A nurse comes to see [named family member] twice a week ... we are grateful.”

Staff told us they were keen to assist people to be more independent and to live full, healthy lives at the home. The chef was especially enthusiastic about providing fresh food to ensure people had good nutrition. The chef told us "I try to work with fresh stuff, I order fresh meat, bread, vegetables"

Audits of people’s health using weights, fluid and nutrition charts and mobility helped staff to ensure people were able to live healthy lives as independently as possible. Care plans included information for staff on how to support people to promote their independence. The home had a positive risks policy to ensure people were able to love their lives as they wished, and to the full.

Some people had answered a residents’ questionnaire to say they felt there could be better/more activities at the home and some people told us they could not always change their routine to be cared for as they wished. People were offered drinks to ensure hydration throughout the day, however people who were cared for in bed did not always have a drink within reach, this could lead to a risk of dehydration. One person told us, “No- one comes in and asks me how I am”. Another person living with dementia had a visit from a relative, we asked the relative if the person received any stimulation , or dementia specialist activity or company. They said “Not that I am aware, no”. The inspectors spoke to the registered manager at the time of the visit about the lack of engagement with people by some staff. The registered manager said he was working to change staff culture, and to ensure more friendly communication and stimulation with people.

The registered manager told us there were many ways they monitored people’s care and treatment to ensure they had consistent positive outcomes. The staff liaised with other health care professionals and said they followed up with wound care, speech and language referrals and followed advice from the community matron. People’s experiences did not always reflect this.

Processes were in place for care plan reviews. There were policies to ensure people were encouraged to live independent lives where possible. Audits were in place to look at accidents or incidents and to monitor falls, and use data to minimise the risk of repeated falls. The registered manager carried out monthly checks of people’s care including wound management.

Staff did not always knock before entering people’s rooms and did not always speak to people when they carried out care tasks. However no-one we spoke to, except one person, had complaints about the care or the staff. One person said “I am frustrated that I am not allowed to get up more often”. And when asked about the carers, said “They talk over you sometimes- they want you to do things a certain way- it makes me feel frustrated”. A Facebook page showed pictures of people, staff and visitors at the home. Visitors to the home were not always consulted as to whether they consented to feature on the page, which was open to the public. People and relatives at the home were consulted about consent to appear on the page. Inspectors spoke to the registered manager about staff being respectful, ensuring consent and knocking on doors. The registered manager told us he would address this with staff.

The registered manager told us the majority of people living at the home were subject to Deprivation of Liberty Safeguards (DoLS), some authorised by the local authority, others to be reviewed. Some people’s relatives had lasting powers of attorney, and records of these were kept by the home. Most relatives had LPAs for property and finances. One person’s DoLS had a condition attached, a review of their medicines to be undertaken after 6 months. The registered manager said they would discuss the review of this person’s medicines with the GP when they next visited.

The DoLS were recorded and managed via a spreadsheet, this included reference to when a DoLS expired and needed to be renewed. There was a consent form for people to complete as part of their admission to the service which covered who could access a person’s care plan, how photographs could be used, and the use of bed rails.