CQC report explained · a nursing home
What the CQC found at Ami Group - The Knoll Unit and Ami Court Unit
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2022
Ami Group - The Knoll Unit and Ami Court Unit was rated Requires Improvement; inspectors found people generally felt safe, but visiting, infection control, medicines records and management needed improvement.
This was an unannounced focused inspection on 27 June 2022. Inspectors looked only at Safe and Well-led, after concerns about visiting arrangements. They spoke with people, relatives and staff, observed care, and checked care plans, medicines, recruitment records and management checks.
People and relatives said they felt safe. Inspectors found enough staff, safe recruitment, suitable risk assessments and appropriate safeguarding arrangements. However, some people had only been allowed to see visitors in sheds or a summerhouse, rather than having the option of visits in their rooms.
Inspectors also found infection control and privacy concerns because podiatry treatments took place in the communal lounge. Medicines were usually given as prescribed, but some records did not match stock levels and one medicine had been moved into the wrong box. The provider was in breach of Regulation 17 on good governance.
The overall rating fell from Good to Requires Improvement. The inspection found improvements were needed in Safe and Well-led. The other three key-question ratings were not inspected and carried over from the previous inspection.
People felt safe
People and relatives told inspectors they felt safe, and staff understood how to support people safely.
“People told us they felt safe living at the service and were confident the staff knew how to support them safely.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Staff were observed spending time with people in an unhurried way.
“There were enough staff to support people safely and meet their needs.” from the report
Risk management
Risks such as diabetes, epilepsy, falls and skin damage had been assessed, with guidance for staff. Accidents and incidents were reviewed for patterns.
“Accidents and incidents had been recorded and analysed to identify patterns and trends.” from the report
Safeguarding
Staff knew how to recognise and report abuse. The manager had reported concerns to the local safeguarding authority when appropriate.
“The registered manager understood their responsibility to report concerns to the local safeguarding authority.” from the report
People's views
People could suggest changes to activities and menus, and inspectors found that some suggestions had been acted on.
“People suggested ideas for celebrating Easter and the Jubilee.” from the report
Visiting arrangements
needs fixingBefore the inspection, some people who could leave their rooms were only allowed to see visitors in outdoor sheds or a summerhouse. The manager changed the arrangements during the inspection.
“This did not follow government guidance.” from the report
Infection control and privacy
needs fixingPodiatry treatments took place in the communal lounge, where meals were also served and other people were present. People were not given the option of another room.
“This practice is not promoting infection control following best practice guidance.” from the report
Medicine records
seriousThe number of tablets did not always match the electronic records. Some medicines were also stored in the wrong original box, creating a risk that the wrong medicine could be given.
“Medicines were not always managed safely.” from the report
Weak management checks
seriousThe management team did not always follow guidance or identify risks around visiting, privacy and infection control. The provider was also unaware that the latest CQC rating had to be displayed on its website, although this was corrected during the inspection.
“The registered person had failed to assess, monitor and improve the quality of the service and mitigate the risks to the health and welfare of people.” from the report
- 01Can you explain your current arrangements for people who want visitors in their rooms?
- 02How do you now make sure podiatry treatments take place privately and safely?
- 03What checks are in place to ensure medicine stock matches the electronic records?
- 04How do you ensure medicines remain in their original packaging and can be checked against the prescription?
- 05What actions have you taken in response to the Regulation 17 breach, and what evidence can you show of progress?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 9 August 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2021
The Knoll Nursing Home was inspected but not rated; infection controls were mostly assured, but domestic staffing arrangements needed changing.
This was an unannounced, targeted inspection on 29 January 2021. It followed concerns about infection prevention and control measures during the COVID-19 pandemic.
Inspectors were assured about visitors, social distancing, admissions, protective equipment, testing, outbreak arrangements and the infection control policy. They were only somewhat assured about the premises' layout and hygiene practices.
A domestic worker had been shared between this home and another service owned by the provider. The provider acted immediately after the inspection to give each service separate domestic staff. The registered manager had also not always followed national guidance, and inspectors signposted current guidance.
Safer family visits
The home had a separate garden room for visits, with a screen to reduce the risk of COVID-19 transmission.
“There was a screen in place within the garden room to minimise the risk of COVID-19 transmission.” from the report
Cleaning arrangements
Staff followed a cleaning schedule that included frequently touched items and equipment.
“Staff had a cleaning schedule in place which included additional cleaning of areas such as the door bell, handles, phones and hand held devices.” from the report
Protective equipment and testing
The home had protective equipment and hand sanitiser available, and took part in the national testing programme.
“The service provider had engaged in the national COVID-19 testing programme for staff and people who lived at the service.” from the report
Most infection controls were assured
Inspectors were assured about several important arrangements, including admissions, protective equipment, testing and managing outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Shared domestic staffing
needs fixingA domestic worker was being shared between this home and another service owned by the provider. The provider acted immediately after the inspection to allocate separate domestic staff.
“To cover temporary absence, the provider shared a member of domestic staff between The Knoll and another service they owned.” from the report
Following national guidance
needs fixingInspectors found that the registered manager had not always worked in line with national guidance. The provider was signposted to current guidance.
“We found the registered manager had not always worked in line with national guidance.” from the report
Premises and hygiene
needs fixingInspectors were only somewhat assured that the layout and hygiene practices of the premises promoted safety.
“We were somewhat assured that the provider was promoting safety through the layout and hygiene practices of the premises.” from the report
- 01Have separate domestic staff now been allocated to this home, and how is this arrangement checked?
- 02What current national guidance was the registered manager asked to follow, and how do you make sure staff follow it?
- 03How often are frequently touched areas such as doorbells, handles, phones and handheld devices cleaned?
- 04How are visits arranged in the garden room, and what infection control measures are currently used?
- 05How do you maintain supplies and safe use of protective equipment and hand sanitiser?
This was an unannounced targeted inspection of infection prevention and control measures only; it was inspected but not rated and did not assess the other key questions. This explanation was written from the published report of 23 February 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Ami Group - The Knoll Unit and Ami Court Unit
5 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- August 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Ami Group - The Knoll Unit and Ami Court Unit →
- February 2021Inspected but not ratedSafe: Inspected but not rated
Read what inspectors found at Ami Group - The Knoll Unit and Ami Court Unit →
- December 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- December 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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