CQC report explained · a nursing home
What the CQC found at Karenza Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- There were not always enough staff to meet people's needs, particularly when two staff were needed for personal care. Medicines, safeguarding, infection control and risk management systems were otherwise described as safe.
- Effective?
- Requires improvement
- Some premises were in poor condition, including a bedroom, an ensuite toilet and windows. Staff training, supervision, care planning, support with eating and drinking, and consent arrangements were positive.
- Caring?
- Good
- This key question was not inspected during this visit. The report says staff treated people with dignity and respect and supported independence.
- Responsive?
- Good
- This key question was not inspected during this visit. The report records that some people did not receive personal care every day and could wait for help with call bells.
- Well-led?
- Requires improvement
- A new manager had started audits and reviewing care plans, but the provider had not acted effectively on staffing and premises concerns. The service remained in breach of good governance requirements.
What inspectors found, June 2023
Karenza Care Home was rated Requires Improvement; inspectors found serious staffing shortages, poor premises and weak oversight, although some care systems were working.
This was an unannounced focused inspection on 2 May 2023. Inspectors reviewed three care plans and risk assessments, all staff training and supervision records, and other management records. They spoke with people living at the home, staff, relatives, the manager and the provider.
The main concern was staffing. There were not always enough staff to meet people's assessed needs. Some people said they did not get help to wash every day, and call bells could take up to ten minutes to answer. Parts of the building also needed repair and redecoration.
There were positive findings too. Medicines were administered safely, staff understood safeguarding, care plans and risk assessments had recently been reviewed, and staff were receiving training and supervision. People were supported to make choices and staff generally treated them with dignity.
The overall rating remained Requires Improvement. Safe, Effective and Well-led were each rated Requires Improvement. Caring and Responsive were not inspected in this visit, so their earlier ratings were carried over. The provider must send CQC an action plan, and CQC will monitor progress.
Safe medicines
People received prescribed medicines safely. Staff had undergone competency checks and used an electronic system to record administrations.
“People received their medicines in a safe way, as prescribed for them.” from the report
Safeguarding
The home had systems to protect people from abuse. Staff had safeguarding training and knew how to report concerns.
“The service had effective systems in place to protect people from abuse.” from the report
Care planning
Care plans and risk assessments had recently been reviewed and contained guidance about people's needs and risks.
“Care plans were electronic and contained current guidance and direction for staff to meet people's needs.” from the report
Choice and consent
Staff sought consent, used the least restrictive approach and supported people to be as independent as possible.
“People were supported in accordance with the requirements of MCA.” from the report
New leadership
The new manager had begun audits, staff meetings and care plan reviews. Staff said morale and some aspects of the service were improving.
“The new manager had already improved the staff morale.” from the report
Too few staff
seriousStaffing levels were not always enough to meet people's assessed needs. This affected personal care and response times to call bells.
“There were not always enough staff employed and on duty to meet people's assessed needs.” from the report
Poor building condition
needs fixingOne bedroom and its ensuite needed repair and redecoration. Moisture between window panes also obstructed people's view of the grounds.
“One person's room and ensuite was in poor condition and needed repair and redecoration.” from the report
Weak oversight
seriousAlthough audits were taking place, the provider had not acted effectively on staffing and premises concerns or assessed their effect on care.
“The provider had not taken effective action to address the concerns found at this inspection.” from the report
Food temperature
minorFeedback about food was mixed. Some people said meals delivered to their rooms were sometimes cold, especially at weekends.
“Some people commented that their food was sometimes delivered cold to their room.” from the report
Creams not dated
minorExternal creams and lotions were not always dated when opened, so it was not always clear when they should be disposed of.
“However, these creams were not always dated when opened.” from the report
- 01How many care staff and nurses are on duty for each shift now, and how do you cover sickness or vacancies?
- 02What evidence can you show that people now receive their personal care every day when they need help?
- 03How quickly are call bells answered, and how is this checked?
- 04What repairs and redecoration have been completed in the damaged bedroom, ensuite and windows?
- 05How are you managing the change from nursing care to residential care, and what happens if a resident's needs increase?
This was an unannounced focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used for the overall rating. This explanation was written from the published report of 13 June 2023 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, June 2022
Rated Requires Improvement; inspectors found kind, person-centred care, but weaknesses in risk records, staff support, storage and management checks.
This was the home’s first inspection. It was unannounced and took place on 10 May 2022. One inspector spoke with people, staff, managers and a relative, observed care, looked around the home and checked care, medicines, recruitment and management records.
People were generally treated kindly and with respect. Staff knew people’s needs and responded to call bells promptly. Health care, food, infection control and visiting arrangements were managed well. However, activities were limited because there was no activity coordinator, and staff said they did not always have time to provide meaningful activities.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were also rated Requires Improvement. Caring and Responsive were rated Good in the ratings table. The report found three breaches of regulations covering storage, management oversight and staff support.
Kind and respectful care
People had trusting relationships with staff. Staff respected privacy, dignity, independence and personal choices.
“People had built caring and trusting relationships with staff.” from the report
Health needs managed
Staff followed treatment plans and worked with health professionals. Records showed monitoring of weight, nutrition, hydration, skin care and falls.
“People's health conditions were well managed, and staff engaged with external healthcare professionals including occupational therapists, physiotherapists and dementia liaison nurse.” from the report
Infection control
The home was clean and had updated infection control procedures. Inspectors were assured that arrangements covered visitors, PPE, testing and infection outbreaks.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Person-centred planning
Care plans recorded people’s needs, interests, communication needs and preferences. Staff used handovers to share changes in people’s needs.
“Care plans were complete and accurately reflected people's current needs.” from the report
Choking risk record was out of date
seriousA person’s increased choking risk had not been added to their care records or reported in a later review. Staff knew about the change from handover information, but important safety guidance could have been missed.
“Where a person was at risk of choking their care records had not been updated and it had not been reported in a subsequent review.” from the report
Staff supervision was missing
seriousStaff were not receiving formal meetings to discuss performance, training, development and wellbeing. The report says this breached Regulation 18.
“Staff told us they were not receiving supervision support to discuss operational issues, training and development and wellbeing.” from the report
Poor storage arrangements
seriousEquipment and continence supplies were stored in a communal lounge, and urine bottles were kept on a radiator cover. Inspectors said this could affect people’s dignity and communal space.
“The service did not have adequate storage facilities. Some equipment was stored inappropriately.” from the report
Management checks were not effective
seriousQuality systems had not identified the problems found during the inspection. People, relatives and staff were not being asked for feedback through formal systems.
“Systems and processes had not been effective in identifying and making required improvements to the quality of the service.” from the report
Limited activities
needs fixingThe activity coordinator vacancy meant there was a limited choice of activities. Staff said they did not always have time to provide meaningful activities.
“Activities and the choice to take part in them were limited due to their being a current vacancy for an activity coordinator.” from the report
- 01What has been done to make sure choking risks are updated in care plans and reviewed promptly?
- 02How are medicines staff now checked for competency in administering and recording medicines?
- 03How often do staff receive formal supervision, and who is responsible for arranging it?
- 04What changes have been made to storage so equipment and continence supplies do not occupy communal areas or affect dignity?
- 05Has an activity coordinator been appointed, and what activities are now available for people who remain in their rooms?
This was the first unannounced inspection and covered all five key questions, including infection prevention and control measures; there was no previous inspection rating to carry over. This explanation was written from the published report of 15 June 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.
Every inspection of Karenza Care Home
2 rated inspections over a year: the service has held its Requires improvement rating throughout.
- June 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- December 2020
Registered with the Care Quality Commission on 24 December 2020.
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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Most charge £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
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