CQC report explained · a nursing home
What the CQC found at Karuna Manor
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines were managed safely overall, but inspectors recommended clearer prescription instructions and found one seizure plan that needed clearer guidance.
- Effective?
- Good
- No rating for Effective is shown in this report.
- Caring?
- Good
- No rating for Caring is shown in this report.
- Responsive?
- Outstanding
- People's needs were exceptionally well met. Inspectors found highly personalised support, strong cultural and spiritual care, meaningful activities and excellent end-of-life support.
- Well-led?
- Outstanding
- Leadership was exceptional, open and inclusive. The home used detailed governance systems, feedback and partnerships to monitor and improve care.
What inspectors found, November 2023
Rated Outstanding overall; inspectors found exceptionally responsive and well-led care, with a medicines recommendation.
Inspectors visited the home without notice on 13 September 2023 and 20 October 2023. They spoke with 16 people, 11 relatives and staff, and checked care records, medicines records, risk plans and management information.
The home was rated Good for Safe, and Outstanding for Responsive and Well-led. People were described as safe, well supported and treated as individuals. Inspectors found strong leadership, detailed quality checks and a culture focused on improving people's experience.
There was one recommendation about making sure prescription instructions clearly state when medicines should be given through a PEG tube. Inspectors also found that one seizure risk plan did not clearly explain when to call emergency services, but the provider acted immediately and sent updated plans.
End-of-life support
The home provided highly personalised end-of-life care. Staff considered people's religious, cultural and spiritual wishes and worked with families and outside organisations.
“People were exceptionally well supported at the end of their life to have a comfortable, dignified and pain free death.” from the report
Personalised care
Staff knew people's likes, dislikes and communication needs. The home developed activities and services around people's interests, health and preferences.
“People were supported as individuals, in line with their needs and preferences.” from the report
Activities and relationships
People were supported to maintain relationships and take part in activities linked to their past, interests, faith and culture. The home also provided ways for people who were unwell or unable to attend activities in person to join in.
“People were supported to maintain relationships, follow their interests, and take part in activities that were relevant to them.” from the report
Leadership and improvement
The home had strong systems for checking care quality and learning from incidents. People, relatives and staff were involved in developing the service.
“The provider had created an exceptional learning culture at the service which continuously improved the care people received.” from the report
Communication and inclusion
The home supported different languages and communication needs. Information could be provided in pictorial form, and staff adapted how they communicated with people.
“The provider was meeting the Accessible Information Standards.” from the report
Medicine instructions
needs fixingSome medicines given through PEG tubes were not clearly prescribed that way on the electronic system. The provider was asked to review the dosage instructions with prescribers.
“We recommend the provider review the dosage instructions with the prescriber for prescribed medicines.” from the report
Seizure emergency guidance
needs fixingOne risk plan did not clearly say when to call emergency services after a seizure, and the timing for rescue medicine was unclear. The provider acted immediately and sent updated plans.
“1 risk management plan did not have clear guidance on when to call emergency services following a seizure.” from the report
Weekend and night staffing concerns
minorSome people and relatives said there were not enough staff at weekends and night-time. Inspectors found enough staff during the visit and records showed staffing was based on people's assessed needs.
“They don't have enough staff on weekends and nighttime.” from the report
- 01What action has been taken to make sure all PEG medicines have clear prescription instructions?
- 02How do you make sure seizure plans clearly state when to give rescue medicine and when to call emergency services?
- 03How many staff are normally on duty at weekends and overnight, and how is this adjusted when people's needs change?
- 04How will you keep us updated about care plans and reviews if we live far away or abroad?
- 05What rating or evidence would you give us for the Effective and Caring areas, which are not rated in this report?
The inspection looked at the overall quality of the home, but this report gives ratings for Safe, Responsive and Well-led only; no ratings are shown for Effective or Caring. This explanation was written from the published report of 24 November 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, September 2020
Inspected but not rated; inspectors found good infection control during the COVID-19 pandemic.
This was an announced, targeted inspection on 19 August 2020. Inspectors checked how the home prevented and controlled infection during the pandemic.
Inspectors were assured that the home used personal protective equipment safely, supported testing, followed shielding and social distancing rules, and had suitable cleaning and hygiene arrangements.
The home restricted visits except in exceptional circumstances, but used garden visits, window visits and video calls. It also provided socially distanced activities and translated COVID-19 guidance and training into Gujarati.
The service was inspected but not rated. This means the inspection did not give an overall rating or a Safe rating such as Good or Requires improvement.
Safer visiting arrangements
The home used individual risk assessments to support face-to-face visits where possible and offered video calls when visits could not take place.
“Individualised risk-assessments had been carried out to facilitate face to face visits” from the report
Activities during restrictions
The home introduced activities that could take place while people remained socially distanced. Television links also allowed people to join prayer meetings from their rooms.
“The service introduced hall and doorway activities, such as 'hallway bingo'” from the report
Support for staff infection control
Staff were offered the option of staying overnight. The home also washed uniforms on site and provided some basic goods for staff to take home.
“Their uniforms were washed on site and this minimised the risk of staff being unnecessarily exposed to the virus.” from the report
Accessible guidance and training
Guidance and training were translated into Gujarati, the main language spoken at the home, and activity co-ordinators provided training to people using the service and staff.
“All guidance and the training had been translated into Gujarati” from the report
Further development suggested
minorCQC signposted the home to resources to develop its approach. The report does not explain which part of the approach needed development.
“We have also signposted the provider to resources to develop their approach.” from the report
- 01What changes have you made since CQC signposted you to resources to develop your infection prevention and control approach?
- 02How do you currently assess and arrange face-to-face visits for relatives?
- 03How are people using the home supported to take part in activities and prayer meetings if they cannot leave their rooms?
- 04How do you provide infection control guidance and training to people and staff who speak Gujarati?
- 05How do you currently arrange testing, personal protective equipment and outbreak management for people and staff?
This was a targeted inspection of infection prevention and control measures during the COVID-19 pandemic; it did not provide a full service rating. This explanation was written from the published report of 9 September 2020 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 Karuna Manor
4 rated inspections over 7 years: the service has improved, from Requires improvement to Outstanding.
- November 2023Outstandingcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- September 2020Inspected but not ratedSafe: Inspected but not rated
- December 2017Goodup from Requires improvementSafe: GoodResponsive: GoodWell-led: Good
- February 2017Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015
Registered with the Care Quality Commission on 23 March 2015.
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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