CQC report explained · a residential care home
What the CQC found at Katherine House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some risks were not fully assessed or recorded. Cleaning was inconsistent, some environmental hazards had not been dealt with, and medicines were not always managed safely.
- Effective?
- Good
- No separate rating or detailed findings were provided for this question in the report.
- Caring?
- Good
- No separate rating was provided, but inspectors said people were supported by caring and kind staff who knew them well.
- Responsive?
- Good
- No separate rating or detailed findings were provided for this question in the report.
- Well-led?
- Requires improvement
- Quality checks did not consistently identify or follow up problems with care records, cleaning, environmental risks and medicine competencies. The manager was open to feedback and took some immediate action.
What inspectors found, August 2023
Katherine House rated Requires Improvement; inspectors found kind care and enough staff, but safety, medicines and management systems were not reliable enough.
The inspection took place on 17 and 18 May 2023. It followed concerns about how safeguarding concerns were managed. The first day was unannounced. One inspector spoke with all 8 people living there, 1 relative and 9 staff, and checked care, medicines, staff and management records.
The home was caring in many ways. Staff knew people well, communicated in ways that met their needs and supported their choices. There were enough staff during the inspection. However, some risks were not properly recorded or managed, parts of the home were unclean, and medicines were not always handled safely.
Management checks had not reliably found or fixed these problems. The overall rating changed from Good at the previous inspection, published in July 2021, to Requires Improvement. The report says there was an increased risk that people could be harmed, although inspectors found no evidence that anyone had been harmed.
Kind and knowledgeable staff
Staff knew people well, respected them and supported their preferences. They communicated in ways that met people's needs.
“People were supported by caring and kind staff.” from the report
Enough staff
Inspectors saw enough staff to meet people's needs during the visit, including the one-to-one and two-to-one support people required.
“There were enough staff to meet the needs of people, at the time of the inspection.” from the report
People were protected from abuse
People were safeguarded from abuse. Staff understood different types of abuse and said they would raise concerns with management.
“People were protected from the risk of abuse.” from the report
Positive culture
The home had a positive atmosphere. The manager knew people's needs and was involved in day-to-day care.
“The culture of the home was positive. The registered manager knew people's needs well, led by example and was involved in people's day to day care.” from the report
Openness to improvement
The manager and provider accepted the inspectors' feedback and took some immediate action, including deep cleaning and starting a medicines investigation.
“They acknowledged where improvements could be made and took immediate action on some matters.” from the report
Risks were not fully managed
seriousSome care plans did not give staff clear instructions about known risks, including smoking and sore skin. Hazards in the garden and damaged furniture had also not been dealt with.
“Some care plans and risk assessments did not contain important information, including clear and detailed instructions for staff on how to provide safe care and manage people's known risks.” from the report
Cleaning and infection control
needs fixingSome areas were visibly unclean, cleaning records had gaps, and damaged porous surfaces could not be cleaned effectively. Used protective equipment was placed in a bin without a lid.
“Some areas of the service were visibly unclean, some paintwork was damaged and had porous surfaces so could not be effectively cleaned.” from the report
Medicines
seriousA staff member did not follow safe medicines procedures or the provider's policy. Checks had identified that staff medicines competencies needed updating, but this was not done promptly.
“We observed a staff member failing to follow safe medicine administration procedures and failing to follow the provider's own medicine policy.” from the report
Weak management checks
seriousThe systems used to check quality and safety did not consistently identify or resolve problems. Some daily, food, key worker and weight records were also incomplete.
“The provider's quality assurance systems and processes were not always effective and had not enabled them to assess, monitor and improve the quality and safety of the service.” from the report
Limited family feedback
minorThere was no system in place to regularly seek the views of relatives and friends. One relative also wanted more activities for their family member.
“The registered manager told us they would be implementing a system to seek the views of people's relatives and friends, this was not currently in place.” from the report
- 01What has been done to update each person's risk assessments, especially for smoking and sore skin?
- 02How have you fixed the garden trip hazard, damaged furniture and mattresses identified by inspectors?
- 03How do you now check that staff are competent to administer medicines, and what happens if a medicines error is found?
- 04How often are cleaning checks completed, and how do you make sure gaps in the cleaning records are followed up?
- 05How are relatives now asked for their views, and what activities are available for my family member?
This was a concern-led, focused inspection that rated Safe and Well-led; the report does not provide separate ratings for Effective, Caring or Responsive. This explanation was written from the published report of 3 August 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, July 2021
Rated Good; inspectors found kind, person-centred care and improvements since earlier breaches in safety and management.
This was a planned inspection, carried out without notice on 16 and 21 June 2021. Inspectors visited the home, reviewed care and medicines records, spoke with staff, relatives and a professional, and observed people’s care.
All five areas were rated Good: safe, effective, caring, responsive and well-led. Inspectors found enough trained staff, person-centred care, meaningful activities, good support for communication and choice, and effective systems for managing risks, medicines, complaints and quality.
The previous inspection had found breaches involving safe care, safeguarding and governance. This inspection found enough improvement, including stronger infection control, safeguarding arrangements and audits. The report says the home was no longer in breach of those regulations.
Person-centred support
Care was directed by each person and focused on their quality of life, independence and goals.
“The needs and quality of life of people formed the basis of the culture at the service.” from the report
Choice and independence
People were supported to make choices about their daily routines, activities, food, clothing and care.
“People were supported to be independent and had control over their own lives.” from the report
Kind and respectful care
Inspectors found that staff treated people with kindness, patience and respect, while involving families in decisions.
“People and their families told us they received kind and compassionate care.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure the improved infection control systems continue to be followed?
- 02How are people and their families involved in reviewing care plans and risk assessments?
- 03How do you monitor medicines and review them in line with the STOMP principles?
- 04What audits are currently carried out, and how do you make sure any actions are completed on time?
- 05How will you respond if a resident or family member raises a safeguarding concern or complaint?
This was a full inspection covering all five key questions, with particular attention to the Right support, right care, right culture principles and infection prevention and control. This explanation was written from the published report of 28 July 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 Katherine House
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2021Goodup from InadequateSafe: GoodWell-led: Good
- January 2021Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- February 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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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