CQC report explained · a residential care home
What the CQC found at Keb House Residential 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
- Safety checks for the premises and equipment, fire alarm testing and learning from accidents or falls were not robust. Medicines records, storage checks and stock records were also not always reliable.
- Effective?
- Requires improvement
- Staff did not always have the training needed to keep people safe or meet individual needs. Care planning, food support, healthcare involvement and Mental Capacity Act processes were otherwise described positively.
- Caring?
- Good
- This question was not inspected during this focused visit. The previous rating was carried forward, and inspectors observed that people were treated with dignity and respect.
- Responsive?
- Good
- This question was not inspected during this focused visit. Inspectors noted that people's care plans were up to date and that people were asked for their views.
- Well-led?
- Requires improvement
- Quality systems did not consistently identify problems, track actions or analyse accidents and incidents. Inspectors did find an open, relaxed culture and positive relationships with people, staff and other professionals.
What inspectors found, February 2023
Rated Requires Improvement; inspectors found caring staff and good care planning, but ongoing risks with medicines, safety checks, staff training and oversight.
This was an unannounced focused inspection on 10 January 2023. Inspectors spoke with people, a relative and staff, and reviewed care records, medicines records, recruitment files and management documents.
The home was rated Requires Improvement for Safe, Effective and Well-led. Inspectors found problems with premises and equipment checks, fire safety testing, medicines management, staff training and quality monitoring. They found no evidence that people had been harmed, but said people were at increased risk.
People and relatives said they felt safe and well cared for. Inspectors saw a caring and respectful culture, up-to-date care plans, suitable support for people's choices and effective work with health and social care professionals. The home remains Requires Improvement, the same overall rating as at the previous inspection published in January 2020.
Kind and respectful care
People and relatives spoke positively about the care. Inspectors observed a warm, supportive culture where people were treated with dignity.
“The home was welcoming, and the atmosphere was warm and supportive.” from the report
Up-to-date care planning
Care plans included people's health, communication, physical and emotional needs. Risks were assessed and reviewed, and staff followed the support plans.
“Care plans were up to date, risk assessments were in place and regularly reviewed.” from the report
Choice and involvement
People were involved in decisions about the home and could share their views about activities, menus and changes.
“People were able to attend residents' meetings where they discussed changes within the home, activities, as well as the menu.” from the report
Partnership working
The home shared information with other organisations and professionals when people needed additional healthcare or specialist support.
“The registered manager and staff had effective working relationships with other organisations and professionals to ensure people received the right support.” from the report
Medicines management
seriousSome medicine instructions, storage temperature records, stock levels and safety assessments were incomplete or inaccurate. Inspectors said this increased the risk to people, although they found no evidence of harm.
“We found no evidence people had been harmed, however, people were at increased risk as the provider had failed to ensure the proper and safe management of medicines.” from the report
Premises and fire safety
seriousRegular safety checks and maintenance were not reliable. Fire alarm testing records were limited, and some areas needed refurbishment to support effective cleaning.
“Fire safety was not robust. There was minimal evidence of regular fire alarm testing.” from the report
Staff training
seriousA significant number of staff had not completed safeguarding training. Staff had not always received training for people's individual needs, including epilepsy and diabetes.
“Staff did not always receive specific training to meet people's individual assessed needs.” from the report
Weak quality monitoring
seriousThe home's audits and action plans did not consistently identify concerns, record completed actions or analyse incidents and accidents to prevent them happening again.
“Systems designed to monitor the safety and quality of the service and take action to mitigate risk, were not robust.” from the report
Recruitment records
needs fixingRecruitment was considered safe, but interview records did not always show how the home decided that staff were suitable. CQC recommended improving how these records are monitored.
“The registered manager had not kept interview records to show how they had determined staff were suitable for the role.” from the report
- 01What changes have you made to medicines instructions, refrigerator temperature records, stock checks and individual medicine risk assessments?
- 02How often are fire alarms, premises and equipment checked now, and can you show the latest records?
- 03Which staff still need safeguarding, epilepsy or diabetes training, and when will this be completed?
- 04How do you now record management actions, who is responsible for them and when they are completed?
- 05What improvements have been made since the CQC inspection, and what evidence can you share of progress?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 2 February 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, January 2020
Rated Requires Improvement; inspectors found kind, person-centred care but serious problems with medicines, safety checks and quality monitoring.
This was an unannounced inspection on 31 October and 06 November 2019. The inspector spoke with a resident, relatives, staff and managers. They observed care, checked the home and reviewed care, medicine, recruitment and management records.
People were described as happy with the care. Staff were kind, respectful and supported independence. People had choices, activities, personalised rooms, suitable food and access to healthcare. Caring and Responsive were both rated Good.
However, medicines were not managed safely and records were not always accurate. Some safety checks had expired, hand-washing facilities were missing in some toilets, and some furniture was dirty. Staff training records were incomplete and the home did not have reliable systems to find and fix problems. Safe, Effective and Well-led were rated Requires Improvement.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw positive relationships and found that staff respected privacy, dignity, equality and personal choices.
“People and their relatives all spoke highly of the staff.” from the report
Personalised support
Staff knew people's routines, histories and preferences. People and relatives were involved in care planning and people were supported to spend their time as they wished.
“Staff provided person-centred care.” from the report
Activities and relationships
People could take part in hobbies, activities and trips. Visitors were welcomed and staff supported people to maintain important relationships.
“Activities included music, dominoes, arts and crafts, skittles and trips out into the local community.” from the report
Food and healthcare
People were positive about the food and choices were adapted to their needs. Staff supported people to access healthcare and followed professional advice.
“People were positive about the variety and amount of food.” from the report
Medicine safety
seriousStaff did not always have guidance for medicines given when needed. Records did not show the time or dose of some medicines, creating a risk of overdose.
“Staff did not record the time or dose when administering PRN medicines of a variable dose.” from the report
Premises and equipment checks
seriousA hoist had not been serviced as required. Boiler and electrical safety checks had not always been completed.
“The provider had not ensured equipment was safe to use.” from the report
Poor quality monitoring
seriousThe home did not have effective systems to find and address problems. Audits had missed medicine, safety, infection control, recruitment and training issues.
“Systems were not in place to monitor and address quality shortfalls in the service.” from the report
Incomplete care records
needs fixingDaily records and observation charts had large gaps. Care plans were not always updated and records did not always show the care people received.
“Records did not always show the care people received.” from the report
Training and recruitment records
needs fixingNot all staff had completed required or refresher training. Recruitment was considered safe, but interview records did not fully show how suitability had been assessed.
“Not all staff had been provided with sufficient training.” from the report
Infection control
needs fixingSome toilets did not have soap or disposable towels, and some chairs were dirty. The hand-washing problem was fixed during the inspection, but inspectors recommended a review of infection control procedures.
“Some toilets did not have soap or disposable towels for people to wash and dry their hands.” from the report
- 01What changes have you made to medicine guidance and records, especially for medicines given when needed and pain patches?
- 02Have all hoists, electrical equipment and the boiler now been serviced, and how do you make sure future checks are not missed?
- 03How do you check that daily care records and care plans are complete and up to date?
- 04Which staff training and refresher courses were outstanding, and have they now been completed?
- 05How do your quality audits identify and fix problems, and what action was taken after the nine incidents were not notified to the CQC?
This was a planned, unannounced inspection covering all five CQC questions; the previous ratings were reviewed and Safe, Effective and Well-led had deteriorated from Good to Requires Improvement. This explanation was written from the published report of 14 January 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 Keb House Residential Home
5 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- February 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2015
Report published without a new overall rating.
- February 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 17 February 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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32 live-in carers within about an hour of North Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,300 a week. 29 can care for a couple. 11 years' experience on average.
“What truly stands out is how mindful and attentive she is to all of my medical needs, always going above and beyond to ensure I’m comfortable and well cared for.”
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.