CQC report explained · a residential care home
What the CQC found at Keele House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and staff had clear guidance on issues such as diabetes, choking, anxiety, falls and skin damage. Medicines, staffing, recruitment and infection control were found to be safe.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people's preferences, supported independence and respected choices about privacy, daily routines and care.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found stronger leadership, regular audits and action plans for shortfalls. People, relatives and staff were asked for their views, and the home acted on feedback.
What inspectors found, October 2022
Rated Good; inspectors found safer, kinder and better-managed care, with some further work needed on information shared with health professionals.
This was an unannounced, focused inspection on 11 October 2022. Inspectors spoke with people, relatives, staff and a health professional. They reviewed care records, medicines records, recruitment checks and management audits.
The home was rated Good overall. Safe, Caring and Well-led were rated Good. Inspectors found that risks were assessed, medicines records had improved, staffing was sufficient and people were treated with kindness, dignity and respect.
The home had improved from Requires Improvement at the previous inspection in November 2021. A registered manager had been appointed, regular checks were taking place and the previous breaches of regulations 12 and 17 had been resolved.
This was a focused inspection. Effective and Responsive were not inspected during this visit, so the overall rating also used ratings from the previous inspection.
Improvement since the last inspection
The provider had acted on the problems found previously. The home was no longer in breach of the regulations identified at the earlier inspection.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Safer risk management
Staff had clearer guidance for managing important risks, including unstable diabetes and choking. Action was also taken after accidents and incidents.
“At this inspection we found risks to people had been identified and guidance was in place for staff.” from the report
Kind and respectful care
Staff knew people well, respected their choices and supported them to remain independent. Inspectors saw staff reassuring people when they were anxious or unwell.
“Staff were kind and caring towards people and their relatives.” from the report
Better management checks
The home had regular audits and used action plans to deal with shortfalls. A new registered manager had led improvements in the service.
“Effective checks and audits were completed monthly in line with the provider's policy.” from the report
Enough trained staff
Inspectors found enough staff to meet people's needs. Staff had completed relevant training, including dementia, learning disability and autism training.
“Staff had been supported to develop the skills and knowledge they needed to care for people.” from the report
Information shared with health professionals
needs fixingCommunication with health professionals had improved, but inspectors said information was not always accurate and sufficient. Ask how this is being checked now.
“They told us communication was much improved but further work was needed to ensure health care professionals received accurate and sufficient information at times.” from the report
Medicines room temperature
minorMedicines had sometimes been stored above the manufacturer's recommended temperature. The home installed air conditioning and obtained pharmacy advice, and the temperature did not exceed 28°C.
“Medicines had been stored on occasions above the maximum temperature of 25°C recommended by the manufacturer.” from the report
- 01How do you currently manage the person's specific risks, such as diabetes, choking, falls or skin damage?
- 02How do you check that medicines are stored at the correct temperature and that records are completed every time?
- 03What checks make sure health professionals receive accurate and sufficient information about a person's care?
- 04How will you support the person to remain independent while keeping them safe?
- 05What changes have been made since the previous inspection, and how do your audits show that those changes are being maintained?
This was an unannounced focused inspection of Safe, Caring and Well-led; Effective and Responsive were not inspected and their previous ratings were used for the overall rating. This explanation was written from the published report of 29 October 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, November 2021
Rated Requires Improvement; inspectors found kind care and progress, but medicines and risk management still put people at risk.
This was an unannounced, focused inspection on 22 September 2021. Inspectors spoke with people, relatives and staff, and checked care records, medicines records, staff files and management records.
The home had enough staff and people generally said they felt safe and well cared for. Staff were kind, knew people well, responded to health changes and supported people with food, healthcare and daily choices. Infection control arrangements were also found to be effective.
However, medicines were not always recorded, stored or given safely. Care plans and risk assessments did not always give staff the information they needed. Management checks had missed these problems. The home was rated Requires Improvement overall, with Safe and Well-led rated Requires Improvement and Effective rated Good.
Enough staff
There were enough staff to meet people's needs. Call bells were answered promptly and staff had time to spend with people.
“There were enough staff to meet people's needs.” from the report
Improved staff support
Training, supervision and staff support had improved since the previous inspection. Staff said they felt listened to and able to raise concerns.
“Staff had been supported to develop the skills they needed to meet people's needs.” from the report
Healthcare support
Staff acted quickly when people's health changed and worked more effectively with healthcare professionals.
“When people's health needs changed, staff referred them to health professionals for guidance and support.” from the report
Food and choice
Meals were adapted to people's needs and preferences, including vegetarian and low-sugar options. People said they enjoyed the food.
“Meals and snacks were prepared to reflect peoples' individual needs and preferences.” from the report
Improved culture
Relatives and staff described a better atmosphere and a more open culture under the new manager.
“The culture at the service had improved.” from the report
Medicines were not always safe
seriousStaff did not always complete medicines records or give medicines at the prescribed times. Some medicines were stored above the recommended temperature, and storage cupboards were not locked.
“People continued to be put at risk by poor medicines management and storage processes.” from the report
Risk information was incomplete
seriousCare plans and risk assessments did not always tell staff what to do to protect people. This included risks linked to diabetes, choking and behaviours that could cause harm.
“Staff did not always have clear guidance on the actions they should take to protect people from avoidable harm.” from the report
Safeguarding concern was not reported
needs fixingAn incident involving unexplained bruising had been recorded but was not passed to the manager or provider at the time. A safeguarding referral was made after the inspection, and the investigation found no concerns.
“One incident had occurred when a person had unexplained bruising.” from the report
Management checks missed problems
seriousAudits were not completed consistently and did not identify all the medicines and care planning shortfalls found by inspectors.
“The provider had failed to operate effective systems to assess, monitor and improve the quality of the service people received.” from the report
- 01What changes have you made to ensure every medicine is recorded, stored safely and given at the prescribed time?
- 02How do you now check medicine temperatures and ensure all medicine storage cupboards are locked?
- 03What written guidance is available for staff when a person's blood sugar is unstable or someone starts to choke?
- 04How do your audits confirm that care plans and risk assessments contain the right information?
- 05What progress has been made against the action plan since this inspection, and when was the last review?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected, and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 9 November 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 Keele House
6 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- May 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- October 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2019Requires improvementdown from GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016
Registered with the Care Quality Commission on 12 February 2016.
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 £1,260 a week. 33 can care for a couple. 12 years' experience on average.
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