CQC report explained · a nursing home
What the CQC found at Kenroyal Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2022
Kenroyal Nursing Home is rated Good; inspectors found that earlier problems with safety and management had been improved.
This was an unannounced, focused inspection on 10 March 2022. The inspector spoke with six people, seven staff and the nominated individual. They also observed care and checked care records, medicines records, staff files and management records.
The home was rated Good for Safe and Well-led. Inspectors found better risk assessments, safer medicines procedures, improved infection control and stronger checks on accidents, incidents and the quality of care.
People said they felt safe. Inspectors found enough staff, suitable recruitment checks and staff who knew people well. They also found a caring culture, good communication and people involved in decisions.
The previous rating was Requires Improvement, with two breaches of regulation. The home had completed an improvement plan, and inspectors found it was no longer in breach of those regulations. This inspection did not reassess Effective, Caring or Responsive.
Improved safety systems
Risk assessments were reviewed when people's needs changed. Environmental and fire safety checks had also improved.
“Improvements had been made to the risk management systems to reduce potential risks to people.” from the report
Medicines managed safely
Medicines were ordered on time, stored correctly and given by trained staff. The manager checked medicines stocks and records.
“Improvements had been made to the processes in place for the safe administration of people's medicines.” from the report
Stronger management checks
The home had regular quality checks and reviewed accidents and incidents each month so it could identify patterns and learn from problems.
“Records showed these were reviewed monthly to identify any trends and patterns.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure risk assessments are updated promptly when a person's needs change?
- 02What checks are currently made on medicines stocks, records and administration?
- 03How are accidents and incidents reviewed, and how are lessons shared with staff?
- 04How do you maintain enough regular staff to support continuity of care?
- 05How do you keep infection prevention procedures and outbreak arrangements up to date?
This was an unannounced focused inspection of Safe and Well-led; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 18 March 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, October 2020
Rated Requires Improvement; inspectors found safety, medicines and management problems, although staff were kind and caring.
This was an unannounced inspection on 18 August 2020. Inspectors spoke with people, relatives, staff and visiting professionals. They reviewed care records, medicine records, staff files and management records.
The home was not always safe. Inspectors found risks that had not been properly assessed, medicines that were not always given or recorded as prescribed, unlocked doors and hazardous items, and concerns about fire safety and infection control.
The systems used to check the quality and safety of care were not effective. Records about repositioning, skin condition, food, fluids and bowel movements were not always clear or consistent. The home received Requires Improvement for Safe and Well-led.
The previous overall rating was Good, published in July 2018. The provider put an action plan in place after the inspection, and CQC said it would monitor progress and return under its reinspection programme.
Kind staff
People told inspectors that staff were kind, caring and knew them well.
“People told us staff were kind and caring and knew them well.” from the report
Staffing and recruitment
Inspectors found enough staff on the inspection day, with suitable skill levels. Recruitment files included the required checks.
“On the day of the inspection we found there were enough staff available, and the appropriate levels of skilled staff were deployed to meet people's needs.” from the report
Training and safeguarding
Staff had safeguarding training and said they felt confident raising concerns. Staff had also received training to meet people's needs.
“Staff received training on safeguarding adults and understood their responsibilities in reporting any concerns.” from the report
Action after feedback
The provider and manager accepted the inspection feedback and started an action plan immediately after the visit.
“The provider and registered manager were open to feedback and implemented an action plan immediately after the inspection to evidence their actions for concerns raised.” from the report
Risks were not properly managed
seriousSome risks had not been assessed or reduced. This included hot water temperatures, people unable to use call bells, and infection control arrangements.
“Risks to people had not always been identified and detailed strategies had not been put into place to mitigate those risks.” from the report
Medicines were not always given safely
seriousSome medicines were not given as prescribed, and records did not explain why some as-needed medicines were given or whether medical advice had been sought.
“Two people received PRN medicines for seven days without any evidence recorded of the reasons for given or that GP advice had been sought.” from the report
Unsafe areas and fire concerns
seriousHazardous items and doors to potentially dangerous areas were not secured. Fire doors were wedged open and one lacked a fire strip.
“We also found unlocked doors leading to potentially dangerous areas such as stairs, boiler room and sluice room.” from the report
Weak checks and records
needs fixingThe home's audits did not identify important problems. Records about repositioning, skin condition, food, fluids and bowel movements were unclear or did not match.
“The audits completed were not effective. For example, the medicine audit only identified issues with missed signatures or recording errors.” from the report
Bruising was not fully investigated
needs fixingSome unexplained bruising had not been fully investigated or reported. CQC recommended that bruising and injuries should be dealt with promptly.
“However, some unexplained bruising had not been fully investigated or reported.” from the report
- 01What has been done to ensure medicines are given as prescribed and that reasons for as-needed medicines are recorded?
- 02How are risks now assessed for people who cannot use their call bell, and how are checks on them recorded?
- 03Have the unlocked doors, hazardous items and fire-door problems been fixed, and who checks this now?
- 04How are repositioning, skin condition, food, fluid and bowel records kept consistent and reviewed?
- 05What action has been taken to investigate and report unexplained bruising or injuries?
This was a focused inspection prompted by concerns about bruising, record keeping and repositioning; only Safe and Well-led were inspected, while the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 2 October 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 Kenroyal Nursing Home
5 rated inspections over 7 years: the service has held its Good rating throughout.
- March 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- July 2018Goodstayed GoodSafe: GoodWell-led: Good
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Inspected but not ratedSafe: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2011
Registered with the Care Quality Commission on 4 July 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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