CQC report explained · a residential care home
What the CQC found at Kiln Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People had detailed risk assessments, enough staff and safe equipment. Medicines systems were mostly safe, but some medicines care plans lacked detail and audits were not always completed or acted on.
- Effective?
- Good
- Staff had relevant training and people received support with food, drink and healthcare. Staff supervisions and appraisals had not always been completed consistently, although this had improved.
- Caring?
- Good
- Inspectors saw warm, kind and unhurried interactions. Staff promoted people's privacy, dignity, independence and choices.
- Responsive?
- Good
- Care plans reflected people's routines and preferences. People were offered activities, one-to-one interaction and support to communicate and raise complaints.
- Well-led?
- Good
- The management team promoted an open and positive culture and worked with outside professionals. Quality assurance systems had been introduced but were not yet as effective as they could be.
What inspectors found, April 2020
Rated Good; inspectors found kind, personalised care and improvements since the previous inspection, but medicines systems and quality audits still needed strengthening.
This was an unannounced inspection over three days. The inspector spoke with people living in the home, relatives, staff and health professionals. They also checked care records, medicines records, staff files and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, detailed risk assessments, kind interactions, personalised care plans, good food and a wide range of activities.
There were still areas being improved. Medicines care plans did not always contain enough detail, medicines audits were not always completed or acted on, and some staff supervisions, appraisals and meetings had not happened consistently. The home had improved from Requires Improvement at the previous inspection, and the earlier breaches of regulations had been resolved.
Detailed risk planning
Care records included risk assessments linked to people's individual needs, including diabetes, mobility and smoking risks.
“People's care planning records contained detailed risk assessments linked to their needs.” from the report
Kind and respectful care
Inspectors saw staff treating people calmly and respectfully, while protecting their privacy and dignity.
“We saw a warm and caring approach by staff with positive and kind interactions between staff and people.” from the report
Personalised support
Care plans recorded people's preferred routines, and staff knew how individuals wanted to be supported.
“Care plans were personalised, and each person's preferred personal care routines were detailed and incorporated their preferences.” from the report
Good activities and social contact
People could choose from activities such as music, quizzes, arts and crafts, exercise and reminiscence. Those who preferred to stay in their rooms could receive one-to-one time.
“The home provided a range of activities enabling people to live fulfilled lives.” from the report
Positive leadership
The management team was described as approachable and supportive, with a clear focus on developing staff and improving care.
“The manager promoted an inclusive, value based and positive culture. They were committed to developing and valuing staff.” from the report
Medicines records and checks
needs fixingSome medicines care plans did not contain enough detail. Audits were not always completed or followed up when problems were found.
“However, we found that medicines care plans lacked sufficient detail to ensure people were supported safely and audits were not consistently completed and acted on when actions had been identified.” from the report
Quality systems still being embedded
needs fixingNew quality assurance systems had been introduced, but inspectors found they were not yet fully effective, including in medicines management.
“These were not as effective as they could have been, but the manager and provider were working on embedding these into the home.” from the report
Staff support was inconsistent
minorSupervisions, appraisals and staff meetings had not always taken place consistently, although the report found improvement under the new manager.
“We found that supervisions and appraisals had not been completed consistently but that there had been an improvement since the manager had been in post.” from the report
No registered manager yet
minorThere was no registered manager in post at the inspection. The manager's registration application was still being processed.
“A registered manager was not in post. However, the manager had submitted an application to the Care Quality Commission (CQC) and this was in progress.” from the report
- 01What has been changed since the inspection to make medicines care plans more detailed?
- 02How do you now check that medicines audits are completed and that identified actions are followed up?
- 03Has the manager's application to register with the CQC been completed?
- 04How often are staff supervisions, appraisals and team meetings now held?
- 05How do you use people's individual preferences when planning daily care and activities?
This was a planned but unannounced inspection covering all five CQC key questions, as well as the care and premises provided by the home. This explanation was written from the published report of 18 April 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.
What inspectors found, January 2019
Kiln Lodge rated Requires Improvement; inspectors found kind care and enough staff, but risks, medicines records and management checks were not always reliable.
This was an unannounced inspection on 4 December 2018. Inspectors spoke with eight people, three relatives, staff and visiting professionals. They reviewed care records, medicines records, staff files and management records.
People generally felt happy and at home. Staff knew people well, treated them kindly and supported their choices. There were enough staff, recruitment checks were safe, and staff training had improved.
However, some risk assessments and care guidance were unclear or missing. Medicines records were not always accurate. The home did not properly analyse accidents and incidents or use its checks to find and fix problems.
The overall rating was Requires Improvement. Effective and Caring were rated Good. Safe, Responsive and Well-led were rated Requires Improvement. This was the second consecutive Requires Improvement rating.
Enough staff
Inspectors found enough staff to meet people's needs. Staff responded promptly to requests for support and recruitment checks were carried out safely.
“There were sufficient staff to meet people's needs.” from the report
Kind and respectful care
Staff knew people well and treated them with kindness, dignity and respect. People said they could make choices and live their own lives.
“Our observations of staff interactions with people showed that people were treated with kindness, compassion, dignity and respect.” from the report
Improved staff training
Staff training and supervision had improved since the last inspection. Staff had training in areas including dementia, safeguarding and choking risks.
“At this inspection improvements had been made and this was no longer a breach of regulation.” from the report
Food and drink support
People had choices and access to enough food and drink. The home adapted food and prepared additional high-calorie options when people needed them.
“People were protected from risks of poor nutrition and dehydration.” from the report
Medicines records and guidance
seriousMedicines lists did not always match administration records. Guidance was missing for some as-required and variable-dose medicines, and there were unexplained gaps in recording.
“Medicines records were not always clear and accurate.” from the report
Weak management checks
seriousThe home did not analyse accidents and incidents across the service. This meant it had not identified that 12 of 15 incidents in the previous six months happened at night.
“We found there had been a total of 15 accident/incidents in the last six months and 12 of these had occurred at night.” from the report
Care was sometimes task-focused
needs fixingInspectors saw staff prioritising tasks during mealtimes. One person waited for an alternative meal, and staff did not offer another meal after food was taken from someone else's plate.
“there were still occasions were staff's approaches did not focus on people but on the task.” from the report
Care plans lacked detail
needs fixingSome care plans did not clearly explain people's support needs, preferences or how risks should be managed. Staff often knew people well despite the records being unclear.
“Care plans contained an element of personalisation but it was not always possible to identify people's actual support needs, likes, dislikes and preferences from these.” from the report
- 01What has been done to make risk assessments and guidance clear for choking, diabetes and medicines that increase bleeding risks?
- 02How do you now check that medicines lists match the administration records and that as-required and variable-dose medicines have clear instructions?
- 03What changes have been made after analysing the pattern of accidents and incidents at night?
- 04How are care plans being rewritten so they clearly describe each person's needs, preferences and risk management?
- 05What training or supervision has been given to staff to prevent care becoming focused on tasks during mealtimes?
This was an unannounced inspection covering all five CQC questions and both the premises and care provided; the report says the previous rating was Requires Improvement, published on 8 November 2017. This explanation was written from the published report of 17 January 2019 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 Kiln Lodge
4 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2017Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 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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