CQC report explained · a nursing home
What the CQC found at King's Lodge Centre for Complex Care
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were identified and managed, medicines were handled safely, staffing was sufficient and infection control measures were in place.
- Effective?
- Good
- Staff had suitable training and support. People's nutritional, healthcare and consent needs were assessed and care was provided in line with professional guidance.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward.
- Well-led?
- Good
- Inspectors found improved care records, effective audits, better communication and a positive, supportive staff culture.
What inspectors found, June 2021
King's Lodge Centre for Complex Care was rated Good; inspectors found improved safety, effective care and leadership, with no major concerns identified.
Inspectors visited on 11 May 2021. They spoke with people living at the home, relatives, staff and a healthcare professional. They reviewed care records, medicines, recruitment files, incident records and quality checks.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found that care plans, risk management, medicines systems, staff support and quality monitoring had improved since the previous inspection.
This was a focused inspection. Inspectors looked at Safe, Effective and Well-led because these areas had previously required improvement. Caring and Responsive were not looked at during this visit, so their previous ratings were carried forward.
Personalised care plans
Care plans had improved and gave staff clear guidance based on each person's needs and preferences.
“Care plans were comprehensive and personalised, addressing all areas of people's lives in a way which reflected their individual needs and preferences about their care.” from the report
Reliable staffing
People said staff were available when needed. Inspectors saw staff respond quickly to call bells, and the staff team had remained consistent during the pandemic.
“When people used their call bells during the inspection, we observed that staff responded quickly to meet their needs.” from the report
Safe medicines management
Medicines were stored, administered and checked safely. The home had also introduced an electronic medicines management system.
“People's medicines were managed safely. Staff responsible for medicines administration received relevant training and their competency was regularly assessed.” from the report
Good staff support
Staff received induction, training and supervision. The manager and clinical lead helped staff keep up to date with care guidance.
“Staff had the skills and training they needed to provide people's care.” from the report
Improved leadership
Inspectors found better communication, regular audits and a more supportive culture. People and staff said their views were listened to.
“At this inspection, we found the culture amongst the staff team was positive and supportive.” from the report
Manager not yet registered
minorThere was no manager registered with the CQC when inspectors visited. The manager had applied for registration, but the provider remained legally responsible for how the home was run.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01Has the manager's application for CQC registration been completed, and who is currently responsible for the home's day-to-day leadership?
- 02How will you assess and review my relative's individual risks and care plan, especially if their neurological condition changes?
- 03How does the electronic medicines system work, and how will you tell us about any medicines errors or changes?
- 04How will my relative's nutritional needs, food preferences and specialist healthcare advice be recorded and followed?
- 05How can families take part in reviews of care and give feedback now that residents' meetings were suspended during the pandemic?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 29 June 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.
What inspectors found, June 2019
Rated Requires Improvement; inspectors found kind, responsive care, but gaps in risk records, legal consent checks and leadership remained.
This was an unannounced comprehensive inspection on 10 April 2019. Inspectors spoke with people, relatives, staff and health professionals. They reviewed care records, staff files, policies and management records.
The home had improved since its last inspection, when it was rated Inadequate and placed in Special Measures. Staff numbers, medicines, activities, complaints handling and management oversight had improved. People and relatives described the care as kind and said the home was more open and responsive.
However, some important safety records were incomplete. Tracheostomy equipment was out of date or no longer sterile, some health care plans lacked key information, and some mental capacity and Deprivation of Liberty Safeguards checks were missing. Staff supervision was also not up to date.
The overall rating was Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement.
Staffing and recruitment
People were supported by enough staff, with less reliance on agency workers. Recruitment checks were described as robust.
“There are enough staff because we are all getting our breaks now and care isn't rushed.” from the report
Medicines
Medicine records and administration were safe. Staff had competency checks before administering medicines independently.
“Medicine administration records (MARs) were fully completed and as and when medicine (PRN) were given in line with the protocols that were in place.” from the report
Kind and respectful care
People and relatives spoke positively about staff kindness. Inspectors saw people being involved in decisions and supported to remain independent.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Activities and personalisation
The home offered a wide range of activities and had improved the detail in care plans about people's choices, interests and preferences.
“There was a wide variety of activities to help people live fulfilled lives.” from the report
Listening and complaints
People and relatives felt more comfortable raising concerns. Complaints were recorded, investigated and used to look for patterns.
“Complaints were recorded, responded to and analysed for any trends.” from the report
Tracheostomy safety
seriousEquipment in an emergency care box was out of date or no longer sterile. There was no staff policy for tracheostomy care, and staff competency arrangements were unclear.
“The tracheostomy emergency care box contained equipment that was either out of date or no longer sterile as it was out of its packaging.” from the report
Incomplete health care plans
needs fixingSome care plans did not explain important health conditions or what staff should do. The report gives epilepsy as an example where seizure information was missing.
“For example, one person had epilepsy but there was no information around what types of seizures this person suffered from and how to support them during one.” from the report
Mental capacity and liberty checks
seriousSome decision-specific mental capacity assessments and Deprivation of Liberty Safeguards applications were missing for restrictions placed on people.
“However, mental capacity assessments and DoLS applications where needed for other people were missing.” from the report
Staff supervision
needs fixingStaff training was relevant, but some staff said they had received few or no formal supervision meetings. The provider said this was being put back on track.
“Supervisions are rare. I think we should have them every four to six weeks but I have only had one since I've been here.” from the report
Some interactions
needs fixingInspectors saw one staff member fail to engage with people during an activity and move someone in a wheelchair without asking for consent first.
“We observed a staff member not interacting with people during an activity, and also while providing one to one care, and moving somebody in a wheelchair without asking for their consent first.” from the report
- 01How do you now check that tracheostomy emergency equipment is in date, sterile and complete?
- 02What training, policy and competency checks do staff have for tracheostomy care?
- 03How do you make sure each person's care plan contains clear information about their specific health conditions, including seizures?
- 04Have all required mental capacity assessments and Deprivation of Liberty Safeguards applications now been completed?
- 05How often do staff receive formal supervision, and how do you check that agreed improvements are maintained?
This was an unannounced comprehensive inspection of the care, nursing and accommodation provided, covering all five key questions. This explanation was written from the published report of 4 June 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 King's Lodge Centre for Complex Care
4 rated inspections over 5 years: the service has held its Good rating throughout.
- June 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at King's Lodge Centre for Complex Care →
- June 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
Read what inspectors found at King's Lodge Centre for Complex Care →
- April 2019Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
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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