CQC report explained · a residential care home
What the CQC found at Kingland House Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2020
Rated Good; inspectors found safe, caring and better-managed care, but noted some gaps in training, communication and meal delivery.
Inspectors visited the home in August 2020 and continued some of their work remotely because of the Covid-19 pandemic. They spoke with people living there, relatives, staff and health professionals. They reviewed care records, medicines records, staff files and management records.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found suitable staffing, safe recruitment, regular risk reviews and safe medicines arrangements. They also found person-centred care, access to health professionals, good food choices and a positive management culture.
There were some areas to improve. Some staff training and supervision were not up to date. One medicine past its expiry date had not been removed, some relatives wanted clearer communication, and some meals were delayed before being served.
The previous rating was Requires Improvement, published in July 2019. The home had previously breached Regulation 17, but inspectors found enough improvement had been made and it was no longer in breach.
People felt safe
People said they felt safe and well cared for. Staff understood how to reduce risks and report possible abuse.
“People told us they felt safe living at Kingland House, and that staff were caring and supportive.” from the report
Improved management
Management systems had improved since the last inspection. Audits and checks were used to identify problems and take action.
“Records of staff meetings, quality assurance checks and audits showed when issues were identified, these were shared appropriately, and action was taken to address any shortfalls.” from the report
Individual care
Care plans reflected people's needs, preferences and lifestyle choices. Staff were observed supporting people at their own pace and with dignity.
“Care plans were person-centred and reflected both care needs and lifestyle choices.” from the report
Food and health support
People spoke positively about the food and were offered choices and drinks. The home worked with health professionals and followed their advice.
“People spoke positively about the food. We observed home cooked, well balanced meals being served to people and a range of drinks being offered.” from the report
Some training was overdue
needs fixingSome staff had not completed required initial or refresher training. Some Mental Capacity Act training was also overdue, although the manager knew about this and was arranging completion.
“Training records showed that some staff had not completed initial or refresher training as required.” from the report
Medicine expiry check
needs fixingOne medicine had passed its expiry date and had not been removed. A replacement was requested immediately, but the medicines audit had not identified the issue.
“We observed that one medicine had not been removed when the expiry date had passed, and this had not been picked up as part of the audit process.” from the report
Meals were sometimes delayed
needs fixingThere was a significant delay between hot meals being placed on a trolley and being delivered to people's rooms. The manager said changes were already being made.
“There was a significant delay from the time hot plated meals were placed on a trolley to be taken to the rooms and the time they were delivered to people.” from the report
Family communication
needs fixingSome relatives did not always receive clear information or feel fully involved in their loved one's care. The home agreed to consider how communication could improve.
“Some of the family members and representatives we spoke with indicated that they did not always feel fully involved with their loved ones needs and care.” from the report
- 01How have you made sure all staff have completed their required initial and refresher training?
- 02How do you check medicines are removed promptly when they reach their expiry date?
- 03What changes have you made to ensure meals are delivered promptly and remain hot?
- 04How will you keep relatives informed and involved, especially when visiting is restricted?
- 05How often are relatives asked for their views, and how are concerns followed up?
This was a targeted inspection widened to a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 23 September 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, July 2019
Rated Requires Improvement; inspectors found kind, personalised care and major progress, but safety records and quality checks were still not reliable.
This was an unannounced follow-up inspection after the home had previously been rated Inadequate and placed in Special Measures. Inspectors visited on 18 and 20 June 2019. They spoke with people, relatives, staff and a health professional, observed care and reviewed care, medicine, staff and management records.
The home had improved. People were treated with kindness and respect, received personalised care and had opportunities for activities and social contact. Staff understood people's needs and there were enough staff on duty. Food and mealtimes had also improved.
However, some risks were not recorded or monitored properly. Records about food and drink intake had gaps. Some medicine instructions were not kept with the medicine records. Quality checks had not reliably found these problems. This meant the home remained in breach of Regulation 17 on good governance.
The overall rating changed from Inadequate to Requires Improvement, and the home was no longer in Special Measures. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement, so the inspectors did not yet have full assurance that the improvements would last.
Kind, personalised relationships
Staff knew people well and provided care that reflected their history, preferences and communication needs.
“People received person centred care from staff who developed positive, meaningful relationships with them.” from the report
Improved meals and refreshments
People could choose where to eat, had menu choices and alternatives, and could access drinks and snacks around the home.
“There were drinks and snack stations throughout the home where people could help themselves to drinks, snacks and biscuits.” from the report
Good activities and social contact
People were supported to socialise and follow their interests, with activities including arts, reminiscence, singing and quizzes.
“People were encouraged to socialise and pursue their individual interests and hobbies if they chose to.” from the report
Open management culture
People, relatives and staff said the management was approachable and staff felt able to raise concerns.
“There was an open culture at the home. Staff were encouraged to challenge any practice concerns in confidence through a whistleblowing policy.” from the report
Incomplete food and drink monitoring
needs fixingRecords did not always show whether people at risk of dehydration or poor nutrition were offered extra drinks when their intake was low.
“The monitoring of intake had improved but remained insufficient to reduce the risks people faced.” from the report
Medicine instructions not always together
needs fixingSome instructions for when to give as-needed medicines were not kept with the medicine administration records. This could make it harder for staff to give medicines at the right time.
“Some of the information staff needed to decide when to give as and when medicines was not kept with the MAR.” from the report
Quality checks missed problems
seriousAudits did not consistently identify missing information about people's diets, care, medicines and risks. This was the continuing breach of Regulation 17.
“Systems to ensure the quality and safety of care people received were not embedded in the service.” from the report
Sensor mats needed review
needs fixingInspectors said the dark-coloured mats could be seen by people with dementia as holes or uneven flooring and could therefore act as a restraint.
“We recommend you review the sensor mats used in the home in line with good practice.” from the report
- 01How are you now checking that food and drink records are complete, especially when someone has a low intake?
- 02Where are the instructions for as-needed medicines kept, and how do you make sure staff can find and follow them?
- 03What changes have you made to audits so they identify missing information in care plans and risk assessments?
- 04What review has been completed of the dark-coloured sensor mats, and are they still being used?
- 05What actions from the improvement plan have been completed since this inspection, and what evidence can you show that improvements are now consistent?
This was an unannounced follow-up inspection covering all five key questions after the previous Inadequate rating and Special Measures. This explanation was written from the published report of 25 July 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 Kingland House Residential Home
7 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- September 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Kingland House Residential Home →
- July 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
Read what inspectors found at Kingland House Residential Home →
- July 2019Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2016Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- January 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.
- November 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 January 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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