CQC report explained · a nursing home
What the CQC found at Kingsgate Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Medicines, risks, recruitment and infection control were generally managed safely, although some guidance for medicines taken when needed was not detailed enough.
- Effective?
- Requires improvement
- This question was not covered by this focused inspection. Its previous rating was carried forward.
- Caring?
- Good
- This question was not covered by this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This question was not covered by this focused inspection. Its previous rating was carried forward.
- Well-led?
- Good
- The home was well managed, staff felt supported and leaders understood their responsibilities. However, quality assurance systems still needed further development.
What inspectors found, May 2021
Kingsgate Care Home rated Good; inspectors found safe, kind care, but some medicine guidance and quality checks still needed improvement.
This was an unannounced, focused inspection on 14 April 2021. Two inspectors spoke with people, a relative and staff. They observed care and reviewed care, medicine, staffing and management records.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found a warm, clean home, kind staff, safe medicines systems and suitable checks to protect people from harm.
The inspection also found some remaining weaknesses. Guidance for some medicines taken when needed was not detailed enough, and quality checks did not yet fully show whether improvements were working.
The previous rating was Requires Improvement, with three breaches. Inspectors found enough improvement had been made and the home was no longer in breach. The other three question ratings were carried forward from the previous comprehensive inspection.
Kind and welcoming care
Inspectors found a homely atmosphere and positive relationships between staff and residents. Staff were described as friendly, considerate and supportive.
“Kingsgate had a homely, caring environment and promoted a positive culture.” from the report
Safe medicines systems
Medicines were generally given as prescribed. Staff were trained, their competence was checked, and medicine records were completed correctly.
“People received their medicines in a safe supportive way, as prescribed.” from the report
Clean and infection-aware home
The premises were very clean. Inspectors found that infection prevention measures, including cleaning, protective equipment and testing, were in place.
“Regular cleaning, high surface cleaning and deep cleaning was observed throughout the day.” from the report
Supportive leadership
Staff understood their roles and felt supported by managers. Leaders carried out audits and responded to safeguarding concerns and required notifications.
“The service was consistently well managed with effective organisation and leadership.” from the report
Medicine guidance
needs fixingSome instructions for medicines taken when needed were not detailed enough. Inspectors gave the example of laxative guidance that did not say how long someone should go without opening their bowels before it was offered.
“The guidance for the administration of a laxative PRN did not tell staff how many days the named person should go without having their bowels open before offering the laxative.” from the report
Quality checks not complete
needs fixingThe home had audits and an improvement plan, but it had not yet completed the final checks showing whether new systems and initiatives were improving care and outcomes.
“However, the final element of the quality assurance cycle was still required to ensure new systems and initiatives were reviewed to ensure they were producing demonstrable quality improvement to the service and positive outcomes for people.” from the report
Staff cover during absence
minorThere were six care staff on duty during the visit because of sickness and annual leave, instead of the usual eight. Staff said they might not spend as much time with residents when there was unplanned absence.
“On these occasions they said they may not be able to spend as much time with people as they liked.” from the report
- 01What has been changed in the guidance for medicines taken when needed, especially laxatives?
- 02How do you check that new improvement actions are working and improving outcomes for residents?
- 03How do you cover sickness and annual leave, and what happens if several staff are absent?
- 04What were the results of the recent satisfaction surveys, now that they have been analysed?
- 05What were the ratings for Effective, Caring and Responsive at the last comprehensive inspection?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 13 May 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, February 2020
Rated Requires Improvement; inspectors found kind and responsive care, but medicines safety, staff training and management oversight were not reliable.
This was the home’s first inspection since it registered. Inspectors visited unannounced on 3 and 7 January 2020. They spoke with people, relatives, staff and visiting professionals, and checked care records, medicines records, staff files and management records.
The home was caring and responsive overall. People were treated with kindness and respect, had support to stay independent, and could take part in activities inside and outside the home. Their health, food and end of life needs were generally supported well.
There were important safety and management problems. Medicines were not always given, recorded, stored or disposed of safely. Some staff had not received training for complex needs, including Parkinson’s. Care plans and risk assessments did not always give enough personalised information.
The home was rated Requires Improvement overall. It also Requires Improvement for Safe, Effective and Well-led, and was rated Good for Caring and Responsive. CQC found breaches relating to safe medicines, governance and failure to notify CQC about some incidents. A warning notice was issued about medicines.
Caring relationships
People, relatives and professionals described the care positively. Inspectors saw staff treating people with dignity, kindness and respect.
“People, relatives and professionals told us people were well cared for.” from the report
Enough staff
Recruitment checks were completed safely. People and relatives said there were enough staff, and inspectors saw staff respond quickly to call bells.
“Recruitment processes were safe. Checks to ensure staff were fit to carry out their role had been completed.” from the report
Health and food support
People had regular contact with health professionals and were offered choices of food and drink. Staff also supported oral health.
“People's records confirmed they had regular support from healthcare professionals and support from where required to maintain their health needs.” from the report
Activities and community access
People were supported to join activities in the home, go outside and maintain cultural and community links.
“People were supported to access activities both internal and external to the home.” from the report
Unsafe medicines practice
seriousSome people did not receive medicines as prescribed. Records also had missing signatures, unclear stock information and medicines that had not been disposed of when required.
“Medicines were not well managed. People did not receive their medicines as prescribed by their GP.” from the report
Poor follow-up of medicine errors
seriousEarlier medicine incidents were not properly investigated or used to prevent a repeat. CQC found that people were at risk even though no direct harm was identified.
“Lessons were not always learnt where medicines errors had taken place.” from the report
Gaps in staff training
needs fixingStaff had not always received training for complex needs, including Parkinson’s. A medicine error was not always followed by a supervision or competency check.
“The home supported people with complex needs, and staff had not always had all the training needed to ensure they understood and followed best practice.” from the report
Weak management checks
seriousThe home’s quality checks did not identify the problems found during inspection. Incidents did not always lead to learning or improved practice.
“The lack of robust quality assurance meant people were at risk of receiving poor care.” from the report
- 01What changes have been made to ensure every medicine is given at the right time and recorded correctly?
- 02How do you check medicine stocks, patches and eye drops, and what happens after a medicine error?
- 03What training have staff completed for Parkinson’s and other complex needs?
- 04How are care plans now made more personal, including people’s preferences, communication needs and risks?
- 05How does management check quality, report safeguarding incidents and make sure lessons are acted on?
This was a first, unannounced inspection covering all five CQC questions, with both the care and the premises looked at. This explanation was written from the published report of 1 February 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 Kingsgate Care Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- May 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2020Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2019
Registered with the Care Quality Commission on 3 January 2019.
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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