CQC report explained · a residential care home
What the CQC found at Kingshill
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, robust recruitment checks, suitable training and systems to protect people from abuse and manage risks. Medicines and infection prevention were also found to be managed safely.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its rating was carried forward from the previous comprehensive inspection, but that rating is not stated in this report.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its rating was carried forward from the previous comprehensive inspection, but that rating is not stated in this report.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its rating was carried forward from the previous comprehensive inspection, but that rating is not stated in this report.
- Well-led?
- Good
- Inspectors found that audits and governance systems had been substantially improved. They also found an open culture where people and staff were encouraged to contribute to improvements.
What inspectors found, May 2023
Rated Good; inspectors found safe care, improved leadership and a strong focus on helping people live more independently.
This was an unannounced focused inspection on 26 and 28 April and 9 May 2023. Inspectors checked whether improvements promised after the previous inspection had been made. They spoke with people using the service, relatives, staff and other professionals, and reviewed care, medicines, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, suitable recruitment checks, relevant staff training and safe medicines systems. People were protected from abuse, risks were assessed and incidents were recorded and reviewed.
The previous inspection rated the home Requires Improvement and found breaches involving staffing and governance. Inspectors found enough improvement had been made, so the home was no longer in breach. The overall rating changed to Good, although the other three key question ratings were carried forward from the previous comprehensive inspection because they were not examined during this visit.
Enough staff and training
Inspectors found enough staff to support people and robust checks when recruiting. Staff received role-related training and regular refreshers.
“Staff training compliance was maintained.” from the report
People felt safe
People and relatives told inspectors they felt safe. Staff had safeguarding training and knew how to report concerns.
“People were protected from the risks of abuse and staff were trusted to keep them safe.” from the report
Safe medicines support
Medicines were given on time and staff were trained and checked as competent. People were supported to take more responsibility for their own medicines where this was safe.
“Staff supported people to be independent with taking their medicines.” from the report
Focus on independence
The management team focused on building people's skills and confidence. Inspectors said the service's culture had improved people's quality of life.
“The management team's primary focus was to develop people's skills and confidence and provide them with the tools needed to live more independently.” from the report
Improved oversight
The home introduced a new electronic auditing system and a new governance framework. These changes helped managers monitor audits, safeguarding referrals and notifications to the CQC.
“Auditing systems had improved and were robust.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the current ratings and findings for Effective, Caring and Responsive, which were not assessed during this inspection?
- 02How do you check that staffing levels remain enough for people's needs, including at night and when staff are absent?
- 03How are people supported to manage their own medicines, and how do you review whether this remains safe?
- 04What changes have been made to help people develop skills and move towards more independent living?
- 05How do people and relatives contribute to the home's improvement plans and meetings?
This was an unannounced focused inspection of Safe and Well-led only; the other three key question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 23 May 2023 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, August 2021
Kingshill Rehabilitation and Outreach Service is rated Requires Improvement; inspectors found safe medicines and trusted staff, but gaps in staffing, safeguarding and management systems.
This was a focused inspection after concerns about medicines and how the service was managed. Inspectors visited on 4, 7 and 18 June 2021, spoke with people, relatives and staff, and checked care, medicines, staffing and management records.
The home was not always safe. Some staff had not completed required training, staff skills were not always properly matched to people's needs, and there was no reliable system for deciding how many staff were needed. Safeguarding concerns were not always identified or passed to the local authority.
Medicines were managed safely. People's risks were assessed and care plans gave staff information about how to support them. Infection control arrangements were mostly suitable, although some checks and signs were missing.
The home is rated Requires Improvement overall, with Safe and Well-led both rated Requires Improvement. The other three areas were not inspected at this visit, so their previous ratings were carried forward. The previous overall rating was Good.
Safe medicines
Inspectors found that medicines were administered safely and on time. Staff had training and regular checks before administering medicines.
“Medicines were managed safely. People received their medicines in a safe way and systems ensured timely administration of medicines.” from the report
Risk information
People's care needs and risks were assessed. Care plans gave staff information about how to manage identified risks.
“People's care needs were risk assessed and care plans provided staff with the information they needed to manage the identified risk.” from the report
People felt safe
People told inspectors they trusted staff to keep them safe. Staff knew how to report safeguarding concerns.
“People told us they trusted staff to keep them safe.” from the report
Staff support
Staff said they felt supported by the acting manager and provider.
“Staff felt supported and praised the acting manager and provider.” from the report
Staff training and staffing levels
seriousSome staff had not completed important training, including conflict management and breakaway training. The home did not have a systematic way to decide or regularly review staffing numbers and skills.
“The provider did not have a systematic approach to determine and regularly review the number of staff needed to meet the needs of people using the service.” from the report
Safeguarding oversight
seriousSafeguarding concerns were not always identified, escalated to the local authority or reported to the CQC when required.
“In this period, we found two incidents where the provider failed to oversee and escalate safeguarding concerns to the relevant local authority.” from the report
Weak management checks
seriousAudits and governance systems did not identify some of the problems found by inspectors. Monthly care plan reviews did not always happen.
“Governance systems did not identify some of the issues we found during the inspection.” from the report
Limited evening food choices
needs fixingAfter 8pm, people could not access snack foods other than fruit because of the healthy eating approach. The management team changed this during the inspection.
“People were unable to access any other snack type foods besides fruit after 8pm, due to the service trying to promote healthy eating for all people.” from the report
Some infection control checks missing
minorCleaning had increased and staff used protective equipment correctly, but there was no high-touch-surface checklist. Social distancing signs and clear areas for putting on and removing protective equipment were also missing.
“However, a specific checklist for high touch surfaces was not in place.” from the report
- 01Which staff training was incomplete at the inspection, and has all required training now been completed?
- 02How do you now assess the number and mix of staff needed on each shift?
- 03How are safeguarding concerns recorded, escalated to the local authority and reported to the CQC?
- 04How often are care plans now reviewed, and how do managers check that reviews are completed?
- 05What food and snack choices are available after 8pm?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 5 August 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.
Every inspection of Kingshill
4 rated inspections over 8 years: the service has held its Good rating throughout.
- May 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- October 2017Goodstayed GoodSafe: GoodWell-led: Good
- August 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 23 November 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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