CQC report explained · a nursing home
What the CQC found at Kingston Rehabilitation Centre
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2023
Rated Good; inspectors found safe care and good management, with some improvements needed in risk guidance and family communication.
This was an unannounced focused inspection on 10 January 2023. Two inspectors spoke with people living at the home, relatives, staff and managers. They reviewed care and medicines records, staff files, incidents, policies and audits.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe recruitment, suitable safeguarding arrangements, safe medicines management and good infection control. Risks were assessed, although some risk guidance needed more clarity and was updated after the inspection.
The inspection followed concerns about staffing, staff conduct and visiting restrictions. Inspectors found no evidence that people were at risk of harm from these concerns. Some relatives wanted more frequent updates about day-to-day care, so communication books had been introduced and a weekly open afternoon was planned.
Only Safe and Well-led were inspected during this visit. The Effective, Caring and Responsive ratings were carried forward from the previous inspection, and the overall rating remained Good.
Staffing and recruitment
Inspectors found enough staff to keep people safe. Recruitment records included suitable checks and employment information.
“People continued to received care and support from sufficient numbers of staff to keep them safe.” from the report
Safeguarding
Staff knew how to recognise and report abuse and how to raise concerns outside the organisation. The concerns about staff conduct were not substantiated during the inspection.
“Staff were clear on how to escalate concerns both inside the organisation and were confident to whistle blow to the local authority or Care Quality Commission.” from the report
Medicines support
People received medicines when needed, with arrangements for medicines taken only when required. Staff also supported people to become more independent with medicines.
“Records showed that people received their medicines when they needed them, with protocols in place for 'as needed' medicines.” from the report
Management oversight
Managers carried out checks on care records, medicines records and daily safety. People, relatives and staff were generally positive about the management.
“The management team had clear oversight of the governance and day to day running of the service.” from the report
Risk guidance needed more clarity
needs fixingInspectors said some steps to reduce risks were not clear enough at the time of the visit. Updated risk assessments were provided after the inspection, so ask how these are kept current and followed.
“At the time of inspection the provider recognised that steps to mitigate risk would have benefited from additional clarity.” from the report
Family communication
needs fixingSome relatives said they did not receive updates about day-to-day care as often as they wanted. The home had introduced communication books and planned a weekly open afternoon in response.
“Some relatives told us they felt that feedback in relation to their loved ones day to day care needs was not as frequent as they would like.” from the report
Call-bell monitoring
minorCall bells were found within people's reach, but response times were not yet linked to the electronic case management system for analysis. The provider said it planned to introduce this.
“We will review their progress at our next inspection.” from the report
- 01How do you make sure each person's updated risk assessment is clear and followed by all staff?
- 02How will families receive regular updates about day-to-day care, and when will the weekly open afternoon begin?
- 03How do you monitor call-bell response times while the planned electronic analysis is being introduced?
- 04What staffing levels are in place for people with nursing, neurorehabilitation or specialist tracheostomy needs?
- 05How will the home keep families informed if there is an incident or a change in someone's needs?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried forward from the previous inspection. This explanation was written from the published report of 18 February 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, February 2022
Rated Good overall; inspectors found people were safe and the home was well managed, but medicines records and staffing levels needed attention.
This was a focused inspection after concerns about a COVID-19 outbreak and several safeguarding concerns. Inspectors visited on 25 January 2022, spoke with people, staff and a relative, and reviewed records and recruitment files.
The home was rated Good for Safe and Well-led. Inspectors found robust safeguarding arrangements, suitable infection control, safe recruitment, risk assessments and regular checks on the building. They also found a positive atmosphere and management that listened to people and staff.
The overall rating was Good, but this visit only assessed Safe and Well-led. The ratings for Effective, Caring and Responsive were carried forward from the previous inspection. Inspectors found no evidence that people had been harmed by the concerns that prompted this visit.
Safeguarding
Staff knew how to recognise and report abuse. Inspectors found that safeguarding concerns were responded to promptly and efficiently.
“We were assured that the provider had thorough guidance in place and responded to safeguarding concerns promptly and efficiently.” from the report
Infection control
The home was managing COVID-19 risks, including visitor checks, testing, vaccination requirements and the use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Positive atmosphere
People, relatives and staff described the home positively. Inspectors saw a warm and relaxed atmosphere where people and staff appeared comfortable with each other.
“Throughout the inspection we observed a warm and inviting atmosphere where people and staff members appeared at ease with one another.” from the report
Management and oversight
The manager understood their responsibilities and regular audits were used to identify and address improvements.
“Regular quality assurance checks were carried out to ensure that areas for improvement and continuing areas of good practice were identified.” from the report
Medicines records
needs fixingThe reasons why some medicines were not given were not always recorded clearly. The manager arranged training for relevant staff after inspectors raised this.
“We identified occasions where the reasons for non-administration of medicines was not always clearly recorded on the back of people's medicines administrations records.” from the report
Staffing levels
needs fixingSome people and staff said there were times when staffing was too low, particularly given people's complex needs. Recruitment was continuing and the home was using regular agency staff to cover gaps.
“Staff told us the allocation of staff is flexible due to the changing needs of the people they supported, however, there are times when they are short staffed.” from the report
- 01How do you now check and record the reason whenever a medicine is not given?
- 02Have staffing levels improved since the inspection, and how do you cover shifts when there are gaps?
- 03How do you make sure there are enough staff on each floor for people with complex needs?
- 04How are safeguarding concerns reported, investigated and followed up?
- 05How will my relative's rehabilitation needs be discussed with the therapy team and other healthcare services?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 10 February 2022 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 Kingston Rehabilitation Centre
3 rated inspections over 3 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Kingston Rehabilitation Centre →
- February 2022Goodstayed GoodSafe: GoodWell-led: Good
Read what inspectors found at Kingston Rehabilitation Centre →
- August 2019GoodSafe: GoodWell-led: Good
- December 2021
Registered with the Care Quality Commission on 1 December 2021.
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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At least 100 live-in carers within about an hour of Kingston upon Thames
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 82 can care for a couple. 11 years' experience on average.
“Without his support we wouldn't have been able to navigate bringing and keeping Dad at home.”
“We cannot speak highly enough of the care that Angelique gave, and would recommend her to anyone else needing a live-in carer.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.