CQC report explained · a nursing home
What the CQC found at Kirk House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2020
Rated Good overall; inspectors found safe, kind and responsive care, but the home's quality checks needed improvement.
This was an unannounced inspection on 9 and 10 January 2020. The inspector spoke with five people, four relatives and six staff. They also checked care records, medicines records, recruitment information and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. People were protected from abuse, there were enough staff, medicines were usually given as prescribed, and staff supported people's health, choices, dignity and activities.
Well-led was rated Requires Improvement. Quality checks did not always identify problems or show what action was needed. The home was also advised to improve end of life planning and make the environment more dementia friendly.
The overall rating was Good. This was an improvement from Requires Improvement at the previous inspection in October 2018. A manager was now registered, so the earlier breach about there being no registered manager had been resolved.
Enough staff
Inspectors found enough staff to meet people's needs safely. Recruitment checks were also carried out.
“There were enough staff to ensure people's needs were met safely.” from the report
Kind and respectful care
People and relatives described staff as caring and thoughtful. Inspectors saw staff offering choices and protecting people's privacy and dignity.
“The registered manager and staff promoted a kind and caring environment.” from the report
Good food support
People could choose meals and alternatives. Staff knew about dietary needs, and advice was obtained from health professionals where needed.
“The dining experience was positive and calming. People were supported and given choice in a calm and unhurried way.” from the report
Activities and relationships
People could choose activities, spend time with visitors and access the local community. Additional activities support had increased one-to-one time for people unable to leave their rooms.
“People were supported to access the local community and spend time visiting family.” from the report
Quality checks were not reliable enough
needs fixingAudits did not always identify problems or clearly record what needed to happen next. Inspectors found gaps in oral health records, care plan checks, environmental records and the recording of risks.
“Quality assurance checks did not always highlight areas that needed improvement.” from the report
End of life wishes
needs fixingSome end of life plans were in place, but people's wishes about their care were not consistently discussed and recorded. The provider was advised to seek guidance on this.
“However, people's wishes in respect of their care during their end of life had not been consistently gained.” from the report
Dementia-friendly environment
minorBedrooms did not have posters or boxes with recognisable items to help people identify their own rooms. The provider was advised to consider dementia-friendly guidance.
“There were no posters or boxes on people's bedroom doors to help them identify their own rooms.” from the report
Protective equipment during medicines rounds
minorInspectors saw some nurses administering medicines without consistently wearing protective equipment. This was raised during the inspection and the clinical lead said nurses would be reminded.
“We observed a number of nurses administering medicines and saw they did not consistently wear personal protective equipment (PPE) when administering people's medication.” from the report
- 01What changes have been made to the quality checks since the inspection, and how do you make sure actions are followed up?
- 02How are each person's end of life wishes discussed, agreed and recorded?
- 03What changes have been made to help people living with dementia identify their bedrooms?
- 04How do you check that staff wear the required protective equipment when giving medicines?
- 05How are relatives involved in reviewing and updating their family member's care plan?
This was an unannounced planned inspection covering all five key questions, following the previous Requires Improvement rating. This explanation was written from the published report of 18 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.
What inspectors found, January 2019
Rated Requires Improvement; inspectors found kind care and enough staff, but gaps in safety, personalised care and management.
This was an unannounced inspection on 26 November 2018. Inspectors spoke with people using the home, relatives, staff and managers. They reviewed care and medicines records, audits, incidents and staff training records.
People were generally treated kindly and with respect. There were enough staff, medicines were given as prescribed, staff were trained, and people's food and healthcare needs were supported. However, guidance for some health conditions was missing, hazardous substances were not always stored safely, and records did not always show how risks were managed.
The home was rated Requires Improvement overall. Safe, Responsive and Well-led were Requires Improvement, while Effective and Caring were Good. All five areas had been rated Good at the previous inspection in May 2016.
Kind and respectful care
People said staff were kind and compassionate. Inspectors observed staff respecting privacy, dignity and personal choices.
“People living at Kirk House told us that they received care that was kind and compassionate.” from the report
Enough staff
The report found enough staff to meet people's care and support needs. Recruitment checks were also in place.
“There were enough staff to meet the needs of the people living at Kirk House.” from the report
Medicines and safeguarding
People said they received medicines on time. Staff understood how to protect people from abuse and harm, and medicines records showed administration and signatures.
“People told us that they received their medication on time.” from the report
Food and healthcare support
People's dietary needs were catered for, with different food options and support at mealtimes. The home worked with healthcare professionals when people's needs changed.
“There were choices of food available and these were presented to people at each meal time.” from the report
Health condition guidance
seriousStaff did not have clear instructions for managing some specific health conditions, including abnormal blood glucose readings. Inspectors said this could lead to inappropriate or inconsistent care.
“This meant that people were placed at risk of receiving inappropriate and inconsistent care.” from the report
Unsafe storage
seriousA cupboard containing prescription creams and a COSHH cupboard were found unlocked. The prescription cream cupboard was locked later that day, but the laundry room remained open during the inspection.
“This meant that people who were using the service were put at risk of coming into contact with substances, chemicals and equipment that, if not used correctly, could cause significant harm to people.” from the report
Limited personalised activities
needs fixingPeople said they were bored and activities were not regular, meaningful or based consistently on individual interests. Inspectors saw only a short quiz during the inspection.
“The activities that took place were not always person-centred or meaningful for people.” from the report
End of life planning
needs fixingThe home did not consistently record people's wishes or preferences for end of life care. Staff were sometimes waiting for relatives or further medical information before discussing these wishes.
“People did not always have their end of life needs and wishes assessed in a timely way.” from the report
Management and quality checks
seriousThere was no registered manager, and the home's monitoring systems had not identified issues found by inspectors. This was a breach of a legal requirement.
“The failure to ensure that a manager who is registered with the Commission was in post constitutes a breach of Regulation 33 of The Health and Social Care Act (2008).” from the report
- 01What clear written guidance is now in place for people with specific health conditions, including diabetes and abnormal blood glucose readings?
- 02How do you make sure prescription creams, chemicals and laundry equipment are kept safely away from people?
- 03How are people and their relatives involved in creating and reviewing care plans, including personal preferences and life histories?
- 04How do you record and review each person's end of life wishes before their health deteriorates?
- 05Who is now responsible for management, and what quality checks are used to make sure problems are found and fixed?
This was an unannounced inspection covering all five key questions; the report says all five ratings had been Good at the May 2016 inspection. This explanation was written from the published report of 3 January 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 Kirk House Care Home
6 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Goodup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2015Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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