CQC report explained · a nursing home
What the CQC found at Kitnocks House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2022
Rated Good; inspectors found safe care and positive leadership, but medicines records, staffing continuity and communication needed attention.
This was an unannounced inspection on 25 and 30 May 2022. The inspection team spoke with relatives and staff, reviewed care and medicines records, checked recruitment files and looked at the home's management systems.
The home was rated Good overall. Safe and Well-led were both rated Good. People were given care that met their needs, risks were assessed, safeguarding systems were in place and staff were observed to be responsive and unhurried.
There were some shortfalls. Medicines were not always stored as recommended, and some medicines records were incomplete. Relatives and staff gave mixed views about staffing levels, activities and communication. The home was using a new electronic medicines system and was taking action to improve it.
Individual medicines support
People were given medicines in a way that met their individual needs. A new electronic medicines system was being introduced and the management team was responding to issues found during its implementation.
“People were given their medicines in a way that met their individual needs.” from the report
Risk and safeguarding
Risks were recorded in care plans and staff knew how to recognise and report abuse. Accidents and incidents were reviewed for patterns, with changes made where needed.
“There were appropriate policies and systems in place to protect people from abuse.” from the report
Responsive staffing arrangements
Although staffing feedback was mixed, inspectors saw safe staffing levels and staff who appeared unhurried and responsive. The provider was taking steps to recruit and retain staff.
“We observed safe staffing levels throughout the inspection and staff appeared unhurried and responsive to people.” from the report
Clean and infection-safe environment
Inspectors were assured that infection prevention arrangements were in place, including safe visiting, use of protective equipment and cleaning.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Quality monitoring
The home used audits, action plans and governance meetings to monitor care and plan improvements. The provider had also introduced electronic care planning and quality systems.
“Where the quality assurance audits identified issues, remedial action was taken.” from the report
Medicines records and storage
seriousAllergies and people's preferences were not always recorded. Some medicines were not stored in line with recommendations, including concerns about temperature monitoring. The report recommended improvements to storage.
“Allergies were not consistently recorded on medicines administration records (MARs).” from the report
Staffing continuity
needs fixingRelatives and staff gave mixed feedback about staffing levels and the high use of agency staff. Some relatives experienced waits for staff support when visiting.
“All in all, I'm not very happy, there are lots of agency staff, no continuity” from the report
Activities
needs fixingThere was no activities team at the time of the inspection. The home was developing more personalised activities and planned to recruit an activities coordinator.
“At the time of the inspection the provider did not have an activities team.” from the report
Communication
needs fixingSome relatives and staff said communication could be better. Some relatives were not kept updated about management changes, and some had difficulty getting through by telephone.
“However, there were some staff who felt communication could be improved from the management team.” from the report
Visitor booking system
minorSome relatives said the booking arrangements limited visiting times and were not always managed effectively.
“Some relatives told us they felt the booking system for visitors was not always effectively managed and could be improved on.” from the report
- 01How are allergies, medicine preferences and medicines given when needed recorded on the new electronic medicines system?
- 02What has been done to make sure medicines are stored at the correct temperature and that all medicines trolleys have working thermometers?
- 03How many regular staff and agency staff are currently working in the home, and what is being done to improve continuity?
- 04What activities are now available, including personalised one-to-one activities, and has an activities coordinator been appointed?
- 05How will relatives be kept informed about management changes and how can they contact the home outside visiting hours?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive carried over from the previous comprehensive inspection. This explanation was written from the published report of 4 August 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.
What inspectors found, February 2021
Kitnocks House was rated Good; inspectors found safe, person-centred care, but saw problems with infection-control practice, topical medicines records and staff morale.
This was an unannounced focused inspection on 2 and 12 November 2020. Inspectors examined concerns about skin care, staffing, hidden medicines, fire training, staff morale and complaints. They also checked infection-control arrangements during the COVID-19 pandemic.
The safe and well-led questions were both rated Good. Relatives said people were safe and well cared for. Inspectors found enough staff, suitable safeguarding and recruitment checks, safe medicines processes overall, detailed care plans and regular management audits.
There were some shortfalls. Staff did not always follow social-distancing guidance during breaks, topical creams were not always recorded as given, and high use of agency staff had affected morale. The provider took action on social distancing and agreed to improve medicines audits.
The overall rating stayed Good, matching the previous rating published in August 2017. Effective, Caring and Responsive were not inspected during this visit, so their previous ratings were carried forward.
Safeguarding
Staff knew how to recognise and report abuse. Relatives said people were kept safe.
“Staff had the knowledge and confidence to identify safeguarding concerns and act on them and knew how to whistle blow.” from the report
Person-centred care
Inspectors found detailed care plans and examples of care being adapted to people's individual routines and needs.
“Care plans we looked at were very detailed and person centred.” from the report
Staffing and recruitment
Inspectors found enough staff on shift and appropriate checks before staff were employed.
“Recruitment processes checked staff for suitability before being employed by the service.” from the report
Working with professionals
The home worked with health and support services and people had access to a range of specialist services.
“The service worked in close partnership with health and support services.” from the report
COVID-19 social distancing
needs fixingInspectors saw staff not following social-distancing measures during breaks and in a management discussion. The provider acted afterwards by adding markers and speaking to staff.
“We were not assured that the provider was consistently meeting shielding and social distancing rules.” from the report
Topical medicines records
needs fixingRecords did not always show when prescribed topical creams had been given. The manager agreed that medicines audits and staff practice needed to improve.
“However, we found that staff did not always record on people's MAR when they had administered their topical creams.” from the report
Agency staffing and morale
needs fixingThere was a very high use of agency staff, especially on night shifts. Some staff said this had put pressure on permanent staff and lowered morale.
“However, there was a very high use of agency staff especially during the night shifts.” from the report
Quality audits
needs fixingThe home's audits did not identify the medicines-recording and infection-control issues found during the inspection. The manager said the medicines audit would be expanded.
“However, improvements were needed to identify the issues we found during the inspection.” from the report
- 01How do you now check that every topical cream is recorded when it is given?
- 02What changes have you made to keep staff socially distanced during breaks?
- 03How many permanent night staff do you now have, and how much agency cover is still being used?
- 04How do your audits now identify missed medicines records and infection-control problems?
- 05What were the previous ratings for Effective, Caring and Responsive, which were not inspected during this visit?
This was a focused inspection of Safe and Well-led, including infection control; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 17 February 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 Kitnocks House
4 rated inspections over 7 years: the service has held its Good rating throughout.
- August 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2021Goodstayed GoodSafe: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- November 2012
Registered with the Care Quality Commission on 1 November 2012.
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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