CQC report explained · a residential care home
What the CQC found at Kittens Lane
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective systems for safeguarding, risk management, staffing, medicines, infection control and learning from accidents. There were enough staff and recruitment checks were carried out safely.
- Effective?
- Good
- People's health, dietary and hydration needs were assessed and met. Staff had relevant training and supervision, and worked with health and social care professionals.
- Caring?
- Good
- Staff knew people well, treated them with dignity and respect, and encouraged independence. Inspectors saw warm and positive relationships between people and staff.
- Responsive?
- Good
- Care plans were personalised and included people's preferences, health needs and support requirements. People had activities and opportunities to access the community, and complaints were managed under the provider's procedure.
- Well-led?
- Good
- Management audits and reviews were used to identify and act on shortfalls. Inspectors found improvement since the previous inspection, when Well-led was rated Requires Improvement, although relatives gave mixed feedback about communication.
What inspectors found, May 2019
Kittens Lane was rated Good; inspectors found safe, kind and personalised care, with some communication problems for relatives.
This was a comprehensive, unannounced inspection on 10 April 2019. One inspector observed care, reviewed three people's records and checked medicines, risk assessments, staffing, training, recruitment and quality audits. The inspector also spoke with staff, a relative and community professionals.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough safely recruited staff, suitable medicines checks, detailed care records, good support with food and health, and respectful care that promoted people's independence.
People had regular activities and links with their community. Their end of life wishes were recorded, although nobody was receiving end of life care during the inspection. Relatives' views were generally positive, but communication with families was not always consistent.
The previous inspection in October 2016 rated the service Good overall, but Well-led required improvement. This inspection found that the management and quality monitoring systems had improved, so all five ratings were Good.
Safe medicines systems
Medicines were stored securely and staff had their administration skills checked. Regular audits were used to identify and address problems.
“Regular audits and checks on medicines supported the registered manager to identify and address any shortfalls promptly.” from the report
Kind and respectful care
Staff knew people well and adapted how they communicated with them. Inspectors saw people being treated with warmth, dignity and respect.
“Positive and caring relationships between people and staff were seen throughout the inspection.” from the report
Personalised support
Care plans gave staff detailed guidance about personal care, health needs, medicines, eating and drinking, and reducing social isolation.
“People's care plans were personalised and included information for staff on how best to support them with personal care, eating and drinking, medicines and other day to day activities.” from the report
Improved management checks
The home had strengthened its systems for monitoring quality, including audits and action plans when problems were found. This was an improvement from the previous inspection.
“We found that improvements had been made to the systems and procedures used to monitor and improve the quality of the service provided.” from the report
Communication with relatives
needs fixingRelatives gave mixed feedback. One relative said they had not always been told about a change of key worker, and that some arrangements were not followed through. The home said it was putting improved communication systems in place.
“One relative described being well informed and updated about arrangements in place, whilst another relative shared examples of not being aware when a key worker had changed, and arrangements not always being followed through.” from the report
- 01How will you make sure relatives are told promptly if a key worker changes?
- 02How do you record and follow through on arrangements agreed with relatives?
- 03How will families be involved in the revised surveys and family meetings?
- 04What additional training will staff receive for end of life care, positive behaviour support and bowel care?
- 05How often will you review the audits and action plans that monitor the quality of care?
This was a comprehensive unannounced inspection that considered all five CQC questions and both the premises and care provided. This explanation was written from the published report of 18 May 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.
What inspectors found, December 2016
Rated Good overall; inspectors found safe, effective, caring and responsive care, but the home was rated Requires Improvement for being well-led.
The inspection was unannounced and took place on 21 October 2016. One inspector observed care, reviewed records and medicines for four people, checked staff and safety records, and spoke with staff, professionals and relatives.
The home supported ten people with learning disabilities and complex needs. Inspectors found improvements since October 2014. Medicines, staffing, recruitment and risk management were safer. Staff were skilled, kind and understood people's needs, choices and communication.
The main weakness was leadership. Record keeping was still being improved, training records were not reliable, and some staff and relatives lacked confidence about raising concerns openly. The overall Good rating means the inspectors found the service met the required standard overall, but well-led practice needed further work.
Safer medicines
Medicines were stored, given and recorded safely. Inspectors found that balances could be checked and people were receiving medicines as prescribed.
“Medicines were managed safely. People received their medicines in a safe way and as the prescriber intended.” from the report
Kind and respectful staff
Staff built warm relationships with people and treated them with dignity. They understood individual communication, preferences and personal care needs.
“Staff were kind, compassionate and warm in the way they supported people.” from the report
Skilled support
Staff had training, supervision and knowledge of people's health needs. They worked with health professionals and followed advice about people's wellbeing.
“Two health professionals, who had provided support and advice to the service, also expressed their confidence in staff skills, knowledge and competence to meet people's needs.” from the report
Improvement since 2014
The report says the home had improved its medicines systems, risk assessments, care records and quality checks since the previous inspection.
“At this inspection, we found that they had made improvements.” from the report
Manager visibility and openness
needs fixingSome staff and relatives felt the manager was not regularly present or fully aware of day-to-day events. Some were not confident they could raise views without repercussions.
“Some staff and relatives expressed concerns that the registered manager was not fully aware of what was going on in the service and did not understand people's needs well.” from the report
Training records
needs fixingStaff said they had useful training, but the records were out of date or hard to find. This made it difficult to confirm which training had been completed and renewed.
“However, training records made it difficult to verify this.” from the report
Care plans and activities
needs fixingFurther work was needed to make care plans clearer about people's goals and outcomes. Inspectors also found that some people spent a lot of time relaxing in the home, so activity planning was being reviewed.
“The action plan showed that they found there was a lack of clear guidance for staff about support planning, particularly around goals and outcomes.” from the report
Inconsistent choking guidance
needs fixingOne staff explanation about managing choking risk did not fully match the written care guidance. Inspectors raised this so the provider could ensure staff followed a consistent approach.
“However, one explanation we received did not quite match the directions within the person's care records for keeping them safe.” from the report
- 01What has been done to make training records complete, current and easy to find?
- 02How often is the manager now present in the home, and how are the planned spot checks carried out?
- 03How have care plans been updated to include clear goals and outcomes for each person?
- 04How often are relatives invited to care reviews, and are they given notes afterwards?
- 05What activities and community opportunities are now available for people who do not attend regular day services?
This was an unannounced inspection covering all five CQC questions; the inspector observed care, reviewed records and medicines, and gathered views from staff, professionals and relatives. This explanation was written from the published report of 3 December 2016 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 Kittens Lane
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- May 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- June 2011
Registered with the Care Quality Commission on 10 June 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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13 live-in carers within about an hour of Norfolk
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 £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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