CQC report explained · a residential care home
What the CQC found at Kiwi House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- Inspectors found that risks were assessed, reviewed and managed. Medicines, recruitment, safeguarding and infection control were also judged safe, although protocols for some medicines given when needed were not effective.
- Effective?
- Requires improvement
- This question was not covered by this focused inspection. Its previous rating carries over from the earlier comprehensive inspection.
- Caring?
- Good
- This question was not covered by this focused inspection. Its previous rating carries over from the earlier comprehensive inspection.
- Responsive?
- Good
- This question was not covered by this focused inspection. Its previous rating carries over from the earlier comprehensive inspection.
- Well-led?
- Requires improvement
- Management systems had improved and previous governance problems had been addressed. However, there was no registered manager at the time, and people and staff said they did not think there were enough staff.
What inspectors found, January 2022
Kiwi House was rated Requires Improvement overall, with safe care rated Good but leadership still needing improvement.
This was an unannounced focused inspection on 16 December 2021. One inspector spoke with people and staff, checked care, medicine and staff records, and reviewed management systems. The inspection covered only Safe and Well-led.
Inspectors found that risks were assessed and reviewed, medicines were generally managed safely, and there were enough trained staff. Infection prevention arrangements were also judged suitable. Improvements had been made since the previous inspection, including better care plan reviews, equipment checks and audits.
Safe was rated Good. Well-led remained Requires Improvement because there was no registered manager at the time and people and staff raised concerns about staffing levels. The report says the previous breaches of Regulations 12 and 17 had been addressed, so the home was no longer in breach.
The report contains a conflicting statement saying the overall rating changed to Good, but its rating table and the detailed findings give the overall rating as Requires Improvement.
Risk management improved
Risks were assessed and monitored, and care plans were reviewed when people's needs changed.
“We found risks were assessed and monitored and regular reviews of risk assessments were taking place.” from the report
Safe medicines practice
Inspectors found that medicines were administered safely and staff had been trained and checked as competent.
“Staff had been trained in administering medicine and had been assessed as competent.” from the report
Suitable staffing and recruitment
The inspector concluded that staffing levels were appropriate and found that recruitment checks were carried out safely.
“There were enough experienced and suitably trained staff to support people's needs.. and concluded that staffing levels were appropriate to ensure people's needs were met.” from the report
Better oversight
Audits were being used more effectively to identify improvements, and unsuitable equipment had been taken out of use.
“We observed that there had been significant improvements since our last inspection.” from the report
Medicine instructions
needs fixingSome instructions for medicines given when needed did not explain clearly enough when a person might need them, including signs of pain. The issue was acted on during the inspection.
“This meant that staff could not easily identify when the person may need the medication as they did not explain what signs to look out for when people may be in pain.” from the report
No registered manager
needs fixingThere was no registered manager when inspectors visited. A new manager had been recruited and was expected to apply for registration.
“There was no registered manager at the service and we had not received an application for a manager to register.” from the report
Concerns about staffing levels
needs fixingPeople and staff said they felt there were not enough staff. Inspectors recommended that the provider gather their views and consider these concerns.
“People and staff told us that they felt there were not enough staff.” from the report
- 01Has the new manager now started and registered, or applied to register, with the CQC?
- 02How have you checked whether staffing levels are enough, given that people and staff raised concerns?
- 03What changes were made to instructions for medicines given when needed, especially for recognising pain?
- 04How are audits now used to make sure equipment, care plans and risks remain up to date?
- 05Why does the report give an overall Requires Improvement rating in the rating table but also say that the overall rating changed to Good?
This was an unannounced focused inspection of Safe and Well-led only; the other question ratings were not reassessed and carry over from the previous comprehensive inspection. This explanation was written from the published report of 12 January 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, October 2021
Rated Requires Improvement; inspectors found progress since an Inadequate rating, but ongoing safety and management problems meant the home was not yet consistently safe or well-led.
This was an unannounced focused inspection on 25 August 2021. Two inspectors spoke with people living in the home, relatives and staff. They reviewed care records, medicines records, staff files and management records.
The home had improved from Inadequate to Requires Improvement. Inspectors found enough suitably trained staff and better safeguarding arrangements. A new manager was having a positive effect, but the changes were still recent.
There were still important safety problems. Risks were not always assessed, care plans had not been reviewed regularly, repositioning records were incomplete and medicines were not always given safely. The home remained in breach of Regulations 12 and 17.
The home was no longer in special measures. CQC asked for an ongoing action plan, will monitor progress and plans to inspect again.
Staffing
Inspectors found enough experienced and suitably trained staff to meet people's needs. The previous breach relating to staffing had ended.
“There were enough experienced and suitably trained staff to support people's needs.” from the report
Safeguarding
Safeguarding arrangements had improved, and staff said they knew how to recognise and report abuse. The previous safeguarding breach had ended.
“People were kept safe from abuse and avoidable harm.” from the report
New leadership
The new manager was making a positive impact and staff felt supported. The provider was open about the improvements still needed.
“There was a new manager who was making a positive impact on the service.” from the report
Medicines recording
Recording and administering topical creams had improved. The electronic medicines system and guidance for medicines given as needed were working well.
“They had changed to using an electronic recording system for medicines and it was working well.” from the report
Unreviewed care plans
seriousCare plans had not been reviewed since April 2021. This meant staff might not know about people's changing care needs.
“Care plans we looked at had not been reviewed since April 2021. This posed a risk to people because staff may not be aware of recent care needs.” from the report
Risks and repositioning
seriousSome risks had no assessment or clear instructions. Records showing whether people had been repositioned were incomplete, creating a risk to skin health.
“Some people needed to be repositioned regularly to ensure that they did not develop pressure sores.” from the report
Medicines safety
seriousStaff did not always clean their hands between people when giving medicines. The medicines trolley also lacked a proper waste facility.
“We observed medicine being given to people and there was no hand sanitiser or hand washing carried out between different people.” from the report
Equipment and infection control
needs fixingFour rusty commodes had not been removed from use. Inspectors also found protective equipment stored in sluice rooms, although the manager moved it during the inspection.
“There was a monthly commode audit which had identified four which were rusty. These had not been taken out of service at the time of our inspection.” from the report
- 01How are you now making sure every person's risk assessment and care plan is reviewed when their needs change?
- 02What checks make sure repositioning records are complete and staff follow the correct schedule?
- 03What changes have been made to medicines administration, hand hygiene and medicines trolley waste disposal?
- 04How are audits now signed off, and how do managers check that identified actions have been completed?
- 05What progress has been made on the ongoing action plan requested by CQC?
This was a focused inspection of Safe and Well-led only, so the other key questions were not assessed in this report. This explanation was written from the published report of 5 October 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 Kiwi House
5 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- January 2022Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2021Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- August 2021InadequateSafe: InadequateWell-led: Inadequate
- December 2020Inspected but not ratedSafe: Inspected but not rated
- August 2018Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016
Registered with the Care Quality Commission on 1 July 2016.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
78 live-in carers within about an hour of Derby
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 £1,020 to £1,260 a week. 62 can care for a couple. 12 years' experience on average.
“We particularly appreciate the companionship Dawn gives in the evenings when she plays cards and Scrabble with my mother.”
“Rachel is a quietly spoken, extremely caring person and looked after Val very well.”
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.