CQC report explained · a nursing home
What the CQC found at Knappe Cross Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2023
Knappe Cross Care Centre is rated Requires Improvement; inspectors found risks in monitoring people’s wellbeing, medicines management and quality checks.
This was an unannounced focused inspection on 8 and 13 December 2022. Inspectors reviewed Safe and Well-led only because concerns had been raised about care quality and safety. They spoke with people, relatives, staff and a health professional, and checked care records, medicines records, recruitment files, training records and management information.
Inspectors found that some people were at risk because checks on their wellbeing were not always effective. Records did not always show that people at risk of constipation had been monitored. Staff did not always respond quickly to risks, including one person whose wheelchair was too small and causing pain. Medicines were not always stored, recorded or administered safely.
The home had caring staff, safe recruitment, enough staff according to its dependency tool, infection control arrangements and systems for safeguarding people. Managers were open during the inspection and acted quickly on some concerns. However, the home’s checks had failed to identify all the problems, and earlier actions had not always led to lasting improvement. The overall rating changed from Good to Requires Improvement.
Safeguarding
Staff understood how to protect people from harm and report concerns. The home worked with the local authority when safeguarding concerns were raised.
“Staff understood their roles and responsibilities in protecting people from harm and were committed to keeping them safe.” from the report
Infection control
Inspectors were assured about infection prevention, the use of protective equipment, safe admissions and the management of infection risks.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Open management
Managers were open about concerns and acted during and after the inspection. Staff and relatives generally described managers and care staff positively.
“The management team were open and transparent during the inspection, and in relation to concerns raised.” from the report
Learning from incidents
The home investigated incidents, looked for patterns and held group supervision sessions to discuss concerns and learning.
“Accidents and incidents were analysed by the provider to look for patterns and trends, and to identify any wider actions necessary to keep people safe.” from the report
Wellbeing monitoring
seriousChecks were not always effective for people at risk of constipation. Records showed several days when some people had not opened their bowels, but this had not been identified.
“People were at risk because systems to monitor their wellbeing were not fully effective.” from the report
Responding to risks
seriousStaff did not always respond promptly to people’s needs. Inspectors observed a person in pain because their wheelchair was too small, and the known problem had not been addressed.
“The failure to assess and mitigate risks put people at risk of harm.” from the report
Medicines
seriousThere were missing risk assessments for paraffin-based creams, advice had not been obtained about crushing medicines, and staff did not always follow medicine storage and recording procedures.
“Medicines were not always managed safely.” from the report
Quality checks
seriousGovernance systems did not identify all the problems found during the inspection. Earlier action about medicines administration and recording had not always produced improvement.
“The failure to assess, monitor and improve the quality and safety of the service put people at risk of harm.” from the report
Family involvement
needs fixingMost relatives said they were kept informed, but some said they were not involved in care plan reviews. The home planned meetings with relatives to address this.
“However, some did not share this view and told us they were not involved in care plan reviews.” from the report
- 01How are you now checking bowel movements and other wellbeing risks for people who need increased monitoring?
- 02What checks confirm that medicines are ordered, received, stored and recorded correctly every time?
- 03What advice has been obtained about crushing medicines, and how are staff following that advice?
- 04How are you making sure known equipment problems, such as unsuitable wheelchairs, are dealt with promptly?
- 05How will relatives be involved in care plan reviews and told about changes in their family member’s care?
This was an unannounced focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 10 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 2021
Inspected but not rated; inspectors found good infection control during the COVID-19 pandemic, with limited social activity and laundry points to monitor.
This was a targeted inspection on 15 December 2020. It looked at infection prevention and control during the COVID-19 pandemic. The inspection was announced.
Inspectors found that the home was following infection control guidance. This included safe use of protective equipment, testing, social distancing, cleaning and arrangements for admissions and hospital discharges.
Staff knew the people they supported and staffing levels were being managed. The home was clean, but inspectors advised that incoming laundry should not build up and that clinical laundry bags should stay intact. Social contact was also limited during isolation.
The home was inspected but not rated. This means the inspection did not give an overall quality rating or a rated judgement for Safe.
Infection control
Inspectors found that infection prevention arrangements were working well. Staff used protective equipment safely and followed social distancing and shielding guidance.
“We were assured that this service met good infection prevention and control guidelines.” from the report
Staffing and management
Managers were working to maintain staffing levels, and shifts were covered. Staff knew the people they supported and managers were available to help.
“There was enough managerial support to ensure there were enough staff to enable good governance, and staff available to give medicines safely.” from the report
Clean environment
The home was described as clean and fresh, with no unpleasant smells. Staff also had access to cleaning and protective equipment.
“Domestic shifts had been covered by the maintenance team and the home was very clean and fresh with no odours.” from the report
Support for staff
Staff said they felt supported and valued. Managers provided regular communication and support during a difficult period.
“The provider and registered manager were very supportive in a difficult situation and staff said they felt well supported and valued for working additional hours.” from the report
Laundry handling
minorInspectors advised that incoming laundry should not build up and that clinical bags should remain intact. This was a point for the home to monitor.
“We advised that the laundry coming in was not allowed to build up and to ensure the clinical bags it was in remained intact.” from the report
Limited social contact
minorIsolation made it difficult to maintain usual social activities. Staff were recording wellbeing support and helping people contact family and friends by phone and video.
“It had been difficult to maintain as much social engagement with people during their isolation with the one activity co-ordinator.” from the report
- 01How are laundry bags kept intact and how do you prevent incoming laundry from building up?
- 02What activities and social contact are available now for people who cannot use communal areas?
- 03How will my relative keep in touch with family and friends if visiting is restricted?
- 04How many staff are currently working on each shift, and how do you cover absences?
- 05What infection control arrangements are currently in place for visitors and new admissions?
This was a targeted inspection of infection prevention and control during the COVID-19 pandemic; it did not assess all five key questions and the service was not rated. This explanation was written from the published report of 13 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 Knappe Cross Care Centre
4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- February 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- September 2017Goodup from Requires improvementSafe: GoodWell-led: Good
- July 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2011
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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Most charge £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
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