CQC report explained · a residential care home
What the CQC found at Knells Country House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, staffing was sufficient, recruitment checks were carried out and medicines were managed safely. Fire drill records did not always clearly show that all staff had taken part.
- Effective?
- Good
- Staff training was being monitored and people's needs were assessed before admission. People received support with nutrition, health care and decision-making, although some drink-related care plans lacked clear instructions.
- Caring?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection, but that rating is not stated in this report.
- Responsive?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection, but that rating is not stated in this report.
- Well-led?
- Good
- The new manager had strengthened governance, audits and improvement planning. People, relatives and staff had more confidence in how the home was run.
What inspectors found, June 2023
Knells Country House rated Good; inspectors found safe, kind care and improvements since the previous inspection, with minor records still needing attention.
This was an unannounced focused inspection on 12 and 19 April 2023. Inspectors spoke with people, relatives, staff and a health professional. They observed care and checked care records, medicines records, recruitment files and management records.
The home was rated Good overall. Safe, Effective and Well-led were rated Good. Inspectors found that risks were being assessed, medicines were managed safely, staffing was sufficient and staff training had improved. People received support with food, drink, health care and personal choices.
The previous rating was Requires Improvement, published in November 2022. Inspectors found enough improvement for the home to no longer be in breach of Regulation 17. They noted that fire drill records were not always clear and some care plans did not explain what staff should do if someone did not drink enough.
Warm atmosphere
People and relatives described the home as caring, welcoming and warm. They also described individual lifestyles, activities and trips out.
“People and relatives had many positive comments about the caring, welcoming and warm atmosphere in the home.” from the report
Safer risk management
The home had introduced clearer risk assessments and strategies. These were reviewed monthly or when people's needs changed.
“There were now risk assessments in place with clear strategies to show how specific risks to individual people would be mitigated.” from the report
Improved training
A training plan was in place, and relatives said staff had the skills to support people, including people living with dementia-related conditions.
“The provider had a training plan to ensure staff completed essential training.” from the report
Food and personal choice
Staff supported people's dietary needs and preferences. Inspectors also found that staff respected choices and worked within the principles of the Mental Capacity Act.
“People were supported with their individual dietary needs and preferences. They described the meals as "very good".” from the report
More settled management
The new manager had improved audits and plans for further work. Relatives said the home felt more settled.
“The new manager had improved the effectiveness of governance systems and the stability of the staff team.” from the report
Fire drill records
minorThe records did not clearly show that all staff had taken part in the required fire drills. The provider said this would be addressed.
“It was not always clear from fire records that all staff had taken part in required fire drills.” from the report
Fluid intake plans
needs fixingSome care plans explained how to support people with drinks but did not clearly say what staff should do if someone did not drink enough. The manager addressed this immediately.
“Care plans described how to support people with drinks but were not always clear about what actions staff would take if people did not drink enough.” from the report
- 01Have all staff now completed the required fire drills, and are the records up to date?
- 02How do you now record and respond when someone is not drinking enough?
- 03What is the current status of the new manager's application to register?
- 04How do you check that staff training and supervision remain up to date?
- 05What improvements are included in the building refurbishment plan, and how have people and relatives helped decide them?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried over. This explanation was written from the published report of 13 June 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, November 2022
Knells Country House rated Requires Improvement; inspectors found kind, person-centred care but gaps in risk records, staff training and management checks.
This was an unannounced planned inspection over three visits. Inspectors spoke with people, relatives, managers and staff. They reviewed care records, medicines records, recruitment and training documents, and management records.
The home was caring and responsive. People were treated kindly, their preferences were respected, meals and activities were well regarded, and relatives said communication was good. The home was clean and people received support from health professionals when needed.
There were important weaknesses in record keeping and oversight. Some risk assessments and care plans were not up to date, training records were incomplete, and quality checks had not always led to action. The home must improve its governance, and the CQC will monitor progress through an action plan.
Kind and respectful care
People and relatives said staff were warm, kind and helpful. Staff knew people's needs and supported privacy, dignity and independence.
“People said they were treated with care and kindness. They described the manager and staff as caring and helpful.” from the report
Personalised support and activities
People were supported according to their preferences and encouraged to stay socially connected. The home offered activities, trips and contact with relatives.
“There are good activities and they get everybody involved” from the report
Food and healthcare
People said they had enough to eat and drink and spoke positively about the meals. Staff worked with health professionals and helped people access healthcare.
“The meals are very good and we get a choice” from the report
Open atmosphere
People, relatives and staff described the home as friendly and approachable. Relatives said the new manager and provider listened and acted on issues.
“It's a happy place and well-run” from the report
Risk information was not kept up to date
seriousSome changes in people's needs were not reflected in their care records. Clear strategies were not always recorded for known risks, which could lead to inconsistent support.
“In some cases, significant changes in people's needs were not updated on their care records.” from the report
Management checks did not lead to improvement
seriousQuality checks had identified care recording problems, but some problems were still present at inspection. This was the report's identified legal breach.
“The provider's governance systems were not always effective and actions were not always completed to ensure improvement.” from the report
Essential training records were incomplete
needs fixingRecords did not show that all staff had current training in areas including safeguarding and infection control. The provider said it introduced regular reviews of training records.
“The records indicated that around half the staff team did not have current training in safeguarding and a third did not have current training in infection control.” from the report
Some care plans were unclear
needs fixingSome care plans were out of date or contained conflicting information. This could make it harder for new or agency staff to provide consistent care.
“Some people's care plans were out of date or contained contradictory information so would not be clear to new or agency staff.” from the report
Recruitment checks were not always complete
seriousIn a small number of cases, all pre-employment checks had not been completed before staff were appointed. The provider said it acted immediately and introduced a recruitment checklist.
“In a small number of cases, full checks had not always been completed prior to appointments to make sure staff were suitable to work with vulnerable people.” from the report
- 01How have you updated risk assessments and care records for people whose needs have changed?
- 02What checks now confirm that all staff have current safeguarding, infection control and health and safety training?
- 03How do you make sure recruitment checks are complete before any staff member starts work?
- 04What action plan did you provide to the CQC for the Regulation 17 breach, and what improvements have been completed?
- 05How will you keep care plans clear and consistent for agency or newly appointed staff?
This was an unannounced inspection covering all five CQC questions and infection prevention and control; it was the first inspection of this newly registered service. This explanation was written from the published report of 10 November 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.
Every inspection of Knells Country House
5 rated inspections over 9 years: the service has held its Good rating throughout.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2022Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- October 2020Inspected but not ratedSafe: Inspected but not rated
- June 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2021
Registered with the Care Quality Commission on 11 June 2021.
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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