CQC report explained · a nursing home
What the CQC found at Knellwood
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people were protected from abuse and avoidable harm. Staffing, recruitment checks, risk assessments, medicines and infection control were judged safe.
- Effective?
- Good
- Staff had training and support to meet people's needs. People received suitable food and healthcare, and their rights and choices were respected.
- Caring?
- Good
- Staff were kind and compassionate. Inspectors saw people treated with dignity, privacy and respect, and involved in decisions about their care.
- Responsive?
- Good
- Care plans were detailed and personalised. People were offered activities they chose, and complaints were investigated and used to improve care.
- Well-led?
- Good
- The home had clear leadership and an open culture. Regular audits, meetings and improvement plans were used to monitor quality and act on shortfalls.
What inspectors found, August 2018
Rated Good; inspectors found safe, kind and personalised care, with earlier training improvements sustained.
This was an unannounced inspection on 17 and 18 May 2018. Inspectors observed care, meals, activities and medicines. They spoke with people living at the home, staff and managers, and checked care records, staff files and service records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable training, kind care, personalised support and effective checks on quality.
At the previous inspection in July 2017, the home had breached Regulation 18 because staff training was not always sufficient. This inspection found that the required improvements had been made and maintained, so there was no longer a breach.
Safe medicines
Inspectors found medicines were stored and given safely. Records checked had no gaps, and staff had their medicine skills assessed.
“We noted there were no gaps in these records.” from the report
Kind relationships
People had positive relationships with staff. Inspectors saw warm interactions and staff asking permission before helping people.
“People were supported by staff who demonstrated kindness, compassion and a genuine interest in the people they supported.” from the report
Personalised care
Care plans included people's routines, preferences, interests and life history. Staff used this information to provide individual support.
“People's care plans took into account peoples wishes, needs and preferences.” from the report
Activities and wellbeing
People could take part in activities such as arts and crafts, gardening, sports and baking. Inspectors gave examples of activities improving people's wellbeing.
“People were supported to complete stimulating activities of their choice, which had a positive impact on their well-being.” from the report
Quality monitoring
The management team used regular audits, meetings and improvement plans to identify and address problems.
“There was an effective system of quality assurance in place; this included weekly, monthly, six monthly and yearly audits.” from the report
Building work
minorRenovation work was taking place during the inspection. The provider was trying to limit disruption, but families should ask what work remained and how it affected residents.
“The premises were in the process of being renovated to further meet individual's needs.” from the report
Additional medicine training
minorInspectors found that one new staff member needed more medicine management training. The provider arranged training, a competency check and supervision immediately.
“We observed that one new staff member required further training regarding medicine management.” from the report
- 01What was the outcome of the trial to add extra staff at busy times?
- 02What renovation work was still outstanding after this inspection, and how was disruption kept to a minimum?
- 03How do you check that every new staff member is competent to administer medicines before working without supervision?
- 04How have you maintained the improvements to staff training since the previous inspection?
- 05How are residents and relatives involved in reviewing personalised care plans and choosing activities?
This was an unannounced inspection covering all five questions about the service, including care, the premises, staffing, records and management systems. This explanation was written from the published report of 4 August 2018 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, September 2017
Rated Requires Improvement; training had improved, but inspectors still found gaps that could put people at risk.
This was an unannounced focused inspection on 08 July 2017. Inspectors checked whether the home had acted on a previous requirement about staff training. They spoke with the manager, two staff and three people living at the home. They also observed care and checked training records and other documents.
The home had improved its induction training and staff training in safeguarding, the Mental Capacity Act, food hygiene, moving and handling and hazardous substances. However, some staff still lacked first aid, infection control or equality and diversity training. Some first aid training was also more than three years old.
The inspectors found a continuing breach of Regulation 18 about staffing and training. The home had plans for yearly refresher training, but this system had not yet started. The overall rating was Requires Improvement, and the Effective question was also rated Requires Improvement.
Trained staff available
The manager arranged for trained nursing staff to be on duty while other staff were waiting for training.
“In the interim, the registered manager had ensured that there were always staff members on duty who had received training in first aid and infection control.” from the report
Planned refresher training
The home had planned a rolling refresher programme, with several training dates each year. Inspectors had not yet been able to assess whether it was effective.
“The registered manager had arranged four separate reoccurring training dates throughout the year.” from the report
First aid gaps
seriousSeventeen staff had not received first aid training, and 13 staff had training that was more than three years old. Inspectors said this could put people at risk in an emergency.
“Therefore, out of 47 care and ancillary staff, 30 had either not received first aid training or their training was outside the recommended timeframe for an update.” from the report
Infection control training
seriousOnly three of the 47 care and ancillary staff had received infection control training. Inspectors said this could increase the risk of infections spreading.
“This meant that out of 47 care and ancillary staff, 44 had not received training in this area.” from the report
Training system not effective
seriousThe home did not yet have an effective system to make sure all staff received the right training and updates. This was a continuing breach of Regulation 18.
“The provider did not have an effective system in place to ensure all staff received appropriate training.” from the report
Equality and diversity training
needs fixingEight of the 47 care and ancillary staff had not received equality and diversity training.
“Of 47 care and ancillary staff, eight staff had not received training in equality and diversity.” from the report
- 01Have all staff now completed first aid training, including the 17 staff who had not received it at the inspection?
- 02How many staff have completed infection control training, given that 44 of 47 care and ancillary staff had not received it?
- 03Has the planned yearly refresher training programme started, and how do you check that staff complete it on time?
- 04How do you make sure trained staff are available on every shift to respond to an emergency?
- 05Have all staff now completed equality and diversity training?
This was a focused inspection of Effective, mainly staff training; the other areas were not assessed during this visit. This explanation was written from the published report of 16 September 2017 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 Knellwood
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- August 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Requires improvementstayed Requires improvementEffective: Requires improvement
- January 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 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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