CQC report explained · a residential care home
What the CQC found at Knightsbridge Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks such as falls, weight loss and pressure ulcers were assessed and managed. Staff were recruited safely, there were enough staff, and medicines were generally managed safely, although two signatures were missing from one medicines record.
- Effective?
- Good
- People's needs were assessed and staff had the skills and training to support them. The home had improved its use of the Mental Capacity Act, and people were supported with food, drink and access to health professionals.
- Caring?
- Good
- People and relatives described staff as kind, patient and compassionate. Inspectors found that privacy, dignity, independence and important relationships were respected.
- Responsive?
- Good
- Care plans included people's preferences, wishes, likes and dislikes and were reviewed. People could choose activities and were supported with complaints and end of life wishes.
- Well-led?
- Good
- Managers used audits and feedback to monitor and improve the home. Inspectors found a positive culture, good communication and sustained improvements since the previous inspection.
What inspectors found, February 2018
Knightsbridge Lodge was rated Good after inspectors found safe, kind and personalised care, with only a minor medicines-record error.
This was an unannounced comprehensive inspection over 28 December 2017 and 2 and 3 January 2018. Inspectors observed care, spoke with people, a relative, staff and health professionals, and checked care files, medicines, recruitment, training, complaints, maintenance and quality checks.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, safe medicines systems, personalised care, respectful staff and effective management checks.
This was an improvement from the previous inspection in September 2016, when the overall rating remained Requires Improvement and further work was needed on effective care and leadership. Inspectors found that the recommended improvements had been made and that all necessary regulations were being met.
Managing risks
Staff assessed risks and took steps to protect people while supporting their independence. They reviewed accidents and changed support when needed.
“There were arrangements for keeping people safe which were consistently adhered to.” from the report
Personalised support
Care plans recorded people's preferences and abilities. Staff adapted care and activities to individual needs, including for people living with dementia.
“Care plans included people's personal preferences, wishes, likes and dislikes.” from the report
Improved leadership
The home had strengthened its quality checks and followed up actions. This supported the improvement from Requires Improvement to Good overall.
“During this inspection we found this recommendation had been acted on and effective quality monitoring arrangements were in place.” from the report
Meaningful activities
People helped choose activities and were supported to use their interests and remaining skills. Activities could be adapted for individual abilities.
“People were involved in making decisions about what activities and entertainment would take place.” from the report
Missing medicines signatures
minorTwo signatures were missing from one person's medicines administration record. The medicines had been given, but the missing signatures were a record-keeping error and staff were reminded to check records more carefully.
“Two signature gaps on one person's MAR were seen to be missing during the inspection.” from the report
- 01What checks are now used to make sure every medicine given is signed for correctly?
- 02What dementia care training have staff completed since the inspection, and what further training is planned?
- 03Have all outstanding Deprivation of Liberty Safeguards applications been assessed, and are any conditions being followed?
- 04How will you assess whether you can meet my relative's needs, given that the home does not provide nursing care?
- 05How are my relative's end of life wishes recorded, reviewed and shared with relevant health professionals?
This was an unannounced comprehensive inspection covering all five CQC questions, the building and the care provided. This explanation was written from the published report of 28 February 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, December 2016
Rated Requires Improvement; care was safe, kind and responsive, but mental capacity processes and management audits needed strengthening.
This was an unannounced inspection on 3 and 5 September 2016. One inspector spoke with people living in the home, relatives, staff, health professionals and a visitor. They also checked care records, medicines records, staff files and management records.
The home was rated Good for Safe, Caring and Responsive. Inspectors found enough staff, safe medicines arrangements, kind care, respect for privacy and care plans that reflected people's needs and preferences. People had activities and could raise complaints.
The home was rated Requires Improvement for Effective and Well-led. Some mental capacity assessments and applications under the Deprivation of Liberty Safeguards had not been completed when needed. The auditing system was not strong enough to identify problems, record actions and check that they had been completed.
The overall rating Requires Improvement means the home was not consistently meeting the expected standard in every area at this inspection. Earlier breaches about infection control, staff recruitment and monitoring had been met, although further improvement was still needed.
Enough staff
Inspectors found staffing was sufficient to meet people's needs. Staffing had also been adjusted so there were three care staff on duty when domestic staff were unavailable.
“We did not find any evidence that suggested people's needs may not be met due to a lack of staff.” from the report
Kind and respectful care
People were relaxed with staff, who knew their routines and preferences. Personal care was provided privately and people's choices were supported.
“Throughout the inspection it was obvious the staff knew the people they looked after well because they were aware of people's likes, dislikes, routines, preferences” from the report
Individual care planning
Care plans included people's needs and preferences. Staff involved relatives and worked with health professionals when people's needs changed.
“Care plans recorded what people's needs were, how the person preferred these needs to be met and provided guidance for the care staff.” from the report
Activities and relationships
People could join activities suited to them, including outings and group activities. Staff also found ways for people to take part when they did not want to join a group.
“People were supported to be involved in social activities and other activities which were meaningful to them.” from the report
Mental capacity paperwork
seriousFor several people, the required assessments and applications had not been completed when needed. Work started during the inspection, but inspectors recommended further advice to make sure people were legally protected.
“In some cases where staff had concerns about a person's ability to make specific decisions they had arranged for the person to be appropriately assessed.” from the report
Weak management audits
needs fixingAudits did not consistently record problems, set deadlines or check that actions had been completed. Cleaning records had not been completed for several weeks without the issue being identified.
“The auditing system was weak and required some improvement to ensure that where improvements had been made these were sustained” from the report
Laundry and cleaning procedures
minorLaundry was seen on bedroom floors and was carried through the home without the correct bags or containers. Some cleaning instructions did not match staff practice, although inspectors assessed the risk as minimum.
“Both of these actions were poor infection control practice.” from the report
Limited formal feedback
minorThe views of people and relatives had not been formally collected through questionnaires during the previous year. The home was planning to improve its questionnaires.
“The views of people and their relatives had not been formally sought in the last year through the use of questionnaires.” from the report
- 01Have all outstanding mental capacity assessments and Deprivation of Liberty Safeguards applications now been completed?
- 02How do you record audit findings, assign actions and check that those actions have been completed?
- 03What laundry bags or containers are now available, and how do you check that laundry is not left on bedroom floors?
- 04How do you make sure written cleaning procedures match what staff do in practice?
- 05How are people's and relatives' views formally collected and acted on now?
This was an unannounced inspection covering all five CQC questions, with the previous inspection's breaches and the concerns received before this inspection also checked. This explanation was written from the published report of 30 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 Knightsbridge Lodge
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- February 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2013
Registered with the Care Quality Commission on 22 October 2013.
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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