CQC report explained · a residential care home
What the CQC found at Kynance Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2018
Rated Good; inspectors found safe, kind and personalised care, with some minor issues needing attention.
Inspectors visited the home without warning on 5 and 10 April 2018. They spoke with people living there, relatives, staff and health professionals. They observed care and checked care plans, medicines, staffing, recruitment, safety and quality records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines arrangements, clean surroundings and care that was planned around each person's needs. People were treated kindly and supported to make choices and stay independent.
The home had improved since its previous inspection in February 2017, when it was rated Requires improvement and breached two regulations. Inspectors found those breaches had been addressed and there were no breaches at this inspection. A Good rating means the service met the relevant standards at the time of this inspection, although the report still noted some smaller issues.
Improved choking support
Three nutritional assistants had been appointed to support people with complex eating and drinking needs. Inspectors found this helped staff provide safer and more consistent support.
“The introduction of nutritional assistants had resulted in fewer people losing weight and some gaining weight, which demonstrated the value of their role.” from the report
Kind relationships
People and relatives described staff as kind and compassionate. Inspectors observed friendly, reassuring interactions and a family atmosphere.
“Without exception, all interactions we observed between people and staff were positive and supportive.” from the report
Personalised care
Care plans described people's routines, backgrounds, interests and preferences. Staff showed they knew how each person wanted to receive care.
“Care plans contained detailed information to enable staff to provide care and support in a highly personalised way according to people's individual needs.” from the report
Responsive staff
Staff noticed changes in people's needs and adjusted support, including changing shift times to help people who wanted to get up early.
“Staff responded promptly when people's needs or preferences changed.” from the report
Meals were not served together
minorMeals arrived at different times for people sitting at the same table. Inspectors said this reduced the social quality of mealtimes, and managers said they would explore how to improve it.
“Meals arrived at random times.” from the report
Confusion about legal safeguards
seriousSome staff misunderstood stickers showing that Deprivation of Liberty Safeguards applications were awaiting assessment. Inspectors said this created a risk that someone could be deprived of their liberty without legal authorisation, although the manager acted immediately to clarify the position.
“This posed a risk that people might be deprived of their liberty without legal authorisation.” from the report
Minor safety and recording issues
needs fixingOn the first inspection day, some fire doors did not close properly and one door was held open with a wedge. Inspectors also found cream records did not always identify which cream had been applied, and one recruitment file lacked checks with two previous employers.
“On the first day of the inspection, we found a wedge was being used to hold one person's bedroom door open and some fire doors did not close properly, having been recently painted.” from the report
- 01How are meals now timed so that people eating together receive their food at similar times?
- 02How do you check that any Deprivation of Liberty Safeguards applications are clearly understood by all staff and legally authorised when required?
- 03How are each person's end-of-life wishes recorded, reviewed and shared with the staff team?
- 04Have the improved checks for fire doors, topical creams and recruitment references been kept in place?
- 05How are nutritional assistants used now to support people at risk of choking or unplanned weight loss?
This was an unannounced comprehensive inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 18 May 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, March 2017
Kynance Residential Home was rated Requires Improvement; inspectors found kind, personalised care but safety, diabetes care and quality checks needed improvement.
Inspectors visited on 9 and 10 February 2017 without giving notice. They spoke with people living at the home, family members, staff and a community nurse. They reviewed care plans, medicines, staff files, accident records and quality checks, and observed care.
The home was caring and responsive. People were treated kindly, involved in their care and supported to make choices. Staff knew people well, provided personalised care and helped people access healthcare and activities.
There were important safety and care shortfalls. One person's drinks were not always thickened correctly, creating a choking risk. Two people had missed some prescribed medicines. Diabetes care was not always personalised, and some senior staff were unclear about fire evacuation procedures.
The overall rating was Requires Improvement. The home had addressed concerns from the February 2016 inspection about decision-making and unlawful deprivation of liberty, but inspectors found new breaches relating to person-centred care and safe care and treatment.
Kind and respectful care
Inspectors saw positive interactions. Staff understood people as individuals, protected their privacy and encouraged them to remain independent.
“People were cared for with kindness and compassion.” from the report
Personalised support
Care plans covered people's routines, preferences, backgrounds and interests. Staff adapted support to people's wishes and changing abilities.
“Care plans contained comprehensive information and were reviewed regularly.” from the report
Staff understood safeguarding
Staff knew how to identify and report abuse. Recruitment checks were completed before new staff started.
“People felt safe at the home and staff knew how to identify, prevent and report abuse.” from the report
Risk of choking
seriousOne person's squash was not thickened as advised, and the person coughed when drinking it. There was no specific risk assessment or clear guidance about monitoring and what to do if choking occurred.
“The failure to mitigate risks to the health and safety of people was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Diabetes care
seriousSome people with diabetes did not have suitable care plans or diets. Staff were also unclear about the purpose and correct response to weekly blood sugar checks.
“The failure to ensure people's diabetes care needs were met in an appropriate and personalised way was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Missed medicines
seriousMedicine records suggested that two people had not received some prescribed medicines on three occasions in the previous week. Photographs were also missing from seven people's medicine records.
“The deputy manager told us this indicated that staff had signed to say they had given these medicines to people, on three occasions in the previous week, when they had not done so.” from the report
Weak quality checks
needs fixingThe home used only a limited range of audits to monitor quality and safety. A more robust quality assurance system was still being developed.
“A limited range of audits was conducted to monitor the quality and safety of the service.” from the report
- 01How do you now make sure every drink for a person who needs thickened fluids is prepared to the correct consistency and supervised safely?
- 02What changes have you made to medicine checks after two people missed prescribed medicines?
- 03What written care plans and dietary arrangements are now in place for people with diabetes?
- 04Have all senior staff completed and demonstrated their understanding of the home's fire evacuation procedures?
- 05What is included in the stronger quality assurance system, and how do you check that improvements are lasting?
This was an unannounced inspection of the overall quality and safety of the home, covering all five CQC questions and checking progress since the February 2016 inspection. This explanation was written from the published report of 9 March 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 Kynance Residential Home
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- May 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- February 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 2010.
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
84 live-in carers within about two hours of Isle of Wight
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 £1,010 to £1,230 a week. 68 can care for a couple. 11 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
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.