CQC report explained · a nursing home
What the CQC found at The Knolls Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured that the home was following safe infection prevention and control procedures. They checked areas including PPE, testing, admissions, visitors, social distancing, hygiene and outbreak management.
- Effective?
- Good
- This question was not assessed in this focused inspection.
- Caring?
- Good
- This question was not assessed in this focused inspection, although inspectors observed positive interactions between staff and residents.
- Responsive?
- Good
- This question was not assessed in this focused inspection, although inspectors noted activities and arrangements to support contact with visitors.
- Well-led?
- Requires improvement
- This question was not assessed in this focused inspection.
What inspectors found, October 2020
Inspected but not rated; inspectors found good infection control and supportive care arrangements during a focused COVID-19 review.
Inspectors visited the home on 20 October 2020. The visit was announced and formed part of a national review of infection prevention and control. The home had been identified as a designated setting for people discharged from hospital with a positive COVID-19 status.
Inspectors were assured that the home was managing infection risks. This included the use of personal protective equipment, testing, social distancing, admissions, visitors, cleaning and outbreak planning.
They also found good links with the local GP surgery, ways for residents to keep in touch with visitors, positive staff interactions and activities. The service was inspected but not rated, so this report does not give a Good or Outstanding rating and does not provide a full assessment of all areas of care.
Strong infection controls
Inspectors were assured that the home had suitable arrangements to prevent and manage infection, including safe admissions, PPE, testing and outbreak planning.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Links with primary care
The registered manager had a good working relationship with the local GP surgery. Four nurses had been put forward for a nurse practitioner course, which could help reduce waiting times for treatment.
“The registered manager was knowledgeable of the designated clinical lead at the doctor's surgery and has a good working relationship with the team.” from the report
Keeping people connected
The home supported video calls, window visits and supervised garden visits when face-to-face visiting was restricted.
“I-pads and facetime options are made available to those who are unable to have face to face visitors which is supported by staff.” from the report
Positive daily experience
Inspectors observed positive interactions between staff and residents. Staffing levels supported wellbeing, and activities were available for people who wanted them.
“We observed really good interactions between people and staff with high staffing ratios to enable positive well-being to be supported.” from the report
Inspectors raised no specific concerns in this report.
- 01How are infection prevention, PPE, testing and outbreak arrangements being managed now?
- 02How does the home safely manage admissions of people who may have an infection?
- 03What is the current process for visits, video calls and outdoor visits?
- 04Have the nurses completed or progressed with the nurse practitioner course, and has this improved access to treatment?
- 05Which recent inspection or assessment covers areas not included in this report, such as medicines, care plans and staffing?
This was an announced focused thematic inspection of infection prevention and control only; the service was inspected but not rated and the other four questions were not assessed. This explanation was written from the published report of 30 October 2020 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, May 2019
Rated Good overall; inspectors found safe, kind and responsive care, but the home required improvement because there was no registered manager.
Inspectors visited on 11 April 2019. They observed care, spoke with people, relatives, staff and visiting professionals, and checked care records, medicines records, incidents, audits and other management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found significant improvements since December 2017. Risks and medicines were managed safely, care plans were detailed, staff were kind, and people had enough food, drink and activities.
Well-led was rated Requires Improvement because there was no registered manager in post. The report says there were no breaches of regulations at this inspection. Overall, the home was rated Good, but CQC will continue to monitor it.
Safety and staffing
Inspectors found that risks were assessed and monitored, staff understood safeguarding responsibilities, and there were enough staff to meet people's needs.
“During the inspection we observed there were enough staff and that they were easily visible throughout the building.” from the report
Personalised care
Care plans had been updated and gave detailed guidance based on people's preferences and needs. People and relatives were involved in planning care.
“The information was person centred and described the way staff should support the person with reference to the person's preferences.” from the report
Kind and respectful staff
People described staff as kind and respectful. Inspectors saw positive relationships and staff supporting people's choices and privacy.
“There was a friendly atmosphere where people enjoyed light hearted but respectful exchanges with staff.” from the report
Improved food and drink
Since the previous inspection, snacks and drinks were available between meals. People told inspectors they enjoyed the food and mealtime atmosphere.
“We saw snacks and drinks were readily available throughout the service for people to help themselves to between meals.” from the report
Improvements since 2017
Inspectors found significant improvements across the service, including in risk assessments, dignity, food and drink, care plans and the premises.
“This inspection we found improvements had been made and there were no breaches of regulations.” from the report
No registered manager
needs fixingThere was no registered manager in post on the inspection day. This was the reason Well-led was rated Requires Improvement, even though the acting manager and provider had improved management systems.
“There was no registered manager in post on the day of the inspection.” from the report
Activities did not suit everyone
minorSome people said there were not enough activities that appealed to them. Some people also felt there was not enough time for one-to-one activities, particularly for people cared for in bed or staying in their rooms.
“Some people, however, told us they did not feel there were enough activities that appealed to them.” from the report
- 01Has the new registered manager now taken up the post and completed registration with CQC?
- 02How will you build on the improvements made since the December 2017 inspection?
- 03How do you assess whether there are enough activities for each person, including people who stay in their rooms or are cared for in bed?
- 04How are people and relatives involved in reviewing care plans and deciding on activities?
- 05How do you use audits, complaints and incident records to check that improvements are maintained?
This was a planned inspection covering all five CQC questions, with care, records, medicines, incidents, audits and management systems examined. This explanation was written from the published report of 30 May 2019 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 The Knolls Care Centre
5 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- October 2020Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- May 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 23 March 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.
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
At least 100 live-in carers within about an hour of Central Bedfordshire
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 £980 to £1,260 a week. 83 can care for a couple. 12 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“She handled the new situation in front of her with such professionalism and I felt I could trust her 100%.”
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.