CQC report explained · a residential care home
What the CQC found at The Knowles
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2024
Rated Requires Improvement; inspectors found fire, medicines storage and hygiene risks, with a breach of Regulation 12.
This was an unannounced focused inspection on 16 January 2024. Inspectors reviewed Safe and Well-led only. They spoke with people, relatives, staff and health professionals, observed care and checked care, recruitment and management records.
People said they felt safe and medicines were usually given by trained staff. However, fire doors were not closing properly, another bedroom door had a hole, and a medicines fridge was too cold. Some areas and shower equipment were also not clean. The provider fixed several issues during the inspection.
The home was rated Requires Improvement overall, and also Requires Improvement for Safe and Well-led. The inspection found a breach of Regulation 12 because safety risks in the environment and medicines storage were not managed reliably. The previous overall rating was Good in 2022, but the other three question ratings were carried over because they were not inspected this time.
People felt safe
People told inspectors they felt safe with staff. Safeguarding training and reporting arrangements were in place.
“I feel safe, everyone is nice to me.” from the report
Medicines administration
Medicines were given as prescribed by trained staff whose competence was checked regularly.
“I have tablets twice a day, they always wait till I take them, no problems at all.” from the report
Safe recruitment
The provider checked references and completed DBS checks when recruiting staff.
“Staff were recruited safely. The provider sought references and completed DBS checks.” from the report
Supportive staff culture
Staff said managers were approachable and that they received support through individual and team meetings.
“Managers are approachable, you can speak up. There is an open atmosphere, and everyone is respected.” from the report
Fire safety delays
seriousSome fire doors were not closing properly and agreed safety measures were not being followed. Other fire risks were missed until inspectors found them.
“Fire safety risks were not always well managed.” from the report
Medicines fridge
seriousThe fridge used for medicines had ice inside, but daily checks had not identified the problem. Medicines stored there may not have been safe to administer.
“Medicines were not always stored safely.” from the report
Cleanliness and hygiene
seriousSome areas were not clean and hygienic. Inspectors also found dirty shower aids with rusty patches.
“Some areas of the home were not always clean and hygienic, and some shower aids were dirty, with rusty patches underneath.” from the report
Weak monitoring checks
needs fixingThe home's audits did not always find safety and cleanliness problems quickly. CQC recommended stronger systems and checks.
“The provider's systems and processes to monitor the service were not always effectively operated or embedded.” from the report
- 01What has been done to make sure all fire doors close properly, and how are these checks now recorded?
- 02How do you check that medicines stored in the fridge remain within the correct temperature range?
- 03What work has been completed to improve cleanliness and replace or repair the shower aids with rusty patches?
- 04How often are environmental safety checks completed, and who reviews whether problems have been fixed?
- 05What changes were made to staffing after people said they sometimes waited for drinks and breakfast?
This was a focused inspection of Safe and Well-led only; the other three question ratings and the previous overall rating were carried forward from the last inspection. This explanation was written from the published report of 21 March 2024 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 2022
Rated Good; inspectors found safe care and stronger management systems after the previous Requires Improvement rating.
This was an unannounced focused inspection. Inspectors checked whether improvements had been made in Safe and Well-led. They spoke with people, relatives and staff, observed care, and reviewed care plans, medicine records, recruitment files and management records.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, medicines were managed safely, staffing levels met people's needs and safeguarding systems were in place. They were also assured about infection prevention and control.
Management checks, audits, meetings and feedback systems had improved. The previous registered manager had left, and a new manager was completing their registration with the CQC. The overall rating improved from Requires Improvement to Good.
The other three key questions were not inspected during this visit. Their previous ratings were carried forward when calculating the overall rating.
Risk management
Care plans and risk assessments gave staff clear instructions. Inspectors found that staff understood how to reduce risks such as falls.
“Care plans and risk assessments contained detailed information to inform staff of how to support people and reduce individual risks.” from the report
Safe medicines
People received their medicines as prescribed. Staff had training and competency checks before administering them.
“People received their medication as prescribed. Systems were in place for the safe storage, administration and recording of medicines.” from the report
Staffing and recruitment
The home completed pre-employment checks and had enough staff to meet people's needs. Staffing was adjusted according to people's needs.
“There were enough staff on duty to meet the needs of people.” from the report
Improved oversight
The provider had strengthened its monitoring systems. Audits, meetings, surveys and reports were used to identify and act on improvements.
“The manager and provider monitored quality and compliance with regular audits, meetings and surveys.” from the report
No registered manager
minorThere was no registered manager in post when inspectors visited. A new manager had been recruited and was completing their registration with the CQC.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Has the new manager now completed registration with the CQC, and who is legally responsible for the home while this is being completed?
- 02How are my relative's risks recorded, reviewed and shared with staff?
- 03How do you decide how many staff are needed on each shift for my relative's needs?
- 04How are medicine staff trained, assessed and checked over time?
- 05What recent improvements have been made from feedback, audits or accident and incident reviews?
This was a focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 25 May 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 The Knowles
6 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- March 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2022Goodup from Requires improvementSafe: GoodWell-led: Good
- November 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- September 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- July 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 13 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.
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What to check when you visit
At least 100 live-in carers within about an hour of Coventry
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 £950 to £1,260 a week. 80 can care for a couple. 11 years' experience on average.
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
“My mum would not eat, drink, bath nor sleep without her. In short, she was FAMILY and we loved her dearly”
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.