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CQC report explained · a nursing home, run by TLC Group

Karuna Manor

Christchurch Avenue, Harrow, HA3 5BD

Outstandingpublished 24 November 2023, 2 years ago

Rated Outstanding: inspectors found the service performing exceptionally well.

The five questions inspectors ask
Safe?
Good
People were protected from abuse and avoidable harm. Medicines were managed safely overall, but inspectors recommended clearer prescription instructions and found one seizure plan that needed clearer guidance.
Effective?
Good
No rating for Effective is shown in this report.
Caring?
Good
No rating for Caring is shown in this report.
Responsive?
Outstanding
People's needs were exceptionally well met. Inspectors found highly personalised support, strong cultural and spiritual care, meaningful activities and excellent end-of-life support.
Well-led?
Outstanding
Leadership was exceptional, open and inclusive. The home used detailed governance systems, feedback and partnerships to monitor and improve care.
The latest report, explained

What inspectors found, November 2023

Rated Outstanding overall; inspectors found exceptionally responsive and well-led care, with a medicines recommendation.

Inspectors visited the home without notice on 13 September 2023 and 20 October 2023. They spoke with 16 people, 11 relatives and staff, and checked care records, medicines records, risk plans and management information.

The home was rated Good for Safe, and Outstanding for Responsive and Well-led. People were described as safe, well supported and treated as individuals. Inspectors found strong leadership, detailed quality checks and a culture focused on improving people's experience.

There was one recommendation about making sure prescription instructions clearly state when medicines should be given through a PEG tube. Inspectors also found that one seizure risk plan did not clearly explain when to call emergency services, but the provider acted immediately and sent updated plans.

What inspectors praised

  • End-of-life support

    The home provided highly personalised end-of-life care. Staff considered people's religious, cultural and spiritual wishes and worked with families and outside organisations.

    “People were exceptionally well supported at the end of their life to have a comfortable, dignified and pain free death.” from the report

  • Personalised care

    Staff knew people's likes, dislikes and communication needs. The home developed activities and services around people's interests, health and preferences.

    “People were supported as individuals, in line with their needs and preferences.” from the report

  • Activities and relationships

    People were supported to maintain relationships and take part in activities linked to their past, interests, faith and culture. The home also provided ways for people who were unwell or unable to attend activities in person to join in.

    “People were supported to maintain relationships, follow their interests, and take part in activities that were relevant to them.” from the report

  • Leadership and improvement

    The home had strong systems for checking care quality and learning from incidents. People, relatives and staff were involved in developing the service.

    “The provider had created an exceptional learning culture at the service which continuously improved the care people received.” from the report

  • Communication and inclusion

    The home supported different languages and communication needs. Information could be provided in pictorial form, and staff adapted how they communicated with people.

    “The provider was meeting the Accessible Information Standards.” from the report
What inspectors were concerned about

  • Medicine instructions

    needs fixing

    Some medicines given through PEG tubes were not clearly prescribed that way on the electronic system. The provider was asked to review the dosage instructions with prescribers.

    “We recommend the provider review the dosage instructions with the prescriber for prescribed medicines.” from the report

  • Seizure emergency guidance

    needs fixing

    One risk plan did not clearly say when to call emergency services after a seizure, and the timing for rescue medicine was unclear. The provider acted immediately and sent updated plans.

    “1 risk management plan did not have clear guidance on when to call emergency services following a seizure.” from the report

  • Weekend and night staffing concerns

    minor

    Some people and relatives said there were not enough staff at weekends and night-time. Inspectors found enough staff during the visit and records showed staffing was based on people's assessed needs.

    “They don't have enough staff on weekends and nighttime.” from the report
Questions to ask them, based on this report
  1. 01What action has been taken to make sure all PEG medicines have clear prescription instructions?
  2. 02How do you make sure seizure plans clearly state when to give rescue medicine and when to call emergency services?
  3. 03How many staff are normally on duty at weekends and overnight, and how is this adjusted when people's needs change?
  4. 04How will you keep us updated about care plans and reviews if we live far away or abroad?
  5. 05What rating or evidence would you give us for the Effective and Caring areas, which are not rated in this report?

The inspection looked at the overall quality of the home, but this report gives ratings for Safe, Responsive and Well-led only; no ratings are shown for Effective or Caring. This explanation was written from the published report of 24 November 2023 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.

The story over the years

Every inspection of Karuna Manor

4 rated inspections over 7 years: the service has improved, from Requires improvement to Outstanding.

  1. November 2023Outstandingcurrent rating
    Safe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding

    Read what inspectors found at Karuna Manor →

  2. September 2020Inspected but not rated
    Safe: Inspected but not rated

    We are reading this report · the original is on cqc.org.uk

  3. December 2017Goodup from Requires improvement
    Safe: GoodResponsive: GoodWell-led: Good

    Read this report on cqc.org.uk

  4. February 2017Requires improvementstayed Requires improvement
    Safe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement

    Read this report on cqc.org.uk

  5. July 2016Requires improvement
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement

    Read this report on cqc.org.uk

  6. March 2015

    Registered with the Care Quality Commission on 23 March 2015.

Ratings and report dates from the Care Quality Commission. A service can also be visited without a new rating being published, so the timeline shows published inspections, not every contact the CQC has had with the service.

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