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CQC report explained · a residential care home, run by Knowle Care Home

The Knowle Care Home

5-7 Egerton Road, Ashton-on-Ribble, Preston, PR2 1AJ

Requires improvementpublished 9 March 2024, 2 years ago

Rated Requires improvement: inspectors found the service was not performing as well as it should and told it what to change.

The five questions inspectors ask
Safe?
Requires improvement
Medicines were not always managed safely. Some training, competency checks and records of medicine times were not up to date or complete.
Effective?
Good
The report does not give a rating or detailed findings for this question.
Caring?
Good
The report does not give a rating for this question. Inspectors found that some staff were kind and respectful, but people's experiences of care varied.
Responsive?
Good
The report does not give a rating for this question. Inspectors found that people's preferences and simple requests were not always respected or met.
Well-led?
Requires improvement
There was not enough oversight of risks, records and incidents. The culture did not always support person-centred care.
The latest report, explained

What inspectors found, March 2024

Requires Improvement; inspectors found unsafe medicines management and weak oversight, although staffing and some care had improved.

This was an unannounced inspection on 12 and 23 January 2024. One inspector spoke with people living in the home, relatives and staff. They reviewed care records, medicine records and records about safety and management.

The home was rated Requires Improvement for Safe and Well-led. Medicines were not always managed safely. Records did not show when some time-sensitive medicines were given, and some staff did not have up-to-date medicines training or competency checks.

Inspectors also found weak oversight of risks, incomplete incident reporting and care that was not always based on people's preferences. Some people experienced kind care, staffing levels met the provider's assessment, and recruitment checks had been completed.

The home was already rated Requires Improvement at the previous inspection in 2022. Some improvements had been made, including better management of falls risks and cleaning, but the home remained in breach of regulations. The provider must send an action plan, and CQC will monitor progress with the local authority.

What inspectors praised
  • Recruitment checks

    The home completed the necessary checks before staff started work.

    Staff had been recruited properly. All necessary pre-employment checks had been completed before staff started work.from the report
  • Some kind care

    Some people and relatives were happy with the care, and inspectors saw staff supporting people kindly and respectfully.

    Some people living in the home and their relatives were happy with the care they received.from the report
  • Improvements made

    Inspectors found that falls risk management had improved and that earlier cleaning and kitchen work had been completed.

    At this inspection we found the necessary work had been completed.from the report
  • Staffing assessment

    The number of staff met the provider's assessment of people's needs, although some relatives reported delays at times.

    We found staffing levels were at the level the provider had assessed as necessary.from the report
What inspectors were concerned about
  • Medicine safety

    serious

    Medicine administration times were not always recorded. Some staff lacked current training or regular competency checks.

    Not all staff had up to date medicines training and not all staff responsible for administering medicines had their competencies checked regularly.from the report
  • Person-centred care

    needs fixing

    People did not always receive care that respected their preferences. Some people did not have hot water in their bedrooms.

    Not everyone who needed it had hot water in their bedrooms which prevented them from meeting their needs independentlyfrom the report
  • Weak oversight

    serious

    The home did not adequately review falls, care records and other risks. The provider also missed some opportunities to learn from incidents.

    There was not enough oversight and governance of risks.from the report
  • Missed notifications

    needs fixing

    Not every incident that should have been reported to CQC or safeguarding authorities had been submitted.

    Not all incidents which were notifiable to CQC and local authority safeguarding had been submitted.from the report
  • Call bell delays

    needs fixing

    People gave different accounts of how quickly staff responded when they used their buzzers. One person reported waiting a long time.

    When I ring my buzzer I have to wait a long time.from the report
Questions to ask them, based on this report
  1. 01How are you now recording the exact times for time-sensitive medicines and medicines given around food?
  2. 02Which staff currently administer medicines, and when were their training and competency checks last completed?
  3. 03What has been done to ensure every bedroom needing it has hot water?
  4. 04How are you checking that care records are accurate and that people's preferences and simple requests are being followed?
  5. 05What changes have been made to review falls, report incidents and learn lessons from them?

This was a focused inspection prompted by concerns about staffing and it rated Safe and Well-led; the report does not give ratings for the other three questions. This explanation was written from the published report of 9 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.

The story over the years

Every inspection of The Knowle Care Home

5 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.

  1. March 2024Requires improvementcurrent ratingstayed Requires improvement
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read what inspectors found at The Knowle Care Home

  2. June 2022Requires improvement
    Safe: Requires improvementWell-led: Requires improvement

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

  3. December 2020Inspected but not rated
    Safe: GoodWell-led: Good

    Read this report on cqc.org.uk

  4. February 2019Goodstayed Good
    Safe: GoodWell-led: Good

    Read this report on cqc.org.uk

  5. August 2017Goodstayed Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read this report on cqc.org.uk

  6. July 2015Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read this report on cqc.org.uk

  7. December 2013

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  8. May 2012

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  9. March 2012

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  10. December 2011

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  11. January 2011

    Registered with the Care Quality Commission on 17 January 2011.

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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