Ashton's The Knowle Care Home  is downgraded to "requires improvement" as concerns over fall monitoring, record keeping and cleanliness are raised

The Knowle Care Home provides personal care and accommodation to 28 people currently, some of whom have dementia, and was reinspected between April 13-14 this year, after the CQC received messages of concern.

The inspector undertook “a focused inspection”, only checking if the service was ‘safe’ and ‘well-led’, finding the home in need of improvement in both areas.

This means Knowle Care Home is overall classed as ‘requires improvement’, despite being ‘good’ for the categories ‘effective’, ‘caring and responsive’ in its last full inspection (December 2018.)

In the latest report, the inspector summarised: “Risk management needed to improve in relation to; falls monitoring, record keeping and the cleanliness of some staff areas. We have identified a breach of the regulations in relation to mitigating the risks of falls. We have made recommendations about record keeping and cleanliness of some staff areas in the report.”

Despite previously receiving concerns regarding the management of medicines, moving and handling, nutritional needs, and maintaining people's dignity, the inspectors said they “found no evidence during this inspection that people were at risk of harm from these concerns.”

They did however find that there was an increased risk that people could be harmed, compared to the last inspection.

Safety wise, they noted that falls records showed 50% of falls were only discovered by staff on routine checks, meaning on some occasions people may have been on the floor for up to two hours, indicating a need for more fall sensors.

Currently most people only had sensors on bedroom doors, which would only be activated if the person opened the door.

Inspectors also criticised the home’s record system, for example “Two people who had recently fallen were reported to be having hourly observations, but we found no record of the hourly observations” and “One person was recorded as being supported to get up and ready for the day, but we found they were still in bed three hours after the entry in the records.”

The report said that whilst neither case showed evidence of harm, the operations manager acknowledged staff needed support to be more vigilant in using the record systems.

Additionally, inspectors said “the corridor outside the kitchen, accessible to staff only, was very dirty”, as was the kitchen door and the exterior of pans, risking “infection or cross contamination.”

In terms of service management and leadership, inspectors found it to be inconsistent, meaning “leaders and the culture they created did not always support the delivery of high-quality, person-centred care”.

However the report did praise the cleanliness and organisation of commual areas, the robustness of medicine management, their COVID-19 policies, and the fact that residents were supported to have maximum control of their lives.

The inspector added: “People were supported by trained staff who were caring and compassionate. Enough staff were in place to maintain people's safety, the manager had already identified this could be improved by introducing an additional shift over teatime and the early evening.

“The manager, who had only been in post for a short time, had begun to embed improvements to care quality and record keeping.”

The CQC will return as per their reinspection programme, but may inspect sooner if they receive concerning information.

The Knowle Care Home has been approached for comment.