COULD it get much worse? One care provider owns ten homes in Essex, six are rated 'Inadequate', two 'Require Improvement' and only two are deemed to be ‘Good’.
In the space of just 30 days this summer, teams of Care Quality Commission inspectors arrived unannounced at Dr Davie Vive Kananda’s Essex-based care homes after serious concerns were raised by the local authority. And following comprehensive investigations into nine of the homes, the CQC branded more than half ‘Inadequate’, blocked two of these taking new residents, and raised serious concerns over two others. A tenth home, has already been given an ‘Inadequate’ rating and appears not currently in operation.
Dr Kananda owns the homes through two separate companies, Essex County Care Ltd and Strathmore Care Ltd. The 66-year old is a director and owner of majority stakes in the companies. The Essex County homes are in the Colchester area, Strathmore’s homes are in and around Southend.
Essex County Care is beneficially owned by Johnson Care Ltd – which is also controlled by Dr Kananda. Johnson Care is also the beneficial owner of Leicestershire County care, which controls a further 13 care homes - which are not part of this summer's investigations.
The CQC teams’ first target was Scarletts, owned by Essex County Care. They went in on 6 June following stories of frail elderly residents suffering falls and injuries. According to the CQC report, published last month: ‘The inspection was prompted in part following information of serious concern received from the local authority and their safeguarding team.’
The inspectors said: ‘We received information prior to this inspection telling us that there was a high level of people falling and sustaining injuries. Whilst older frail people are more prone to falls there was a very high level of people falling at this service.’
What they found did not reassure them and Scarletts was given the worst possible rating for all areas of care. According to the CQC: ‘We also shared our concerns with the local authority and their safeguarding team. We took immediate enforcement action to restrict admissions and force improvement.’
Two weeks later, a CQC team arrived suddenly at another Essex County home, Trippier. What they found was that the safety of the 29-residents was compromised. Trippier too was to receive a terrible report, with five ‘Inadequate’ ratings and serious criticism of the care provider.
‘...there had been a lack of oversight by the provider to ensure that the service delivered was of a good quality, safe and continued to improve.’
The inspectors added: ‘The inspection was prompted in part following information of serious concern received from the local authority.’
Trippier too was banned from taking new residents, placed in special measures and given the worst possible rating.
Another CQC team, meanwhile, went to Poplars, a third Essex County home, on 20 June, but reported all was well and gave the Walton on the Naze facility a ‘Good’ rating. But the impressive-looking Ramsay Manor near Harwich, which is described online as the group’s flagship home, was given an Inadequate rating following an inspection nearly two years ago. At the time, although it was being prepared to take 84 residents, just 18 people were living there. Inspectors raised concerns over their safety. Although there is no indication on the CQC’s website, Ramsay Manor is not listed by Essex County as a functioning home and it currently appears not to be in operation. This afternoon there was no response to callers.
CQC concerns had not ended with Trippier, however, and between 3 and 6 July, a further four investigations were launched into Kananda homes. They now also included homes under the Essex-based Strathmore Care brand.
Beechlands and Well House, the two remaining Essex County homes, were inspected on 3 and 6 July and emerged with poor ratings – and ‘Requires Improvement’ grades. But CQC efforts were clearly aimed at inspecting all the provider's homes and teams were also arriving at Strathmore’s Meyrin on 3 July and at nearby Milton House on 4 July.
Inspectors confirmed that a whistle-blower led them to inspect Meyrin next, on 3 July. The small home was to emerge with a highly-critical report, damning in its findings of life for its 13 residents. The report stated: ‘Prior to our inspection, whistle-blower concerns were raised that people using the service may be at risk of abuse. Due to the severity of the concerns and conversations with the Local Authority we carried out an urgent inspection.’
They added: ‘Prior to the inspection, we had received concerns that the night staff were waking people up in the early hours of the morning (between 4-5am) as this would help the day staff. We carried out an early morning visit and our findings confirmed the concerns we had received. We arrived at 04.35am and found that three people were up and dressed in the main lounge with a hot drink in front of them, however, they had all gone back to sleep. On reviewing every person's care plans we could not find anyone who had a preference of being up before 6am.’
One of the only two to receive a ‘Good’ rating Milton House was praised by the CQC. But concerns over Dr Kananda’s homes had not ended. On 10 July, the inspectors arrived at Whittingham, another Strathmore home, which was to receive four out of five Inadequate ratings. Concerns had already been circulating about the home, which could house up to 70 residents.
The inspectors said: ‘During the inspection we were informed by the care supervisor that currently there was only one on-going safeguarding investigation, however after the inspection we received information from the local authority which showed that during the period 6 April 2016 to 14 August 2017 they had received 21 safeguarding concerns/alerts.
‘One alert was in respect of neglect however the investigation was not taken further and a further 20 concerns were for neglect/physical abuse and institutional abuse. Two safeguarding concerns had been substantiated by the Local Authority, three partially substantiated and five have been "unsubstantiated" and closed. The remaining safeguarding concerns are subject to on-going investigation.’
Meanwhile, the inspectors still had one final Essex-based Kananda home to see – Fairview. A team arrived there on 17 July. They did not completely leave the 55-bed home until 28 July. The home, which received the group’s fifth ‘Inadequate’ rating in just 30 working days, was already well known to the local authority.
‘During the period 8 June 2016 to 12 July 2017 13 safeguarding alerts were received by the local authority. Eight of the safeguarding alerts were in respect of neglect, one for neglect/physical abuse and two in relation to physical abuse; the types of abuse for two safeguarding alerts have not been determined. One safeguarding alert has been substantiated by the local authority and four have been 'unsubstantiated' and closed. The remaining safeguarding alerts are subject to on-going investigation. The Commission is working closely with the local authority as they investigate these.’
Meanwhile, the CQC inspectors once again level their criticism directly at the care provider. In the report, they said: ‘The provider states on their website, "We know that providing excellent care can make a huge difference to people with dementia. We provide a comfortable and secure environment that is stimulating and preserves and enhances residents' life skills. We do this through reminiscence. By triggering and exploring memories of the past we build self-confidence and most importantly we aim to keep residents engaged and communicating."
‘We found this was not an accurate reflection of the service.’
The CQC made no comment today, beyond the statements made in the reports issued by its teams of inspectors. Under its procedures, it now gives the care provider the opportunity to put right its homes and bring them up to the required standard. Until then, the homes which received Inadequate ratings will remain in special measures. Reports on the Inadequate homes have been released over the last few week. They can be seen at:
The events of the summer highlight the CQC tough approach in tackling concerns across care groups. But it also must raise concerns about repeated bad reports. One of the homes belonging to Dr Kananda, Whittingham House, had received no fewer than 11 reports raising concerns going back to 2011. And several other of Dr Kananda’s homes have less than impressive track records, with five, six and seven critical reports on file.
Leicestershire County Care, which is also controlled by Dr Kananda, runs 13 care homes. Eleven of these have ‘Good’ ratings. Only five have been inspected this year, two of these were graded as ‘Requiring Improvement’.