January has been a bad month for care home residents. It is far from a Happy New Year – with truly shocking reports of serious injuries, whistle-blowers’ concerns and a lack of respect and the neglect of elderly residents. But it is not just the exceptions. There have been widespread complaints over inadequate staffing, basic failings in care and safety.
- More than half the reports issued by the regulator have revealed failings in essential standards with more than 90 per cent failing in terms of residents’ safety.
- In one case, trained staff had to be parachuted into a home, because the residents were at serious risk of immediate harm.
- According to the Care Quality Commission, which oversees England’s residential homes, more than 53 per cent of reports issued in January were negative – with many highlighting significant failings. Fewer than five per cent were ‘Outstanding’.
Among the 55 homes which received the lowest possible ‘Inadequate’ rating, were distressing examples of the reality of life for too many older people throughout the country. Time and again, home owners were found to have too few staff to care properly for their frail and vulnerable charges. Numerous homes had problems going back years, during which time residents have endured neglect and lack of consideration – and worse.
But the worst example of all must be two homes in the west midlands. Orchard Manor and C&V Orchard are both owned by the same provider and both are ‘Inadequate’ in all respects. The CQC did not have a good word to say about them.
The inspections came after news of serious injuries at Orchard Manor. But, even the CQC could not have expected the distressing and unpleasant scenes they encountered at the home. It was so bad that, at the end of the first day, additional staff were brought in to protect the 32 residents from harm. According to the report. Orchard Manor was ‘dirty and smelt offensive’, residents were not cared for by enough trained staff to ensure their safety and people were at risk of injury from poor practice by staff.
The state of the home clearly shocked the inspectors, even though they are accustomed to poor standards: ‘A number of people's beds had been made that morning by staff working at the home using soiled and dirty bed linen...a number of dirty and full urine bottles had been found on people's dining tables in their rooms.’
They added: ‘We found widespread incidents of neglect throughout this inspection. We spoke with one person in their bedroom...The person's bedding and room was found to be soiled and offensive smelling. The person was found in a distressed and unkempt state and the person informed us they were in need of a drink.’
But, in the most damning comment of the month, the inspectors said: ‘People did not experience kind and compassionate care and we found numerous examples where people had experienced harm and serious omissions in their care. We found people in distressing states where their physical, mental or emotional health needs had not been adequately addressed or recognised by the provider. Overall the service provided at Orchard Manor was not caring.’
News of serious injuries also took CQC inspectors into Wordsworth House, a 63-person home in Newcastle owned by the homes group Akari. They said: ‘Before the inspection we received notifications of incidents following which two service users sustained a serious injury. These incidents are subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident.’
But concerns about the service did not stop at a one-off incident. According to inspectors: ‘Everyone we spoke with about staffing raised concerns that there were not enough staff.’
Meanwhile, at Milner House, owned by the luxury homes operator Care UK: ‘There were not sufficient numbers of staff present to meet people's needs safely.’
The same situation was repeated at most of the care homes which received negative reports, with inspectors writing that residents were not safe or supported adequately, were left alone and bored or not helped to go to the bathroom or to eat in a timely way. Concerns were raised about the length of time residents were left in bed as well as over the handling of medicines and unhygienic practices.
At River View Care home in Dartmouth, a whistle-blower had warned about the lack of staff. And inspectors discovered numerous serious issues at the home, everything from malnutrition to falls to serious skin problems. There were concerns over fire safety, infection and squalor. A relative told the CQC: ‘The cleanliness of the place is disgusting at times; hallways you stick to, tables, remote controls sticky. I had to take my relative's slippers home and wash them as they were revolting; food, hair etc. stuck on them.’
Inspectors found other instances of serious neglect: ‘There was a strong odour in the room and we heard them calling, "I want my mummy." We found the person with faeces on their sheets...We advised the staff so they could address the situation...When we went to check 30 minutes later the situation had not changed...we spoke to staff again, they told us they were going on a break. The person remained in soiled sheets until the staff returned from their break. The following day we visited the person again at 1pm. They were in bed as they are at the end of their life. We found the person had faeces on their pillow cover just by their face and their incontinence pad was soiled.’
At Treetops home in Epping, the CQC acted to prevent the home taking any more residents, so concerned were inspectors about safety. The local authority withdrew residents and the CQC’s report reveals a litany of poor and dangerous practice, unpaid bills – and a miserable existence for Treetops’ residents.
Southminster, also in Essex, also had a clean sweep of negative ratings and inspectors had serious concerns across the board – with multiple breaches of the Health and Social Care Act. There were staff without appropriate knowledge or skills, uncaring and disrespectful behaviour and controlled medicines not being handled properly. Residents and their families were said to be ‘scared’ to raise problems – and staff who made vulnerable people wait for help until they finished their tea break.
OLM was planning to report every month on the worst homes of that period. But there were simply so many dreadful cases, it has been impossible to highlight each one. We have, therefore, decided to return to our practice of having a worst home of the week.