CHRONIC understaffing was the story of the worst reports into care homes last week, revealing the shocking conditions endured by some of our most vulnerable citizens. In one Cheshire home, a single member of staff was left to care for no fewer than 17 frail older people - while the inspectors were present.
Residents were found to be on the brink of malnutrition, neglected, in danger and ignored. Management, once more, was held responsible for appalling living conditions.
But, again, lack of staff emerged as the most serious issue at all four of
OLM’s Worst Care Homes of the Week:
These stand-out losers each received a highly-critical report from the Care Quality Commission and were served with the lowest-possible overall grade – Inadequate. Between them, the four homes, could muster only one non-Inadequate rating – and that was for care at Avondale Lodge, which nevertheless ‘Requires Improvement’.
Overall, Avondale, which is home to 12 adults with learning disabilities, was criticised for lack of staff, inadequate fire safety and for poor living conditions in which residents had to bathe in what was unacceptably cold water.
It was no surprise to find C&V Orchard among last week's ‘Inadequate’ homes – it was a winner in January of a worst care of 2017 award. And the inspectors found little or nothing had changed since the last report in November.
The picture of life they present is grim for the 22 residents who are still living in the home – despite three successive ‘Inadequate’ reports.
The CQC’s warning could not have been clearer: ‘There was not enough staff deployed to meet people's needs and people were not always protected from the risk of harm or abuse.’
Residents were found to have lost significant weight and be at risk of malnutrition, while injuries and unexplained bruising went unreported and complaints about possible abuse were ignored. According to the report, a member of staff said: "I don't think there are enough staff to meet people's needs. It’s chaotic here.”
Meanwhile, at Park Grange in Barnsley, the CQC team went into the 60-bed home after a whistle-blower raised concerns over a number of problems – including staffing. After a highly-unusual six-day inspection, the CQC closely documented multiple failings at the home and, in particular, issues with the management.
According to the report: ‘We found staffing levels were not always sufficient to meet the needs of people who used the service. On the second day of our inspection the registered manager told us there was one senior staff member and three care staff on shift. When we checked we found this was not the case.’
A poisonous working atmosphere was described by the CQC, with staff frightened to talk to the regulator: ‘Some staff told us the management team would not be happy they were speaking with us. One staff member said, "I was scared [name of registered manager] would tell me off."
Another staff member said, "At the moment it's a horrible atmosphere, staff are reluctant to speak to you.”’
We have kept the worst until last. The owners of Lyme Green Hall may boast of its grade 2 status, but the home is anything but a national treasure.
It was here that the CQC discovered one carer responsible for 17 residents. It was also here that the regulator found repeated occasions when planned levels of staff left residents at risk as well as problems with the handling and administration of medicines.
Staff were found not to be suitably trained or competent. There was poor communication, ineffective and inappropriate care practice. They CQC found the food ‘poor and inadequate’ and no one was monitoring people who were deemed at risk of malnutrition.
Managers had not acted over allegations of neglect and abuse – until the inspectors questioned them. The best the inspectors could say about the home was: ‘We could see that individual members of staff were caring in their approach but their efforts were often hampered by a lack of knowledge, skill, support and managerial oversight.’
None of the big care home groups was among the ‘Inadequate’ reports last week, although several featured on the list of homes which ‘Require Improvement’. This is far from a ringing endorsement and such care facilities offer residents a quality of life that fails to live up to adequate levels.