It never fails to shock that older and vulnerable people live in unsafe and disgusting conditions. It is so much worse when the authorities are fully aware that there is a serious risk of harm. And, to add insult to injury, payment is expected for the privilege of being put at risk.
Three care homes this week share the ‘Worst Home of the Week’ title and each has a track record of poor standards. So there were no surprises for the care inspectors, but continuing appalling care for some 80 older and vulnerable people
Northgate House, Norwich; Woolton Manor, Liverpool and Holly Tree Lodge EMI, Barnsley each has a long history of delivering poor care but each remains home to many frail residents. This week these three were given another to add to their collection - including the worst possible grades from the CQC, calling into question why on Earth they are still in operation.
Holly Tree Lodge EMI care home in Barnsley has a chequered history. Well, it is has had one bad report after another since 2014. Nevertheless, there were 38 people living in the two-storey facility when it was inspected in March. It is included in this week’s blog, because the CQC report was not published in time for last week’s ‘awards’ and it should not miss out.
There were many issues. Too many to list here: ‘We found shortfalls in the care and service provided to people. We identified seven breaches in regulations – staffing, safe care and treatment, safeguarding, dignity and respect, person-centred care, consent and good governance. The Care Quality Commission is considering the appropriate regulatory response to resolve the problems we found.’
People were losing weight and experiencing falls. Medicines systems were not always safe.
‘One person's care records showed staff were regularly applying creams to their body yet no creams were prescribed...The nurse did not know what creams staff had been applying.’
There was little choice for residents, who were left with few activities: ‘One person was sat in a chair when we arrived in the lounge at 8.30am and they remained in the same chair until we left the unit at 1.10pm.’
Concerns were voiced too about the attitude towards residents, who were often discussed in their presence and spoken about in a disrespectful manner. And, according to the report: ‘The registered manager told us physical restraint was not used, it was evident from our discussions with staff that they were dealing with incidents on a frequent basis and physically restraining people.’
The inspectors continued: ‘We reviewed two people's daily notes and found one person had received one bath/shower over a nine week period; there was no evidence to show the other person had received any bath or shower over a five week period.’
In its report on Northgate House, the CQC said: ‘We observed some poor practice that put people's safety and wellbeing at risk.’
And they weren’t kidding. Checks had not been made on staff to ensure they were suitable to work with vulnerable people. Residents were not given medicines as required, there were gaps in records, the premises were unsafe and dirty, there were not enough staff to care properly for people and residents did not enjoy ‘opportunities to engage in meaningful activity’ – which is code for they were sitting in chairs all day looking at the wall/TV. And several people had lost significant amounts of weight. One person had lost more than two stone but was assessed as being at low risk.
The presence of CCTV cameras in communal areas had clearly not improved the quality of life in the ‘Inadequate’ home. But, according to the report, the home owner failed, despite repeated requests, to provide information about the use of cameras and whether residents had consented to them.
It was so bad, the CQC states: ‘Immediately following our inspection, we formally notified the provider of our escalating and significant concerns.’
But what about the 17 older people who are living in unsafe conditions? They are still at risk – and presumably someone is paying for this. Let's hope it's not them. Incredibly, according to the CQC, the home has been in breach of ‘the same regulations over the last six inspections – since 2014’. It has not had a totally good inspection report since 2012.
It appeared from newspaper reports that Woolton Manor might have closed, following an inspection last July which found that the Liverpool-based home was ‘Inadequate’. But no. Only the nursing unit closed.
In fact, 25 people were still living in the home in February at the time of this most recent inspection. In 2017, the CQC found eight breaches of the Health and Social Care Act Regulations. And this time...all the same breaches remained. Concerns had been raised in several reports and as long ago as 2016 about issues at the home and, according to the latest report, similar issues were found again.
According to the CQC. ‘People who lived at the home continued to be placed at serious risk.’
Once more, there were not enough staff, people had no access to activities and residents went ‘significant periods of time without a bath or shower’.
There is a theme here. Two people had not had a bath or shower for seven weeks. There were also concerns over fire safety and the premises and over staff recruitment. Sounds familiar?
The CQC said: ‘The provider's lack of action to address these issues both at this inspection and two previous inspections demonstrates they lack the competency and accountability to ensure the service is safe, effective, caring, responsive and well-led.’
Yet, those 25 people were still living in the unsafe, uncaring home.
These three are worthy winners of this week’s award. But one very worrying fact is that all ten of this week’s ‘Inadequate’ homes are deemed ‘Inadequate’ in terms of the key areas of safety and management. Obviously, safety is a fundamental issue but management too is a bellwether of standards – with the best homes always having excellent leadership.
This week’s other Inadequate homes are:
Norton Lees Hall and Lodge, Sheffield
Arnold House, Enfield
Fernica, Manchester
Safeharbour, Stourbridge,
Giltbrook, Nottingham
Lostock, Northwich
Canal Vue, Ilkeston
Bartley Green, Birmingham