'˜Inadequate' care homes placed into '˜special measures'

Greenfield House in Morecambe and Greenroyd Residential Home in Hest Bank, both operated by Greenroyd Residential Home Limited, were visited by Care Quality Commission inspectors at the end of last year.

Greenfield House is registered to provide care and accommodation for up to 33 people living with dementia.

It had last been rated in 2016 as ‘requiring improvement’ but inspectors found those changes had not been made.

Inspectors found five safeguarding incidents had occurred at the home since their last visit, with staff having reported concerns to management but unsure what action was taken.

No cleaner was employed at the home and staff did not have time to carry out additional duties. Infection control processes were inconsistent, malodours were noted and some bedrooms were dirty.

During the inspection stained bed bases, stained chairs and a carpet and door with faeces on it were all found.

Risk was not suitably identified, managed and addressed, and equipment to support staff manage risk was not suitably maintained and fit for purpose.

The door security system was not sufficient, the call bell system was not fit for purpose and not fully functioning, and the fire alarm had not been serviced since 2015. Areas of the home were in a poor state of disrepair.

Staffing levels had not been reviewed to reflect the needs of people who lived at the home, including those individuals who displayed behaviours which challenged the service.

Staff felt they were not fully equipped with the required skills and knowledge to carry out their roles.

Care records were inaccurate and had information missing.

Meanwhile, Greenroyd Residential Home – registered for up to 23 people living with dementia – had previously been rated as ‘inadeuate’ following an inspection a year ago.

Inspectors found the management team had worked hard to make improvements, however further work is required to ensure the fundamental standards are understood and embedded within the service.

Deployment of staffing was poor and measures put in place to review staffing levels and staff deployment were ineffective.

Whilst some improvements had been made to manage risk, inspectors found not all risks had been considered.

Care records did not consistently identify risk and ways to reduce risk and good practice guidelines were not always considered and implemented.

Infection control processes were inconsistent and did not always follow regulatory guidance.

Whilst improvements had been made in relation to the recording of falls, records continued to be inaccurate.

Improvements had been made to mitigate risk within the environment. However, the CQC found recommendations had not been acted upon to ensure premises were inclusive for people living with dementia.

Equipment required to meet people’s needs was not always provided and fully functional at the home.

Organised activities did not always take into consideration people’s individual needs and abilities.

Relatives said the food provided at the home was satisfactory, although deployment of staffing at meal times was variable and had a bearing upon the meal time experience for people.

Staff were positive about ways in which the service was managed and the support received from the management team. They described a positive working environment.

Inspectors rated both homes as ‘inadequate’ and as a result both were placed into ‘special measures’.

Services in special measures will be kept under review and, if the CQC has not taken immediate action to propose to cancel the provider’s registration, will be inspected again within six months.

The expectation is that providers should have made significant improvements within this timeframe.

If not enough improvement is made so that there is still a rating of inadequate for any key question or overall, action will be taken in line with enforcement procedures to begin the process of preventing the provider from operating the service.