EIGHT out of nine homes for older people branded 'Inadequate' last week had got worse since the Care Quality Commission's last inspection. Only one home had improved - slightly.
Although most were supposed to be under close supervision by the CQC, the eight all had deteriorated to the point where the regulator had to slap 'Inadequate' notices on them. Two had previously been sitting on ‘Good’ recommendations. But, according to last week's reports, these are now very wide of the mark and they received the most damning reports last week.
In many ways they are quite similar. Neither had been inspected since 2015, both are in leafy Cheshire and they each boast impressive mansion-style premises. But, as with much in the care industry, appearances count for little.
Inspectors found that residents had suffered dozens of falls, staff were recruited to work with vulnerable people without proper checks and frail dementia sufferers were left alone for long periods and there insufficient numbers of staff.
Madeley Manor in Crewe was home to 31 vulnerable older people when the CQC arrived and last week’s report found it was failing in every respect – although its last report was ‘Good’ in almost every respect. Meanwhile, Tabley House in Knutsford, was also sitting on a ‘Good’ report but was found to be failing its 49 residents in most aspects of care from safety to management
Although the CQC awarded Madeley home a clean sweep of 'Inadequate' marks last week, a dedicated website claimed today, 25 June, that the home has a 'Good' report. And it states Madeley is: 'Providing you with luxury living, Exceptional Care and Unrivalled views of the Cheshire countryside.'
The CQC report admitted that its inspectors had gone into the erstwhile highly-rated Madeley Manor because of ‘information we received from the public and the local authority’. When there, the regulator found people calling for help, mismanagement of medicines and residents deliberately prevented from summoning help.
The report stated: ‘People's calls bells had been placed out of their reach meaning that they were unable to summon support from staff. We heard one person shouting, "Help, help, I can't shout any louder. Please help me I can't do anything." We went to the person and they told us that a staff member had wrapped their emergency call bell around the bed post so that they could not use it.’
According to the report: ‘Comments from people included, "We are invisible"...We saw people were left unsupervised in lounges for long periods of time without staff supervision, despite people being at risk of falls. We saw that one person pressed their buzzer to call for help and no one responded. They told an inspector that they needed the toilet and were in pain. They became distressed and after ten minutes of waiting, the inspector went to find staff.’
Before the inspection at Tabley House, however, the local authority had said it had no concerns about this service. But the CQC found residents isolated and unsafe: ‘We asked the manager and a nurse told us that staff checked on people's welfare every two hours when they were in their bedroom. We found this practice to be unsafe. This was because the frequency of these checks was inadequate....it was unlikely staff would hear people shouting for help if they fell or needed help in between the two hourly checks.’
And, even more worrying: ‘One person's accident and incident records showed that they had fallen over 30 times since July 2017....Another person's accident and incident records were equally concerning. We saw that this person had fallen and been found on the floor of their bedroom and bathroom 12 times in a 12 month period.’
Inspectors also raised concerns over the reliability of the home’s record-keeping, which must be 100 per cent accurate if residents are to be cared for properly: ‘One person's daily records showed that they were assisted to the toilet at 7:19 am. The next recorded assistance...was at 10:51pm - over twelve hours later. The gaps and inconsistencies in people's care indicated that there were not enough staff on duty to meet people's needs and ensure their safety at all times.’
Good recruitment practices are important, since so staff will be working with very vulnerable people. But the CQC said: ‘The majority of the job applications we looked at were sparse in detail about the staff member's suitability.’
Only one of the nine, St Mark’s Care Centre, Sale, had actually improved since its last inspection – going from ‘absolutely dreadful’ to ‘not that great’ (not technical terms).
Other Inadequate homes which had deteriorated, according to last week's reports were:
Ormidale House, Wednesbury,
Adbolton Hall, Nottingham,
Chasewood Care Ltd, Coventry,
Woodland Manor, Gerrards Cross,
Carlton Hall, Lowestoft and
Andrin House, Derby,