Each week OLM studies the latest reports on care homes and each week there are distressing tales of appalling care of older people. A report this week on The Limes Trees, in Enfield, however, represents a whole new low for the care industry. And it raises the urgent question: why did the regulator leave 17 frail, vulnerable people living at the North London home where they have been treated in the most degrading way and where they are at risk?
So much for the ‘Mum’ test, the much-publicised hurdle suggested as a way of assessing care homes by the CQC's chief inspector, Andrea Sutcliffe OBE.
The Lime Trees, which was previously graded ‘Good’ by the Care Quality Commission, was found to be ‘Inadequate’ in every respect, although this case deserves a new category. ‘Appalling’, perhaps or ‘Disgraceful’ might be appropriate for The Lime Trees, which must be an early candidate for the Worst Care Home of 2018. We can only hope there is none worse.
This week's CQC report speaks for itself: ‘People were not safeguarded from abuse and neglect. People were sleeping in soiled and dirty bedding. People were showered in view of communal areas and as a result were exposed naked to other people, staff and visitors. Safeguarding incidents were not always recognised or reported to the local safeguarding authority.... People were not treated with dignity and respect. The majority of people we spoke with during the inspection told us of their unhappiness living at the Lime Trees.’
Usually, residents and family members are positive about a care home, even when the CQC has concerns. Not where The Lime Trees is concerned. According to the report: ‘One person told us, "I want to escape from here it is terrible and I will escape." A second person told us, "They are nasty people; they will not let me out."’
Among other comments were: ‘"If this place burnt down I would put petrol on it", "You work hard all your life and end up in a place like this" and "I wouldn't like to see my mum here."’
It is little wonder that such views were expressed. The CQC found little or no respect was given to residents who showered in full view of communal areas and made to walk naked to their rooms afterwards. Inspectors found ‘faeces between a person's bed and wall’ and ‘people had been sleeping in soiled bedding’. The report stated: ‘People had been subjected to degrading treatment which included people sleeping in soiled bedding and being left naked and inappropriately clothed.’
There were other significant concerns about the maintenance, cleanliness and the failure of the management to safeguard people from abuse and improper treatment.
‘Very strong odours were detected throughout the home during the inspection especially in people's bedrooms where soiled bedding was found.’
There were concerns about staff recruitment and numbers, medicines and infection control: ‘We observed on two occasions, staff not remove their gloves following supporting people with personal care and carried out other tasks wearing the gloves.’
The attitude towards residents appeared to be at the heart of the regulator's concerns, however. One person told inspectors: ‘"There should be more kindness. There is mistreatment, abusive words and comments."’
And the CQC team reported that ‘staff routinely showed a lack of respect for people’. One person who went out to have a cigarette was locked outside in heavy rain by staff although the resident was wearing pyjamas – and this, in front of the CQC!
Another person was seen being dressed in ‘torn clothes’ by staff, while others were heard being told to ‘sit down’ abruptly. One person complained they were not allowed out, even to the local paper shop: ‘”They said I was prohibited.”’.
The CQC has stopped future admissions to the home. But what of the residents, many of whom were living with dementia or even receiving 'end of life care'?
This was not the first time that concerns had been raised about The Lime Trees, although the last inspection report on the home was ‘Good’.
While the sheer awfulness of the Lime Trees would seem to overshadow the week, other ‘Inadequate’ reports have emerged this week which each highlight different concerns over the care industry and the inspection system.
OLM's regular readers will be familiar with Scarletts, in Colchester, which this week, received its fourth appalling report in 12 months from the CQC. Yet it is still in business and 18 people were still receiving ‘care’ at the Colchester home at the time of the inspection. Whistle-blowers and the Local Authority had sent the care regulator back to the home – a matter of weeks after its previous inspection.
Willow Cottage, Bristol, showed a continuing decline. Despite the CQC’s efforts it has gone from Good to Requires Improvement to Inadequate.
Meanwhile, Yew Tree Manor in Manchester was given an ‘Inadequate’ report just six months after it had been rated as ‘Requiring Improvement’ – which many providers shrug off as a technicality. Why had the regulator returned to Yew Tree Manor and discovered it was actually ‘Inadequate’? Because Manchester Police are investigating a ‘serious incident’.