A local nursing home has been placed in special measures following a highly critical report from the Care Quality Commission (CQC).
CQC inspectors visited the South Wold Care Home in Tetford in January and discovered a catalogue of shortcomings.
The home is registered to provide accommodation for up to 16 people - and people living with dementia.
The report was split into five categories:
• Is the service safe? Inadequate;
• Is the service effective? Requires improvement;
• Is the service caring? Requires improvement;
• Is the service responsive? Requires improvement;
• Is the service well led? Inadequate.
The report reveals in two previous full inspections - in 2014 and 2016 - it was rated as ‘requiring improvement.’
However, the report adds: “On this inspection (January) far from improving, we found the quality of the service had deteriorated and people were not receiving the safe, effective and caring or responsive service they were entitled to expect.
“We are currently taking action against the registered provider to ensure they make the necessary improvements to become compliant with legal requirements.”
Issues highlighted in the report included:
• Failing to notify the CQC of any serious injuries sustained by residents since the care home was registered with the CQC in 2010. At first, the report states the manager said there had been no notifiable injuries, but later confirmed there had been ‘several serious injuries’ which, by law, should have been notified to the CQC;
• Senior staff were not always prompt in seeking appropriate external advice - one resident had suffered from a ‘gangrenous toe for several months’ before getting specialist treatment;
• Several people, most of them living with dementia, left for extended periods without staff support or supervision;
• A clinical waste bin on the driveway of the home was so full the lid could not be closed and bags containing hazardous items such as incontinence pads, wipes and dressings were overflowing;
• People’s medicines had been left on an open shelf in an office, creating an increased risk that they could have been accessed by residents, many of whom were living with dementia;
• Plastic containers for administering liquid medications left to dry on dirty paper towels, creating an increased risk of cross-contamination and infection;
• Empty prescription medicine bottles left in an open skip on a driveway at the home - breaching the confidentiality of the person who the medicine had been prescribed for;
• Some of the bottles had not been washed out, meaning powerful mood-altering properties in some of the medicines created a risk to anyone who came into contact with the skip;
• An unreliable hot water system which increased the risk of infection and meant staff had to carry containers of hot water from the kitchen through the home , adding to safety concerns.
The report noted an example where a carer wore single use protective gloves while ‘supporting’ a resident in the toilet. The carer then left the toilet to talk to another person in their bedroom and inspectors watched as they placed their hands near the person’s face, while still wearing the gloves.
There was also criticism of staff training and recruitment.
A failure to employ an activities manager meant residents were sometimes left ‘staring into space’ with nothing to do.
In all, January’s inspections found three breaches of the Health and Social Care Act 2008, namely:
• Continuing shortfalls in organisational governance;
• A failure to properly assess and mitigate risks to people’s safety;
• A failure to ensure sufficient staffing to meet people’s need for emotional support, and to keep them safe.
The report reveals the provider also breached Regulation 18 of the CQC (Registration) Regulations 2009 due to a failure to notify the CQC of serious injuries sustained by people living in the home.
The report adds: “The registered provider was also failing to provide people with the effective, caring and responsive service they were entitled to expect.
“People were not supported consistently in a person-centred way, and did not receive sufficient physical and mental stimulation to meet their needs.”
The report also highlights how in May 2017, a resident was placed at high risk of developing pressure sores.
Staff were instructed to help the person change position every two hours. However, when inspectors reviewed the charts used by staff to record when they supported the resident, they found ‘multiple gaps.’
In December, 2017, the record had over 130 missing entries.
Owner/manager Shailen Munnien told the News he was focused on addressing the issues raised by the report and stressed residents were ‘all well.’
Mr Munnien did not dispute the CQC’s findings and said steps were already in place to put things right. He added: “We are working hard, we have to turn the corner.”
He said he had now employed a secretary who would help with administrative shortcomings identified in the report.
• Although overwhelmingly critical, the CQC report highlights a number of positives at the South Wold Nursing Home with staff, in particular, coming in for praise.
The report notes that:
• Staff worked well together in a mutually supportive way.
• Staff were kind and caring in their approach and encouraged people to maintain their independence - and to exercise some choice and control over their lives.
• Staff provided end of life care in a sensitive way.
• Staff enjoyed their job
One staff member told inspectors who compiled the report: “I enjoy it (work). We all get on and work as a team.
“We’ve got a good atmosphere (and) if you have a problem there is always someone there to hold your hand.”
Another employee praised the system of team meetings, daily logs and shift handover sessions, adding: “They are helpful.
“We can talk and express how we feel.”
The report notes how the family of one resident described staff as a ‘good caring bunch’ but added...‘there are not enough of them.’
Staff also told inspectors about the problems caused by the hot water supply, saying they had to make sure ‘the washing machine isn’t running before someone has a shower.’
The report adds: “Staff had received training in adult safeguarding and were aware of how to report any concerns relating to people’s welfare, including how to contact the local authority and the CQC, should it be necessary.
“Staff had access to a range of publications and other information sources to help them keep up to date with changes to good practice and legislative requirements.”
The report also adds: “People’s concerns or complaints were handled effectively.”
The standard of food is praised. It notes the cook regularly provides meals for individual requirements, even going to the length of preparing seperate gravy - because some residents had said they didn’t like it in cottage pie.
The report also notes how internal signage and colour schemes had been upgraded (after previous inspections)to make it easier for people living with dementia to find their way around the home.
People’s care plans were well organised and provided staff with information on individual needs and preferences.
However, care staff told inspectors they often did not have time to read the plans in full as they were asked to do other tasks, including laundry.
The report highlights several mentions of ‘good relationships’ with residents’ families.
Inspectors also said registered manager (Mr Munnien) was ‘well-liked’ by everyone but the report added there were ‘insufficient management and administrative resources ‘ which had a ‘negative impact on the running of the home.
The family of a resident of the South Wold Nursing Home say they did not have ‘ a single complaint’ but admitted they were not aware of comments in the CQC report.
John Jordan said his mother had been a resident of the home for ‘several years’ and was always treated with ‘care and respect.’
Mr Jordan said if the time ever came for him or other family members to move into a nursing home, they would be more than happy with South Wold.
He also praised owner/ manager Shailen Munnien and other staff who he said were ‘dedicated and commited’ and often went ‘above and beyond’ to provide extra care and support.
The News informed Mr Jordan of some of the failings listed in the CQC report but he said he ‘did not recognise them.’
He added: “I am at the home every day to see my mother and I am very happy with the standard of care, and she is very happy.
“I know and see the staff and they do an absolutely first class job.
“Mr Munnien is always available and is very approachable.
“I’d have no hesitation recommending the home. If for any reason, I had to move into a care home, I’d be delighted to come here.
“Everything is always clean and tidy.
“I’m delighted. I have no criticisms and I think others (familes of residents ) would say they feel the same.
“That is certainly the impression I get from speaking to them.”
The News was invited to visit South Wold in 2014 following another critical inspection by the CQC.
Elaine Minchin , a resident at the home at the time, said “I would not want to be anywhere else.”
The CQC had called for improvements in 2014 after inspectors discovered a raft of failings, including claims patients had being left in soiled beds.
Mrs Minchin said “I can’t understand how anyone can attack an establishment like this.
“It’s so happy, warm, loving and caring. The CQC were picking as many holes as they possibly could.
“I have not come across anyone who has a bad word to say about South Wold. I am happy here.”
Mrs Minchin was backed by relatives and staff who came forward after the News published details of the report.
Several relatives and staff hit out at the News for publishing the article and called on the newspaper to apologise to Mr Munnien and his staff. They also accused the CQC of having a ‘hidden agenda.’
Following the 2014 report, the CQC threatened to cancel the registration of South Wold - effectively meaning it would have to close. However, the CQC withdrew the threat after a follow up inspection revealed the home met ‘all the required standards.’