Residents at a care home in the northeast of England have been left in unchanged incontinence pads and stuck in their beds unable to get up for lunch because of low staffing levels and poor management support, the healthcare watchdog has found.
The Care Quality Commission (CQC) has rated Willow View Care Home in Stockton-on-Tees as ‘inadequate’ and placed the service into special measures following an inspection in May.
The latest inspection of the home – which provides personal care for up to 77 older people, some of whom may have dementia, a physical disability or sensory impairment – came as a follow-up to check on the progress it had made on improvements the CQC had ordered after an inspection last year.
But inspectors found the care home remained in breach of regulations regarding assessing risk and medicines management, as well as records and governance. Further breaches were also found in relation to dignity, respect and consent.
In its latest report, inspectors concluded that the service ‘was not safe’ and that infection, prevention and control measures were ‘insufficient’.
They also found that medicines were not stored, recorded or administered safely and that people were ‘regularly not given their prescribed medicine due to poor stock management’.
In addition, they highlighted how safe staffing levels ‘were not always in place’ and that while a dependency tool was being used to calculate staffing levels, the ‘data used was not accurate’.
Rotas also showed that the required level of staff had ‘not always been maintained’ and that there were ‘numerous examples in April when staffing was below expected levels’.
The CQC’s report also flagged concerns about the care home’s recruitment processes and, worryingly, it found that the registered manager ‘did not have effective systems in place to ensure proper pre-employment checks had been completed prior to employment commencing’.
During the inspection, staff had described ‘how they were unable to meet people’s care and support needs’ because of low staffing levels and said they had been forced to work in a ‘task orientated way’ as a result.
The report highlighted comments from staff such as: ‘We don’t always have time to change people’s incontinence aids or get people out of bed because there isn’t enough staff to support people.’
Meanwhile, a resident had told inspectors how there were not enough staff to support them to get out of bed for lunch.
Other observations from the CQC included faeces on bedding which had not been changed when the bed was made and a person’s dentures left, unclean, on a person’s wheeled walker.
The report also highlighted the ‘poor culture’ within the service, as described by staff, as well as ‘low’ staff morale.
‘There was a lack of confidence in the management team,’ said the report. ‘Comments included, “I think they (management) are trying, but they don’t really listen to what staff say. I’ve never seen the home this bad to be honest.”’
But despite this, the CQC recognised that ‘staff were keen to ensure improvements were made’.
And the registered manager stated they would be ‘implementing clear lines of responsibility to empower staff and begin to improve the culture’, the report added.
In addition, the healthcare watchdog noted how people did speak ‘highly of their staff team and the care they provided’. One relative told the CQC how staff ‘will go above and beyond’.
Following the inspection, the CQC has downgraded the overall rating for the home, as well as for how safe and well-led it is, from ‘requires improvement’ to ‘inadequate’.
The ratings for being caring and responsive have also declined from ‘good’ to ‘requires improvement’.
And for being effective, the home – which does not provide nursing care – was again rated as ‘requires improvement’.
It has now been placed into special measures, meaning the home will be kept under review and re-inspected by the CQC within six months to check for significant improvements.
Sarah Dronsfield, CQC deputy director of operations in the North, said: ‘When we inspected Willow View Care Home, it was concerning the provider still hadn’t addressed the issues highlighted at previous inspections.
‘There were significant shortfalls by the leadership team, the culture they’d created didn’t ensure the delivery of high-quality care.’
She added: ‘It was concerning to hear how worried staff were about being unable to meet people’s care and support needs due to low staffing levels and poor support from management.
‘They told us they didn’t always have time to change people’s incontinence aids or get people out of bed because they didn’t have enough time.’
Ms Dronsfield concluded that the standard of care was ‘totally unacceptable’.
‘It was really concerning how people were made to feel, in a place that was supposed to be their home and leaders must take immediate action to improve the quality of care, as people living at Willow View deserve better,’ she added.
The CQC will ‘continue to monitor the service closely to ensure significant and urgent improvements are made’, she noted.
‘If we are not assured people are receiving safe care, we will not hesitate to take further enforcement action so people receive the high standard of care they deserve,’ added Ms Dronsfield.
A statement from Willow View Care said: ‘The CQC report is a real disappointment for us all at Willow View Care Centre, however, prior to publication of the report we have already made significant progress in the areas needing improvement.
‘We quickly identified a lack of trust and confidence in the previous management of Willow View and acted swiftly to bring in a team of two senior care consultants to work with our dedicated deputy and the whole Willow View staff team in making these improvements.’
It added: ‘We are confident that when CQC revisit Willow View, they will see the dedication and commitment shown by all at Willow View to ensure significant improvements have been made for the well-being of our residents.’