People ‘not safe’ at Merseyside care home rated inadequate in five key areas

A Merseyside care home has been placed under special measures after failing to protect residents from abuse and harm, according to a report from the Care Quality Commission (CQC).

Inspectors visited Thornton House in Ellesmere Port, after receiving concerns about safeguarding incidents that had not been reported to Wirral local authority.

An inspection took place on March 14, 15, 17 and 20, and the residential home’s rating was downgraded from ‘good’ to ‘inadequate’. Thornton House rated ‘inadequate’ in all five key categories:

• Is the service safe?
• Is the service effective?
• Is the service caring?
• Is the service responsible?
• Is the service well-led?

About Thornton House: Thornton House Residential is run by GN Care Homes Limited, and can support up to 22 people in one adapted building. At the time of the inspection, 22 ‘older people’ were living at the home, with age related conditions, including dementia.

The inspection and key findings: Three inspectors carried out the survey. According to the CQC, ‘the provider had not fully protected people from the risk of abuse and improper treatment. Incidents and accidents involving people were not consistently reported, recorded and investigated. Lessons were not learned from accidents and incidents to drive improvement or to mitigate future risk.’

Is the service safe? -The CQC said the service was not safe, as systems to protect people from the risk of abuse or neglect were in place but had not been followed. People had come to harm and prompt and appropriate action had not been taken to safeguard people.

The report notes: “On day one of our inspection, we identified a first-floor window that did not have a restrictor in place. We were given an assurance by the registered manager and provider that this would be immediately addressed. On day three of our inspection, six days later, this risk had not been addressed, leaving people at risk of harm.”

However, it is noted that medicine administration records (MARs) were accurate and up to date and all medicines, including controlled drugs, were stored safely. Infection control procedures were also followed.

Is the service effective? - The service’s effectiveness was rated as inadequate and ‘people were supported by staff who did not have the right skills or training to meet their needs - this placed people at risk of harm’.

Is the service caring? - The CQC said that ‘people were not always treated well. Some people had been harmed through staff not having received appropriate training or guidance to meet people’s needs. There were many records where people may have experienced avoidable harm’.

The report also notes that ‘language used in some people’s care plans and records to be disrespectful and undignified,’ and two relatives of residents described their loved ones ‘having very dirty and long fingernails’.

Is the service responsive? - The CQC found that residents’ care plans were ‘variable’ in completion, and though people were encouraged to participate in communal activities and though the activities co-ordinator was enthusiastic, people who chose to spend time in their bedrooms were not offered any engagement.

People had a basic communication plan in place to offer guidance to staff, however, consideration was not given for people living with dementia. The report notes, ‘people living with dementia did not have any clear plans or guidance in place to guide staff about how best to support people on their dementia journey. This had resulted in a high number of potentially avoidable incidents where people had been harmed.”

Is the service well-led? - The CQC stated, ‘leaders and the culture they created did not assure the delivery of high-quality care.’

The report also notes that there was a registered manager in post at the beginning of the inspection. However, they left before the report was published. The nominated individual and area manager were managing the home on an interim basis until a new manager was recruited. The registered manager and nominated individual were open and transparent throughout the inspection and took immediate action to address some of the concerns that were brought to their attention.

Despite this, ‘staff did not have regular supervision to receive feedback on their performance and constructive feedback on how this might be improved’ and ‘people were at risk of being supported by staff that were not competent and confident in their role’.

Next steps: As the service is in ‘special measures’ it will be kept under review and, if the CQC does not propose to cancel the provider’s registration, they will re-inspect within six months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, the CQC will take action in line with our enforcement procedures. This will mean the CQC will begin the process of preventing the provider from operating this service - this will usually lead to cancellation of their registration or to varying the conditions of the registration.

Thornton House has been contacted for comment.