CQC demands action to improve services at Taunton nursing home

20 June 2011

The Care Quality Commission has told the managers of a nursing home at Taunton in Somerset that they must take action to improve standards of care.

Inspectors found that Ruishton Court Nursing Home in Henlade was failing to meet nine of the essential standards of quality and safety. The report identifies concerns with care planning, safeguarding, records, nutrition and staffing arrangements.

The registered provider, Ruishton Court Limited, has been placed in administration. CQC has told the administrators that they must produce plans to show how they intend to achieve compliance. By law, providers of care services have a responsibility to make sure they are meeting all the essential standards of quality and safety.

Since the inspection in March, CQC has been working with Somerset County Council’s adult social care service and NHS Somerset to ensure that there is no undue risk to residents.

Inspectors visited the home as part of their routine schedule of inspections. They talked to residents and staff over two days. The main areas of concern included the following.

• Respecting and involving people
  Inspectors said there was little evidence to show that some residents were given the choice about their care. While people who can communicate easily were treated in a respectful and dignified manner, this was not apparent for those who are less able to communicate their needs, likes and dislikes.
• Care and welfare of people
  The report says that people’s general health and welfare was put at risk through inadequate care planning. Risk assessments to determine people’s care needs such as nutrition, wound care and pressure sore prevention were not completed correctly. Nursing care plans were not in place to prevent people from developing pressure sores or malnutrition/dehydration.
• Nutrition
  Inspectors said that people were at risk of malnourishment and dehydration due to a lack of consistent guidance, leadership and staff knowledge in how to assess and maintain suitable levels of nutrition and hydration. Meal times were not conducted as a social event and people requiring assistance were not helped in a dignified manner.
• Safeguarding people
  While there were systems in place to protect people from abuse, inspectors found that staff showed little awareness of the issues around safeguarding and whistleblowing.
• Staffing
  Inspectors said there was no clear management structure and there was an over-reliance on agency nurses to provide nursing care and guidance for staff. There were inconsistencies in the standards of care and in the guidance and support offered to the other staff to carry out their daily tasks.
• Supporting workers
  Mandatory training had not been completed and staff had not received additional training relevant to people's needs.
• Records
  Record-keeping systems were disorganised. Records could not be found, or were out of date. Care plans did not contain clear, accurate and up-to-date information.

Bernadette Hanney, acting Regional Director of CQC in the South West, said: "It is clear that the standard of care provided by Ruishton Court has been falling far short of standards people should be able to expect.

"The last permanent manager left last year and since then the home has been left without a manager or clinical lead for significant periods of time. Staff have had to manage on their own, and the result is that people have not been properly protected from the risk of unsafe or inappropriate care.

"While some people seemed to be supported properly, we were concerned that those who suffer from dementia or who were less able to speak up for themselves seemed to be treated differently. We saw people sat in the lounge with no engagement with staff. Nobody came to speak to them, check that they were all right or offer them a drink. At meal times people were not helped in a dignified way when being assisted to eat.

“The law says these are the standards that everyone should be able to expect. Providers have a duty to ensure they are compliant and we have given them 14 days to show us how they plan to achieve this. We expect the management company brought in by the administrators to address the compliance issues and ensure people are safe and receiving appropriate care.

“We need to ensure that people living at the home are not at any immediate risk of harm, which is why we have been working closely with Somerset County Council’s adult social care service and NHS Somerset to ensure the safety of all residents. If there was evidence that people were at risk, we would take immediate action.

“We will continue to monitor this nursing home. Our inspectors will return to Ruishton Court in the near future and if we find that the home is not making progress we won’t hesitate to use our legal powers on behalf of the people who live there."

Ends

For further information please contact the CQC press office on 0207 448 9401 or out of hours on 07917 232 143.

Notes to editors