Norfolk care home has failed to protect people’s safety and welfare says regulator

The Care Quality Commission (CQC) has told Shouldham Hall (Registration) Limited that it must make improvements at Shouldham Hall Nursing Home to comply with the essential standards of quality and safety.

Inspectors have found that the care home on New Road, Shouldham, has failed to protect the safety and welfare of people receiving their service.   

A report published by CQC says that the provider was not meeting all nine essential standards inspectors looked at and in all of these areas a major concern was identified.    

Providers of care services have a legal responsibility to make sure they are meeting all essential standards of quality and safety.

The visit to Shouldham Hall Nursing Home, whichprovides accommodation for people who require personal or nursing care, took place in December 2011 and January 2012as part of CQC’s routine programme of inspections. When inspectors visited the care service they found the care provided was falling short of standards people should be able to expect and improvements were needed. Thereport, published on the CQC website highlights nine major areas of concern:   

Respecting and involving people who use services

Inspectors found that the floors and furnishings were soiled and dirty. The sofa was heavily soiled, a chair had mould growing on the arm and mattresses were dirty. When people's appearances were observed, inspectors saw that some residents were wearing clothing that was soiled with food and some people had dirty fingernails. They had not been supported to maintain their appearance in order to promote their dignity.

Care and welfare of people who use services

Five out of six care records looked at were incomplete, inaccurate and out of date. Nutritional needs assessments were not being completed accurately. Staff were writing down that certain residents had eaten all of their meals when they had not. Food intake was not being monitored effectively and regular weighing was not being done. 

Meeting nutritional needs

Tables were set too far away for residents to comfortably reach their food. Several people ended up with food on their clothing or on the floor and no replacement meals were given to those who spilled their food. The home served frozen ready meals and catering and managerial staff did not know whether these meals were meeting people’s nutritional needs.

Safeguarding people who use services from abuse

Despite staff receiving further training in safeguarding since CQC’s last visit, inspectors found that staff still failed to recognise and respond to the risks to people's health and welfare in order to protect them from harm. Local authority safeguarding meetings, held in relation to concerns on the ability of the service to safeguard people's welfare were still ongoing.

Cleanliness and infection control

Floors at the home were stained with food and patches of dry fluid and an unpleasant odour was present in some bedrooms. Wheelchairs used by residents were dirty and soiled. Several medication creams were not labelled and were being used on multiple people meaning the risk of cross-contamination was high.

Management of medicines

Medication records contained gaps and omissions meaning it was difficult to tell if people had received their prescribed medicines. During the inspection CQC saw a number of medicines in a trolley that had already been prepared into small unlabelled plastic vessels. This was unsafe practice because the bottles did not show who the medicine belonged to and when it was to be administered.

Safety and suitability of premises

The standard of bedding at the home was poor; some people had ripped blankets and lumpy pillows. In some bedrooms, people had sheets instead of duvets and a torn bedrail with holes in it was observed on one bedroom. The general standard of décor was poor with chipped and damaged paintwork in most areas. The standard of some of the furniture in people's bedrooms was poor, for example, inspectors saw broken door handles on wardrobes and some of the communal toilets had stained walls and flooring.

Staffing

Despite the number of staff available during CQC’s visit and the further training that staff had been provided with, inspectors still had concerns about how well people's needs were being met. Staff still appeared to lack the necessary knowledge and skills to meet the needs of people living with dementia and to protect them from harm.

Assessing and monitoring the quality of service provision

CQC has had ongoing concerns about the quality of service provided to people living at this home since March 2011. Compliance actions and warning notices have been issued to the home in an effort to drive improvement. Despite this, inspectors found that the service was still failing to provide adequate care.

Frances Carey, Regional Director of CQC in the East of England, said: “The failings at Shouldham Hall Nursing Home are a real concern and improvements need to be made.

 “CQC has been working closely with Norfolk County Council to ensure the safety and wellbeing of people receiving this service and we have told the provider where they need to improve.

“Where improvements are not made we have a range of enforcement powers that can be used, including prosecution, closure or restriction of services.”

Any regulatory decision that CQC takes is open to challenge by a registered person through a variety of internal and external appeal processes.

The provider has given CQC assurances since the inspection that they will work hard to improve the service and achieve compliance.

Ends

For further information please contact Helen Gildersleeve, regional communications officer, on 0191 233 3379. The CQC press office is also available on 0207 448 9401 or out of hours on 07917 232 143. 

Notes to editors

A full copy of the inspection report carried out at Shouldham Hall Nursing Home is available here.