Rapkyns Nursing Home a residential care home based in Horsham, West Sussex has been rated as Inadequate overall and placed into special measures by the Care Quality Commission. This unannounced inspection took place in June.
Rapkyns Nursing Home provides nursing and personal care for up to 60 people living with a learning disability, physical disability or complex health condition. Accommodation is provided in two buildings on the same site and comprises the main building, Rapkyns Nursing Home, and a smaller building, Sycamore Lodge. At the time of this inspection, Rapkyns Nursing Home was empty, so this inspection is solely about what we found at Sycamore Lodge. Sycamore Lodge is a service that provides residential care and support for up to 10 people with a learning disability and/or autism, with some challenging behaviours.
Rapkyns Nursing Home is rated Inadequate for providing safe and well led care and Requires Improvement for providing caring, effective, responsive care. Overall the service is rated Inadequate. and is now placed into special measures. Previously the service was rated as Requires Improvement overall.
The provider and associated locations have been subject to a period of increased monitoring and support by commissioners. Investigations are ongoing by the local authority, police and partner agencies at some of the provider's locations, including Rapkyns Nursing Home. However, the police investigation is ongoing and no conclusions have been reached. Our inspection did not examine specific incidents and safeguarding allegations which have formed part of these investigations. We have inspected a number of Sussex Health Care locations in relation to concerns about variation in quality and safety across their services and will report on what we find.
Amanda Stride, CQC’s Head of Inspection of Adult Social Care, said:
“I am extremely disappointed in reading the findings of this report and concerned on behalf of the people the home is supposed to be caring for.
“Our inspectors will return to Rapkyns Nursing Home in due course to see what improvements have been made. If we do not see significant improvement we will not hesitate to take further action to protect people using the service - even if this means removing the registration of the home.
“Our first priority is always the welfare of the people who are living at the service. We will continue to monitor Rapkyns Nursing Home and work with the statutory agencies to make sure that people living there are safe and receive care which meets their needs.”
Inspectors found people were at risk because there was a lack of clear guidance around supporting people with epilepsy and staff were unclear who had epilepsy. Care plan information lacked detail and instruction for staff to follow or how to recognise epileptic seizures.
Inspectors observed some issues with the day to day culture such as how people were spoken to in a childlike manner and people's dignity was not always upheld. Some senior staff and other staff had not challenged their colleagues who used inappropriate language or spoke about personal things in front of people and other individuals.
Care plans were not written in a way that met people's preferred methods of communication, therefore, people could not be involved in reviewing their care plans. Some documentation did include pictures of reference, but the majority of documentation contained only writing that people would have found difficult to understand.
We will continue to monitor Rapkyns Nursing Home and work with the statutory agencies to make sure that people living there are safe and receive care which meets their needs.
Amanda Stride, Head of Inspection for Adult Social Care