The Care Quality Commission (CQC) has rated The Firs Residential Care Home in Tower Road, Little Downham, inadequate, and placed it in special measures to protect people, following an inspection in September and October.
The Firs Residential Care Home is a residential care home providing personal care for up to 29 people, including older and younger adults, people living with dementia, and those with physical disabilities.
The inspection was prompted in part due to concerns CQC received, including about the cleanliness and upkeep of the home, staffing, and how the home was managing general risks and safeguarding.
Following this inspection, the care home’s overall rating has dropped from requires improvement to inadequate. The ratings have also dropped from requires improvement to inadequate for being well-led and being safe. It has dropped from good to inadequate for being effective. The rating for how caring the service is has dropped from good to requires improvement and it remains rated as requires improvement for how responsive it is.
The service has been placed in special measures which means it will be kept under close review to make sure people are safe and, if CQC do not propose to cancel the provider's registration, there will be a re-inspection to check for significant improvements.
Gill Hodgson-Reilly, CQC deputy director of operations in the east of England, said:
"At our inspection of The Firs Residential Care Home, it was disappointing to see they hadn’t taken on board feedback from our previous inspections about the environment that people were expected to live in. At this inspection we found a further decline in the appearance of the home, and we were so concerned about fire risks and cleanliness, that we made referrals to the fire service, and environmental health to keep people safe.
“Leadership was poor which was behind these issues. We saw there had been a high turnover of managers, and it was clear they didn’t have an understanding of the Health and Social Care Act, and what was expected of them to provide good accommodation and safe care to the people who called this service home.
“It was very concerning to see how dirty the kitchen was, with overflowing bins and expired food contributing to a fly infestation. This isn’t only distressing for people living here, but also poses serious health risks.
“Our inspection also uncovered poor infection control practices. Essential items like hand gel dispensers were empty, and personal care equipment wasn’t clean. Shared facilities, including toilets and bathrooms, were dirty with personal items such as toothbrushes left in unhygienic conditions.
“It was incredibly concerning that we found the home’s fire alarm wasn’t working, and the provider wasn’t doing anything to urgently fix this putting people at very serious risk if there was a fire. As the fire alarm had been switched off, this also meant that all pin coded doors weren’t working meaning people could come and go freely in unsafe areas like fire doors above a staircase.
“We are now considering what further regulatory action to take to keep people safe and we will report on this when we are able to.”
Inspectors also found:
- People weren’t being given dignified care. Relatives told inspectors that family members were told to use a pad instead of being supported to go to the toilet. This practice had become normalised, and inspectors found the home smelled strongly of urine as a result
- Relatives also told inspectors that people were still in their rooms in their nightwear in the middle of the afternoon rather than having been supported to get dressed and moved into the lounge to eat and socialise. This and a lack of consistent, meaningful and person-centred activity left people at risk of social isolation as sometimes their only interaction came from visitors
- Leaders did not keep good records around accidents and incidents. This meant they weren’t able to identify trends or take necessary actions to mitigate risks, to avoid incidents happening again
- Staffing levels were inadequate to meet the complex needs of residents. While staff displayed some kindness, their approach was more task-oriented than person-centred
- As there was no registered manager at the time of the inspection, the provider should have taken ownership of managing the service. Inspectors found this wasn’t happening
- There were gaps in the training and support provided to the staff, particularly in areas related to the management of challenging behaviours and dementia care.
However:
- During our inspection, we witnessed some positive interactions, particularly during instances where residents required more intensive support, such as hoisting. Staff consistently offered words of encouragement and maintained a respectful and supportive demeanour throughout these interactions.
The report will be published on CQC’s website in the coming days.