The Care Quality Commission (CQC) has rated Oakham Grange care home in Rutland inadequate and placed it in special measures following an inspection in April.
This unannounced inspection was prompted due to concerns received regarding medicines management and allegations of neglect.
Oakham Grange, run by Ardale (Oakham) Limited, provides accommodation and personal care for up to 68 people. It was providing care for 49 people at the time of the inspection.
As well as the overall rating dropping from good to inadequate following this inspection, it has also declined from good to inadequate for being safe, effective and well-led. The ratings for how caring and responsive the service is have declined from good to requires improvement.
The service is now in special measures, which means it will be kept under close review by CQC and re-inspected to check sufficient improvements have been made.
Craig Howarth, CQC deputy director of operations in the midlands, said:
“When we inspected Oakham Grange care home, we found poor leadership. Our experience tells us that when a service isn’t well-led, it’s less likely they’re able to meet people’s needs in the other areas we inspect, which is what we found here. When we inspected, the management team already had a plan in place to make improvements, however they weren’t happening fast enough to keep people safe.
“We found people weren’t always kept safe from abuse. For example, someone had hit another person, and the incident wasn’t referred for investigation until a week later when the inspector raised concerns. The service also hadn’t updated the person’s care plan to help staff know what to do if the person was aggressive to others in the future. This puts people at risk of harm.
“Inspectors found there was a serious lack of staff training in many areas, including how to support agitated people. Someone with dementia who had complex behaviour at times, had to be supported by more than one member of staff during moments of distress as they didn’t feel confident dealing with them alone due to lack of training.
“We have reported our findings to the provider, and they have provided us with an action plan showing planned improvements. We will return to inspect and if sufficient progress hasn’t been made and embedded. We will not hesitate to take further action to ensure people’s safety and wellbeing.”
Inspectors found:
- Staff did not have clear guidance on how to support people's needs
- Staff did not record when clinical care was provided to people, so inspectors were not assured that people received clinical care as planned
- There were no nurses in the service at night-time – which left people at risk
- Staff did not always have time to spend with people using the service
- Medicines were not always managed safely, and lessons were not always learnt to ensure improvements were made to care
- Staff were not always suitably trained to complete safe care
- Nurses did not receive recent clinical supervision or competency assessments to ensure they were suitably skilled
- People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests
- Some people required altered textured food and drink to ensure they could swallow safely. This had not been altered safely for one person - which put them at risk of choking
- People received support to access support from external health and social care professionals, but people's healthcare needs were otherwise not well supported by staff
- Care was not always personalised to people's preferences as staff did not have specific guidance on people's unique needs
- There was no assurance that people would receive good quality end of life care. This is because most staff had not received end of life training.
However,
- There were safe recruitment checks to ensure staff were of good character
- People's communication needs were met
- People were able to engage in activities at the home
- The management team responded to individual complaints about care to ensure improvements were made.