The Care Quality Commission (CQC) has rated two Westcliffe-on-Sea care homes inadequate for a second time following inspections undertaken in October.
Inspectors visited Alexander House Private Nursing Home and Ravensmere Rest Home to assess whether improvements had been made, as they were rated inadequate earlier last year.
Both services are run by Health and Home (Essex) Limited and care for people needing nursing or personal care, including people with learning disabilities and autistic people.
The latest inspections found the quality of care at services the services had deteriorated since they were previously inspected. This meant both services were rated inadequate for a second time.
Debbie Ivanova, CQC’s director for people with a learning disability and autistic people, said:
“We previously told Health and Home where it needed to improve care people received at Alexander House Private Nursing Home and Ravensmere Rest Home, so it is unacceptable that we found worse care on our latest inspections.
“There was evidence of a closed culture at both services. This is an environment where people could experience harm, including human rights breaches such as abuse, because insufficient measures are in place to ensure their safety.
“We were concerned that Health and Home’s management and leadership didn’t understand the severity of our concerns, and it hadn’t developed satisfactory plans for improving the quality of care for people.
“However, no one is currently at risk of harm in these services as no one is currently receiving care from them.
“Where we find standards of care fall below those people have a right to expect, we do not hesitate to take action to protect people. While we are taking regulatory action in respect of these services, we cannot provide further detail at the moment due to legal restrictions.”
The inspection at Alexander House Private Nursing Home found:
- People were not supported to have choice, control and independence=
- There were not enough staff to adequately support people to have a fulfilling and meaningful everyday life – including to participate in activities, pursue interests or lead empowered lives
- Some people's nutritional needs were not being met in line with their care needs or care plan
- Recommendations and advice by healthcare professionals were not always implemented or followed up
- People were not protected from poor care and abuse. A 'closed culture' had developed, whereby there was a risk of harm for people living there
- Leadership, management and governance arrangements did not provide assurance the service was well-led, that people were safe, and their care and support needs could be met
- The registered manager and staff did not ensure people were always put first. People did not receive care that was person-centred, or that protected and promoted their rights.
However:
- Suitable arrangements were in place to ensure the proper and safe use of medicines.
The inspection at Ravensmere Rest Home found:
- Risk management was poor, and staff did not have adequate guidance to support people safely. There were not safe and robust systems in place when incidents and accidents occurred, and these were not reported – which placed people at serious risk of harm
- There were limited opportunities for people to have choice, control and independence – including to access the community or pursue interests
- People were not supported in the least restrictive way possible, or in their best interests
- Where people lacked capacity to make decisions, there was a failure to put in place documents to support decision making
- Care was not always person-centred or designed to promote people's dignity, privacy and human rights
- Staff did not always understand how to protect people from poor care and abuse
- Visits from other agencies were often delayed or cancelled
- Not all staff were appropriately skilled to meet people's needs and keep them safe
- People were supported by staff who did not understand best practice in relation to people with a learning disability and autistic people
- There were indicators of a closed culture. Staff did not ensure risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity
- Routines were not always personalised
- There was not an effective governance and quality assurance system to assess the quality and safety of support people received. Health and Home failed to acknowledge the concerns consistently identified during CQC’s inspections, which meant improvements were not made.