The Care Quality Commission (CQC) has changed the rating for St Martins, a care home in Whitstable from good to inadequate following an inspection in June, and placed the service into special measures to protect people.
St Martins provides personal care for up to 30 people. It provides support to older people, some of whom may be living with dementia. At the time of this inspection there were 25 people living at the home.
This unannounced inspection was prompted, in part, due to concerns CQC received about how the service was being managed. As a result, a focused inspection to review the key questions of safe, effective and well-led was undertaken.
Following the inspection, the overall rating for the home, as well as the areas of safe and well-led, have moved down from good to inadequate. The rating for how effective the service is has moved down from good to requires improvement.
The service has been placed in special measures which means it will be kept under close review to keep people safe and re-inspected within six months to check for significant improvements.
Neil Cox, CQC deputy director of operations in the south, said:
“When we inspected St Martins, it was concerning to find a poor service that wasn’t open because leaders hadn’t taken steps to address known issues, to prevent a closed culture from forming.
“This closed culture meant leaders were protecting each other and St Martins, rather than the people who called it home. We found incidents of alleged abuse hadn’t been reported to the local safeguarding authority, and staff told us they had been reprimanded by management for acting to keep people safe. Relatives told of times they hadn’t been informed that their loved ones had been in an incident.
“Staff told us they felt that there was a toxic unprofessional culture in part because some of the management team were related, so they didn’t feel confident raising concerns. This was because concerns involving staff who were related had been raised previously, and action hadn’t been taken.
“People’s mealtimes weren’t well organised, with delays to breakfast creating only a short gap until lunchtime. This put people at risk of malnutrition as they may not have eaten due to still being full from breakfast, and then a long gap between their evening meal and breakfast. When meals were served, we also saw people who needed it, weren’t supported to eat.
“We have taken enforcement action to ensure the safe care and treatment of people in the service. In the meantime, we will continue to monitor the service closely to ensure significant and urgent improvements are made. If we aren’t assured people are receiving safe care, we will not hesitate to take further enforcement action so people receive the high standard of care they deserve.”
Inspectors found:
- Staff didn’t always have guidance in place to help them reduce risks
- Staff hadn’t been recruited safely, people had been placed at risk, by staff not having all the required checks before they started work
- There wasn’t always enough staff to meet people's needs
- People weren’t supported to have maximum choice and control of their lives.
- Staff didn’t support people in the least restrictive way possible or in their best interests which respected their human rights. One person used their walking stick to hit people to express distress or anxiety, and rather than work with the individual to reduce their anxiety or distress, one of the strategies put in place was to remove their stick
- People's communication needs weren’t always met
- Lessons hadn’t been learnt when things went wrong.