The Care Quality Commission (CQC) has taken action against Mitchell’s Care Homes Limited following inspections of its three care homes.
Rainscombe Bungalow, Rainscombe House and Nutbush Cottage in Horley, Surrey, provided care to autistic people or people with a learning disability.
The three homes were inspected in June and August 2024, to follow up on progress made since the previous CQC inspections in November 2023.
CQC took regulatory and legal action against the provider this year to cancel the registration of Mitchell’s Care Homes Limited in respect of the three care home locations. The provider exercised its right of appeal to the Care Standards Tribunal in order to challenge CQC’s decision. During tribunal proceedings, Mitchell’s Care Homes Limited withdrew their appeal. This means the regulatory action is completed and all people living in the three homes have now moved. CQC will continue to engage with the local authority and other stakeholders as required.
Following these latest inspections, Rainscombe House has been re-rated as inadequate overall, as well as the ratings for safe and well-led. Responsive and caring have dropped from requires improvement to inadequate. Effective has been re-rated as requires improvement.
Rainscombe Bungalow has been re-rated as inadequate overall as have the ratings for safe, effective, caring and well-led. Responsive has dropped from requires improvement to inadequate.
Nutbush Cottage has been re-rated as inadequate overall as have the ratings for safe, caring and well-led. Effective has dropped from requires improvement to inadequate. Responsive improved and raised from inadequate to requires improvement.
Amy Jupp, CQC deputy director of operations in the south said:
When we inspected Rainscombe Bungalow, Rainscombe House and Nutbush Cottage, we found very little progress on the significant improvements we highlighted were needed at previous inspections. There was an unacceptable deterioration in the level of care across the services, which put people living there at risk of harm.
Leaders hadn’t addressed the closed culture at Rainscombe House, which was isolating the people living there. Staff didn’t understand their safeguarding duties and people’s human rights weren’t always acknowledged or respected.
At previous inspections of Rainscombe House we found people weren’t being treated with kindness, compassion and dignity, and this hadn’t improved. We saw most staff didn’t acknowledge people’s presence and they didn’t treat the service as the home of the people living there. We saw that people’s individual preferences and wishes were ignored and staff made decisions for people without their input.
People were at risk of financial abuse There were poor records on how resident’s’ personal money was being spent at Rainscombe House, and at Rainscombe Bungalow records showed the daily balance of people’s personal money did not tally with what had been spent.
In addition, staff didn’t consistently follow people's care plans, putting people at risk of harm. At Nutbush Cottage, loved ones told us they were not confident staff had the skills required to keep people safe. Despite speech and language therapy assessments recommending a wet consistency diet for some people, staff at Rainscombe House didn't always follow this guidance. We saw people who needed a soft diet were regularly eating dry foods such as pizza, biscuits and crisps, putting them at risk of choking.
Mitchell’s Care Homes Limited withdrew their appeal. This means the regulatory action to close the three services now stands. People living at the homes have been moved to alternative accommodation and CQC continues to work with the local authority and other partners as needed.
At Rainscombe House inspectors also found:
- There wasn’t enough staff to keep people safe, and staff handover records showed staff were working at Rainscombe House and Rainscombe Bungalow at the same time.
- The outdoor environment was unsafe. Inspectors saw a disused radiator, a large shard of glass and other rubbish on the ground. There was also an unattended step ladder next to a fence and an open, unlocked, gate to disused farm buildings. Despite auditing the garden, leaders hadn’t identified these issues.
- Staff hadn’t received all the training needed to support people.
At Rainscombe Bungalow inspectors also found:
- Risks to people’s nutritional health were not being managed safely. One person with diabetes had put on weight when their care plan stated they needed to be supported to eat a healthy diet, however staff had taken no action in relation to this.
- The service did not support people’s individual communication needs. People living at the service who were visually impaired did not have any audio communication aids. A relative had provided a communication book to support their loved one but when inspectors requested this staff could not locate it.
- People at risk of constipation weren’t being supported or monitored effectively. One person had not had a bowel movement in three days and staff recorded they weren’t drinking enough fluids, but they had not intervened further.
- Staff at Rainscombe Bungalow weren’t following processes to protect people from harm and safeguard them from emotional abuse. There had been two instances where someone had left the building and ran into the road, but staff hadn’t recorded them as incidents or raised them to leaders. Leaders reported the incident after inspectors raised this with them.
At Nutbush Cottage inspectors also found:
- Staff did not recognise and report incidents of anxiety and staff did not always report safeguarding concerns putting people at risk of abuse.
- Staff worked in a task focussed way which created an institutionalised feel to the home. People’s care followed the same set routine each day rather than exploring what was important to them as individuals. For example, people were supported to shower and get changed into their night clothes before 7pm each evening.
- Inspectors saw staff did not always treat people with honesty and kindness. Staff were heard repeatedly telling one person they would be going to see their family member the following day and continued to reassure the person this was the case. When inspectors asked staff about the arrangements, staff said this was not the case, but the person liked talking about their family and they will have forgotten by tomorrow.
The reports will be published on CQC’s website on the provider’s page in the next few days.