The Care Quality Commission (CQC) has rated Field House, Spalding, Lincolnshire inadequate overall, following an inspection in May and June.
Field House is a residential care home, run by Farrington Care Homes Limited, providing personal care for up to 28 older adults. At the time of this inspection there were 23 people using the service, and another person in hospital.
CQC carried out an unannounced focused inspection to look at how safe and well-led the service was after receiving concerns about their response to deterioration in people's health, as well as concerns raised by the local authority safeguarding team around care planning and incident reporting. Following further concerns during the visit, inspectors also looked at how effective the service was.
Following the inspection, the overall rating for the service has dropped from good to inadequate. The ratings for being safe and effective have also declined from good to inadequate. Well-led has dropped from requires improvement to inadequate.
The service is now in special measures which means it will be kept under review and re-inspected to check if sufficient improvements have been made.
Natalie Reed, CQC head of inspection for adult social care, said:
“When we inspected Field House, we found a lack of oversight from the registered manager and provider. The service didn’t have a person-centred culture and the registered manager wasn’t always accessible to relatives.
“People's health deterioration wasn’t always monitored safely. One person who had presented with pain for a prolonged period wasn’t supported by staff to have their health appropriately observed, despite equipment being in place to do this. Subsequently, the person was taken to hospital where their condition deteriorated further.
“It was worrying that people weren’t protected from abuse. We found several recorded incidents of alleged physical and sexual abuse which hadn’t been reported to the local authority safeguarding team by staff or the registered manager. These incidents were not investigated at the time which could put people at serious risk of harm.
“Additionally, the provider failed to take appropriate action to protect people following recorded incidents of abuse. One person was recorded to have physically assaulted people, relatives or staff on at least eight occasions, but no actions were taken to support this person and protect others.
“Following the inspection, the provider made referrals to the safeguarding authority about recorded incidents of alleged abuse found by inspectors. Actions were also taken to reduce the risk of abuse and harm at the service.
“We have told the provider what improvements need to be made to address the concerns identified. We will monitor the service closely and return to check on progress to make sure people are safe.”
Inspectors found the following during this inspection:
- People 's medicines were not administered safely, and people were at risk of being over medicated
- Risks to people were not always adequately assessed and recorded
- People were not always adequately protected from the risk of infection. Lessons were not always learned following incidents
- Nutritional and hydration needs were not always adequately assessed and documented. Relatives told us there was a good standard of food choice
- People, relatives and staff were not engaged in the running of the service. The provider did not work well with partner agencies and this impacted on the care people received
- People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests.