The Care Quality Commission (CQC) has rated Layden Court Care Home in Rotherham inadequate overall, following an inspection in May and June.
Layden Court Care Home provides personal and nursing care for up to 92 people, some of which live with dementia. There were 54 people using the service at the time of the inspection.
The inspection was prompted due to concerns received from the local authority. These were regarding poor care and support, lack of robust infection prevention and control, ineffective systems and processes, as well as poor management of the service.
The service was registered with CQC in December 2021 and this is its first inspection. The last rating for the service under the previous provider was requires improvement overall.
Following the inspection, the overall rating for the service has dropped from requires improvement to inadequate. The ratings for being safe and well-led have also dropped from requires improvement to inadequate. The ratings for being effective, caring and responsive have declined from good to inadequate.
The service is now in special measures which means it will be kept under review and re-inspected to check sufficient improvements have been made.
Sheila Grant, CQC head of inspection for adult social care, said:
“When we inspected Layden Court Care Home, we found a service which lacked oversight from the provider, and they didn’t provide enough support to staff. Some staff weren’t clear about their roles and responsibilities and didn’t understand their regulatory requirements. The provider must address these concerns as a matter of urgency.
“The environment wasn’t clean. Mattresses, bath and shower chairs, lounge chairs and pressure relieving cushions were all heavily stained with urine and excrement. We also found furniture, equipment and the general environment wasn’t well maintained which made it difficult to clean effectively.
“Staff didn’t always follow guidance regarding personal protective equipment (PPE). Staff didn’t wear masks correctly, always wash hands or change PPE when required. We found bags of opened clinical waste on top of bins in sluice areas and hand sanitiser and soap dispensers empty which could put people at risk.
“People’s weight loss wasn’t managed appropriately. People had lost considerable weight and there was a lack of systems in place to manage the risks. Additionally, people weren’t given choices at mealtimes and there was a lack of support for them. It wasn’t clear if advice from health care professionals was being followed to ensure people received adequate nutrition.
“We found people’s privacy wasn’t always respected. Staff hadn’t noticed when people's clothes were wet or stained. There were people with heavily stained, food encrusted clothes that hadn’t been changed after their meal, also people had dirty nails.
“There were systems and processes in place to safeguard people from abuse. However, we reported three safeguarding concerns to the local authority following our visits.
“The provider is aware what action is needed to address our concerns. We will continue to monitor the service closely to ensure the improvements are made and fully embedded. If we find no improvements have been made when we return, we will not hesitate to take action”
Inspectors found the following during this inspection:
- Infection prevention and control (IPC) practices were poor. There were many areas that were not clean and areas that were not well-maintained to enable effective cleaning
- There was a dependency tool used to determine staffing levels. However, it was not clear if there was adequate staff on duty to meet people's needs. Staff were not present in communal areas or available on units when people required assistance
- Medication procedures were predominantly followed. However, we found some minor issues, regarding documentation and lack of oversight of records
- People were not 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
- There was lack of social stimulation and activities provided. The registered manager had employed a new activity coordinator and they were commencing activities. However, there was no stimulation or appropriate activities provided for people living with dementia
- Complaints were recorded in line with the provider's policy. However, not all concerns had been documented and dealt with appropriately. This did not evidence actions had been taken to minimise issues reoccurring. End of life care plans were in place, but they were very brief and did not identify people's preferences, religious beliefs or choices
- Systems and processes used to ensure the service was running safely were not robust or effective. We identified many shortfalls during our site visit that had not been identified as part of the quality monitoring. For example, IPC practices, person centred care, effectiveness of training and staff deployment
- Feedback from relatives varied depending on which unit their family member lived on. Some relatives did not feel involved in the day to day running of the home. They felt communication was poor and they were not kept informed of issues or general welfare of their loved ones.