The Care Quality Commission (CQC) has rated The Old Rectory in Tenbury Wells, Worcestershire, inadequate overall, following an inspection in July.
The Old Rectory is a residential care home that provides personal care for up to 28 people, some who live with dementia or have a physical disability.
Following the inspection, the overall rating for the service has dropped from good to inadequate. It was rated inadequate for being safe and well led, and rated requires improvement for being effective, responsive and caring.
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.
Amanda Lyndon, CQC head of inspection for adult social care, said:
“When we inspected The Old Rectory, it was disappointing to see that the quality of care had declined since we last visited.
“It was concerning that staff hadn’t been trained to prepare food for people who required a textured, modified diet. People were often given food which was unsuitable for them, which put them at risk of choking.
“Following the inspection, the provider put urgent training in place to ensure staff who prepared food had the relevant training and knowledge.
“The home had a rota for people to have a bath or shower once a week on a set day. This approach was not personalised and didn’t support people to be involved in decision making about their care. People we spoke with told us they’d like to be able to have a bath more frequently and at a time that suits them.
“The communal lounges were sparse and lacked stimulation, triggers for memory or conversation, which is especially important for people living with dementia. Where people weren’t independent with activities, we saw they spent their time sat with the television on, which doesn’t promote their wellbeing or offer any stimulation.
“However, we observed staff being respectful towards people when speaking with them and they worked with people at their own pace. The registered manager was actively seeking a new activities co-ordinator.
“We also saw improvements had been made to communal areas, and some bedrooms. The registered manager was keen to ensure all bedrooms were decorated to a good standard.
“We have told the provider what improvements need to be made to address the concerns identified. We will monitor the service to ensure people are safe and will return to check on progress.”
Inspectors found the following during this inspection:
- Systems for ensuring staff were trained and competent to provide care to people were not effective. Staff had not been adequately trained in key areas which exposed people to risk of potential harm
- There were no systems in place to identify unsafe environmental issues, for example, wardrobes not always being secured to the walls. It was also identified that window restrictors were not in line with the Health and Safety Executive guidance. The provider assured CQC these areas would be addressed promptly
- People’s personal information was not always kept confidential. Offices where records were held and had information about people's care needs written on walls were unlocked with doors left open
- Call bells throughout the home had not worked since 16 June 2022, the measures that had been put in place to support people to call for help were not effective
- We observed some bedrooms that people were living in were in a poor state. The registered manager told us they were working with the provider to improve the environment, design and decoration to meet people's individual needs
- Staff monitored people's weight to ensure this remained stable and people remained well. Where people required support with weight management, this was monitored and where necessary discussed with the person's doctor
- Records showed people were supported to attend health appointments, opticians, chiropodists and dental appointments to promote their health and wellbeing.