A care home has been rated “inadequate” after an inspection found that residents’ health conditions and safety risks were not being managed well enough.
The Care Quality Commission, an independent health watchdog, has downgraded Dene Holm care home in Dene Holm Road, Northfleet, from “good” to “inadequate” following the inspection in August.
Dene Holm is run by Rapport Housing and Care, and at the time of the inspection it was looking after 38 people.
CQC inspectors have raised a number of concerns, but noted staff “were doing their best to provide the best care they could”. Rapport has said it has taken “immediate action on the CQC’s findings “at a time when the industry is “amidst the greatest workforce crisis in history”.
The ratings for how safe, effective, caring, responsive and well-led the home is have dropped from “good” to “inadequate” alongside the overall rating.
The home was inspected because of concerns about safeguarding, the management of risk, and the provider’s overview of the service. Inspectors found that because of staff shortages, many employees were from agencies, and “did not know the people living there and the routines of the home”, which meant that residents were not always supported sufficiently.
It also found that one resident, whose care plan stated they must only eat minced or moist consistency food due to a choking risk, had chosen not to follow this, and there was no information on the person’s capacity to make this decision or a risk assessment on how to support them eating safely.
‘Staff told us they didn’t feel supported and were short staffed. Yet, despite this, they were doing their best to provide the best care they could.’
It was found that medicines had been stored at higher temperatures than recommended for extended periods of time, which affects the effectiveness of the medication. These concerns were reported by staff to the senior management team, but no action was taken to solve this.
Inspectors also said that while most interactions were respectful, on arrival at 6am two door guards on bedroom doors were found to have been beeping throughout the night due to low batteries and this had kept residents awake. Reportedly, although staff were aware of the issue no action had been taken and the problem was not reported to on-call maintenance.
Risk assessments were also found to lack detail and included contradicting information. One example given was that two residents at high risk of falling had differing information in their records about the equipment they used and the levels of support and supervision they needed.
Inspectors were especially concerned about this because of the high number of agency staff who were not necessarily familiar with specific residents’ needs.
It was also found that people were not always being supported to manage their health conditions. One example given was that five residents had diabetes, and inspectors were told no adjustments were being made to food, other than custard for everyone being made with sweetener.
‘The social care sector is currently under extreme pressure and is in urgent need of reform.’
One resident, whose GP was said to be having difficulty getting their diabetes under control, had it written on their information sheet that their favourite foods were chocolate and sweets, and that they took sugar in their tea.
Hazel Roberts, head of inspection at the CQC, said: “When we inspected Dene Holm we were concerned to find managers had no oversight of the home. Risks to people’s safety, such as falls or choking risks, weren’t being well managed.
“Staff told us they didn’t feel supported and were short staffed. Yet, despite this, they were doing their best to provide the best care they could.
“People and their relatives told us the staff were kind and caring, and we saw warm relationships between staff and the people living at the home.
“We have told leaders at the service what it needs to do to improve. People living in care homes deserve to receive safe care, and we will continue to monitor the service and ensure the provider makes the necessary improvements to enable them to deliver a quality service.”
Rapport Housing and Care chief executive Leon Steer said: “We have taken immediate action on the CQC’s findings and are working closely with them on the improvements we need to make.
“We want to reassure our residents and their relatives that the safety and wellbeing of our residents remains our top priority.
“Prior to the pandemic and subsequent staffing crisis within the care sector, Dene Holm held a ‘good’ rating from the CQC, and we are working hard to restore this rating.
“The social care sector is currently under extreme pressure and is in urgent need of reform. We are amidst the greatest workforce crisis in history and staff shortages are cited as a key problem in 75% of CQC reports of care homes which have received a lower rating.
“In addition to that, a poll by the South East Social Care Alliance found that almost half (45%) of care providers in the region are thinking of exiting the sector because of underfunding for local authority/NHS funded residents.
“Health care leaders have previously warned that the sector is facing a ‘ticking time bomb’ and action is needed immediately if it is to remain sustainable.”
Barnes Lodge in Tonbridge, which is also run by Rapport Housing and Care, also received an inadequate rating following an unannounced inspection in July.
Investigators at the nursing home in Tudeley Lane found that residents had “long and dirty” fingernails and clothes, and unexplained bruises which were not being investigated.