A care home in Preston has come under fire in a health surveillance report which found residents were going for hours in the morning without food or drink.
The Old Vicarage Care Home is a residential care home that provides personal care for up to 35 people. During a recent inspection by the Care Quality Commission (CQC), many gaps and inaccuracies in the home’s service were discovered by inspectors.
Overall, the care home was rated “inadequate” by the CQC. The previous rating for the house in September 2020 was ‘Needs Improvement’ and the provider was asked to review staff deployment to ensure people’s needs were met.
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The report says residents started waking up from 5 a.m. – and there were five people in the house who might be able to get up and dress independently, leaving nine people who had need the support of a staff member. Inspectors arrived on site at 6:20 a.m. to observe the morning routine and found five people already in the living room unattended by staff.
The report says these had no access to food or drink until the chef and day staff arrived at 8am. There were often no staff trained to administer medication to people who might need it during the night shift, which included medication “as needed” when people were in pain.
Inspectors say they spoke to a person who had failed to get the attention of staff all night. The resident was left without a call bell and staff failed to respond to his cries for help and told the CQC: “I fell out of bed several times and had to scream for help. “.
Staff knowledge of when to report concerns was found to be limited. Records showed that only 50% had received backup training in the past 12 months, and incidents and accidents that should have been reported and investigated as part of backup procedures do not l have not been.
One person told CQC inspectors, “The male staff member couldn’t get me out of bed, so they just pulled me up.” This had resulted in a bruise on the person’s arm and should have been reported to the backup team.
The service was found not to comply with the principles of the Mental Capacity Act (MCA) and where necessary the appropriate legal authorizations were not in place to deprive a person of their liberty. There were four people in rooms behind a locked door without proper risk assessment or consent and the people had not had their capacity assessed to determine if they understood the restriction and whether they accepted it and accepted it or it was determined that the restriction was in the person’s best interest.
Inspectors found no reports that the home’s fire equipment had been tested weekly to ensure its effectiveness, if needed in an emergency and no evidence available to show that professional testing of the equipment and the electrical and gas safety installation had been completed on time. the required deadlines.
People’s health and well-being were increasingly at risk, but risk assessments were not updated to reflect the steps staff should take to better support them, including increased risks of malnutrition due to reduced eating and increased risk of injury due to increased falls. One person at home needed to be repositioned for one to two hours, but it was not recorded that this had happened, putting that person at increased risk of pressure injuries.
Medicine bottles, creams and liquids should be dated when opened to ensure they are not used past their expiration date. An eye cream that had been dated when it was opened was still being administered a week past its expiration date.
Some records indicated that no one was recorded as having their cream applied according to their prescription. The staff member administering the drugs told the CQC that he did not believe the training on the drugs was sufficient and “that’s why some staff are not administering them”. The staff member added: “I took an online course, I was monitored for about an hour and then I was told I could administer it. I’m only doing it because I had received proper training before working here.”
Overall the level of management was not sufficient as the report indicates that there had not been a stable management team in the home for some time and the management procedure had not been followed. This included a lack of auditing and monitoring of the service provided to people.
Staff did not feel supported and did not have the information needed to provide safe care. The supplier did not have an effective governance process in place to ensure that the required building security measures were taken on a timely basis and that supplier registration requirements, including submission of notifications, were not fulfilled.