Oaklands care home in Dimples Lane has been told to improve after inspectors raised concerns about its cleanliness, staff shortages and the safety of residents on an unannounced visit in October.
A report published by the Care Quality Commission on December 4 said inspectors had identified breaches in relation to safe care, treatment and good governance, whilst staff were heard making 'derogatory comments' about a resident in their care.
The home provides accomodation and nursing for 29 adults with physical disabilities, but inspectors found the service was "not always safe, effective, caring or well-led".
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It was the first time inspectors had visited the care home since Valorum Care Limited took it over in 2019.
The CQC said the inspection was conducted "so that we could give a rating under the new provider", but also because of "concerns about a closed culture in the home, safeguarding incidents and complaints".
The watchdog it defies a 'closed culture' as "a poor culture that can lead to harm, including human rights breaches such as abuse". In these services, it added, "people are more likely to be at risk of deliberate or unintentional harm".
In their report, which concluded that the home 'requires improvement', inspectors for the social care watchdog outlined where urgent changes must be made.
Cleanliness and hygiene
The provider had "failed to provide a clean and hygienic environment for those who lived at the home, which did not promote good infection control practices."
"There were dirty items left on the floors of some bathrooms, such as clothes,personal items and used gloves. Some of the bedding we saw was dirty. There were flies on one person's breakfast. We asked staff to remove this and provide a replacement.
"We established there were not enough domestic hours covered to ensure a structured cleaning programme could be followed. Staff told us there were not enough cleaners employed."
"A cleaning schedule was in place. However, this was ineffective, as we found most of the environment needed a thorough deep clean.
Despite the concerns, the inspectors noted good work which had been done to address the issues.
"On the second day of our inspection, one week later, improvements had been made," they added.
"This was due to the involvement of a cleaning contractor. The operations manager told us additional domestic hours had been covered and another cleaner had been appointed. Action taken mitigated the risk of cross infection."
One staff member told them: "Care staff are pushed to the brink. We have so little time trying to get everyone turned within four hours.
"We are losing the time and ability to interact with people and talk to them about their day. We are just meeting people's needs."
But other staff told inspectors they felt "very well supported in their jobs" and "were able to seek advice and guidance at any time".
One resident told them: "They [staff] seem to be well-trained. They've never made any mistakes with me. They help me to keep comfortable."
Another resident said: "There are not as many staff at night, but it doesn't seem to have a negative impact. I never have to wait long if I ring [my call bell]."
Residents' care and safety
There were also concerns raised over the manner in which some residents were treated - although in general the feedback from residents was positive.
The report said: "On the first day of our inspection we observed one person's privacy being compromised, while being transferred along a corridor in a wheelchair.
"We also observed the lunch time service, which did not ensure people's dignity was always respected.
"Care records did not always refer to people in respectful ways or demonstrate patience and empathy.
"Two staff members we spoke with made derogatory comments about one person and another member of staff contradicted someone who lived at the home.
"The provider had not ensured the premises were maintained to a good standard, which did not promote a homely environment for those who lived at the home.
"The environment was cluttered. Bathrooms were being used as storage areas for items of equipment, which made some personal care facilities difficult to assess."
This meant there was "a risk that people could be harmed", with one fire exit found partially blocked by a piece of equipment parked in the corridor and signage not used to protect people from slipping on wet floors.
But inspectors did recognise the good efforts made by management and staff, with the care home performing well in other areas.
Marking it 'good' for responsiveness, they added: "People were supported to develop and maintain relationships within the home and within the wider community.
"Records showed that one person attended university several days each week and met up with friends regularly within the community. This was observed during our inspection.
"We saw a large activities room was available and an activity plan had been developed, which incorporated a wide range of leisure activities for those who lived at the home."
Management said Oaklands has plans to "refurbish and upgrade" the home, "with a series of adaptation works for the benefit of the service users".
What did the care home say in response?
A spokesman for the Valorum Care Group said: "The outcome of the inspection is disappointing and we recognise that changes are required.
"Our quality and operational teams are now working with staff to implement the actions set out in the report.
"The health, safety and wellbeing of our residents is always a priority for the team, and we are confident the issues will be resolved speedily and in an effective manner.
"We will work with Local Authority and CCG commissioners and involve staff, residents and relatives in our improvement plans and will keep them updated as we progress with the required changes to the service."
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