Lancashire care home downgraded after 3 breaches of legal regulations found during unannounced CQC inspection

A team from the care watchdog made a visit to Sutton Grange in Greaves Hall Lane, Banks, following a tip-off about staffing levels, medicines management systems and moving and handling practices.

The home provides accommodation for people who require nursing or personal care, and treatment of disease, disorder or injury. The home can provide support for up to 70 older people or younger adults, including those living with dementia, or a physical disability. At the time of the assessment, 57 people were living at the home.

Inspectors said: “At the last inspection, the home was rated good. At this inspection we found standards had declined and the home was now in breach of legal regulations for dignity, safe care and treatment, and good governance.”

Management has been asked for an action plan to address the concerns raised.

What were the main concerns?

A report issued this week highlighted:

- “Risks to people were not always recorded or managed safely, and strategies to support people communicating a need, emotion or distress were not consistently followed”.

- “The provider used a dependency tool to calculate staffing levels, but feedback and observations evidenced staff deployment did not ensure consistently safe, good quality care.”

- “Medicines were not always managed safely and people did not always receive their medicines as prescribed.”

- “Staff no longer ensured information in care plans was robust, and records indicated people did not always have the required support to prevent malnutrition or dehydration.”

- “The provider did not ensure staff deployment always afforded compassionate care, which meant people’s dignity was impacted. Care was task led at times. Staff could not always respond to requests for care and support in a timely manner.”

- “Governance and oversight systems had not been effective in identifying concerns found during our inspection, or ensuring these had been rectified in a timely manner.”

Families and residents also gave feedback about low staffing levels at the home. One person said: “Sometimes they’re short staffed and I have to wait. I had a problem yesterday, I needed the toilet, and they told me I had to wait till after tea. It happens pretty regular, but I have to wait my turn”.

Others commented on staff being “rushed”, but in general, people and relatives spoke positively about the staff members and other aspects of living at Sutton Grange, such as the food, activities, and “kind” staff.

Positives

The report did note positives inspectors found during the inspection between October 15 and December 2. These included:

- Staff had a good understanding of the needs of the people they supported, and continuity of care was prioritised.

- People received information in a way they could understand, and systems were in place to enable people and relatives to give feedback.

- The home was adapted to meet the needs of those with protected characteristics and people were supported to make advanced decisions about end of life care.

- There were effective systems to manage and learn from safety events and information was shared with the appropriate agencies.

- Staff were made aware of the home’s visions and values, and managers led by example. Staff told inspectors they felt they were treated fairly and felt confident speaking up.

What do management say?

Barchester Healthcare Homes Ltd, which runs the home, said: “We respect the findings of the Care Quality Commission (CQC) and are grateful for the feedback. All points raised were addressed immediately; and additional training and support has been put in place for the staff to fully embed this.

“Our focus is always on providing the highest quality of care for our residents. We regularly ask residents and their families how they feel we are doing and the most recent research shows 97 per cent satisfaction with the overall care provided. The team at the home is looking forward to being re-inspected and will be aiming to regain their previous Good rating.”

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