Melrose Residential Home: Leyland carer remains in special measures after more safety concerns from latest inspection

A Leyland care home for vulnerable adults remains in special measures and in danger of closing if significant improvements are not made, the health watchdog has said.

Melrose Residential Home in Moss Lane was found to be inadequate overall by Care Quality Commission (CQC) when they visited the service last year. The follow-up, unannounced inspection on February 28 this year was based on the previous one carried out that showed the home failed to meet satisfactory targets in all key areas.

It was also rated as inadequate in reports from 2021 and 2019. According to the watchdogs, a key issue was "there was not enough competent staff deployed effectively to meet people’s needs”. Records showed a person found in pain at 6.40am had to wait until 9am for an ambulance to be called "as it was a busy shift".

Others were observed waiting 15 minutes for help in the lounge. The report published last Wednesday (April 26) which focussed only on the safe and well-led areas showed not enough improvement had been made and that one person’s record showed limited intake of hydration for a number of days.

For the key questions not inspected, the CQC used the ratings awarded at the last inspection to calculate the overall rating of inadequate. Upon arrival, CQC inspectors found that only two staff were on duty and neither of them had been trained or were able to administer medicines. They were informed the manager was on site, but they had not administered the early morning medicines.

Why is Melrose Care Home in special measures?

Inspectors found that:

• There continued to be a lack of suitably qualified and competent staff deployed at the home to meet people's needs
• The home was not cleaned to a suitable standard to minimise the risk and spread of infection and staff were not routinely following safe practice guidelines to reduce this risk.
• Medicines were not managed effectively. There was not the information needed to show when people may need particular medicines and records were not kept in line with best practice. Staff were not all suitably trained and some medicines were not administered as prescribed.
• Guidance supplied to ensure people’s human right to family life was protected, was not followed or implemented by the provider, despite clear prompts from the regulator of the requirement to provide better visiting arrangements for families and loved ones.
• Previous enforcement action taken by the CQC to ensure action was taken to improve services had not been addressed and concerns continued to impact on the quality of care received by people living in the home.
• Fire safety equipment had not been tested and evacuation plans had not been updated and continued to not show staff how to safely support people in the event of a fire.

• The lift was not in operation and steps requested to address this and ensure this was safe had not been taken.

• One person had fallen three times in a short timescale and relevant risk assessments including the moving and handling risk assessment and falls risk assessment found these had not been reviewed following the accidents.
• Four handover records when accidents had occurred found only two included information on accidents that had taken place. This meant staff on the next shift were not formally passed over the information and may not have been aware of any additional support required.

What did Melrose Care Home fail to do?

• Extra care monitoring records including food and fluid charts when people were at risk of malnutrition or dehydration had not been utilised to meet people's needs.
• One person’s record showed limited intake of hydration for a number of days. As these records were not audited this had not been identified.
• Accident and incident records were not analysed each month to ensure any actions required had been taken.
• Previous concerns that some "as required" medicines were being administered without explanation was still happening and had not been identified by medicine audits.

Follow up

A re-inspection has now been scheduled within six months to check for significant improvements. If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, the health watchdog will take action in line with enforcement procedures. This means they will begin the process of preventing the provider from operating the service which usually leads to cancellation of their registration.