A Nottinghamshire assisted living home that cares for people with learning disabilities has been told to make ‘urgent improvements’ after an inspection by heath watchdog the Care Quality Commission (CQC). Richmond Lodge, in Kirkby-in-Ashfield, remains in special measures after the CQC carried out a focused inspection on the site in February 2023.
The care home, in Richmond Road, provides personal care for up to five people with a learning disability, and at the time of the inspection four people were based at the home.
The inspection comes after the care facility, run by Blue Sky Care Limited, was moved from a 'good' rating to 'inadequate' by the Care Quality Commission after an inspection in August last year. At this time, Richmond Lodge was issued with three warning notices around safe care and treatment, person centred care and the need for consent and governance.
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The CQC returned to the site in February this year and the care home remains with an overall rating of ‘inadequate’. Following this recent inspection, the provider remained in breach of regulations. Also, additional breaches were identified in relation to medicines management, infection control, safeguarding, and management of the service
Amongst some of the issues that inspectors found was that medicines weren’t managed safely, staff didn’t always understand how to protect people from poor care, neglect and abuse and that individual risks weren’t always accurately assessed or managed well, and this placed people at risk of harm.
Richmond Lodge will be kept under review by CQC in special measures. The site will be re-inspected to check if significant improvements have been made.
Rebecca Bauers, CQC’s director for people with a learning disability and autistic people, said: “When we inspected Richmond lodge, we were very concerned to find the provider still didn’t have effective systems in place or enough oversight to ensure it was delivering high quality care. Also, the provider hadn’t addressed our previous concerns raised at the last inspection, and new issues were found which meant people weren’t safe and at risk of avoidable harm.
“It’s unacceptable for people using this service to experience poor standards of care. People should be safe and treated with dignity and respect. The leaders in this service were allowing a culture to exist where people weren’t given the opportunity to live fulfilled and meaningful lives. For example, people weren’t always given a choice in how they would like to spend their time. Someone who had been assessed as needing one-to-one support was provided with this by accompanying staff to the tip, there was no evidence to support this was what the person had chosen to do.
“Risks with the environment were badly managed. We found water temperatures weren’t monitored appropriately, and staff failed to take any action when water exceeded safe temperatures which increased the risk of scalding. Also, some people were at risk of absconding. However, the gate and all doors were left unlocked throughout our visits which placed people at risk of harm and must be addressed as a matter of urgency.
“There were signs of a closed culture. Staff failed to recognise some incidents as being abuse. For example, we observed an incident where staff spoke to someone in an inappropriate manner which caused the person to become distressed, however staff failed to recognise this as abuse. Also, we reviewed an incident where someone was becoming distressed, staff failed to act which resulted in another person being hurt. Staff failed to recognise this as a safeguarding incident which placed people at risk. The provider must take action and ensure staff are trained to recognise signs of abuse to safeguard people from the risk of harm.
"The home will remain in special measures and we will be keeping it under close review. We are also working closely with the local authority to mitigate any risk to keep people safe.
“We will not hesitate to take further action if we don’t see significant improvement. Even if this results in the CQC taking action which results in the closure of the home."
Richard Miller, managing director of Blue Sky Care Limited, said: "As an organisation we are significantly disappointed by the external regulators assessment and as a service have invested within the areas of record keeping, support planning, community access, communication and risk management. We now focus upon the aspects within this next commission assessment as we always welcome external feedback. This work has been ongoing with other professionals and partners - it will continue to be invested in. For a service previously rated as good, we have worked to return it to this rating, and this is a journey that is taking a longer period than hoped.
"We respect the assessment and will work in partnership with the commission, our local authority but most importantly the people we support, their families and the staff team to achieve our goal."
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