Archived: Meppershall Care Home

We carried out a follow up inspection on 20 June 2013 and found little progress had been made and people were not receiving the care they required. We were so concerned about the standard of care we saw, that we felt that we had no choice but to take further action on 1 July 2013 to prevent these poor care practices from continuing.

We shared our concerns with Central Bedfordshire Council (CBC) and the Bedfordshire Clinical Commissioning Group (BCCG) who commenced reviews of all people living in the home. These processes highlighted such serious concerns about the quality and safety of care to people who lived at Meppershall Care Home, that we took urgent action on 10 July and 14 July 2013 to ensure people were protected and no longer exposed to these poor care practices. We will report further on all the action we took, when the provider's period for appeal has passed.

We undertook inspections on 9, 11, 12 and 14 July 2013, which included visits during the night, early hours and at the weekend. We found the provider had failed to act on our previous warnings, and had failed to make any improvements. We witnessed neglect and wholly unacceptable standards of care, which consistently put people's health, safety and welfare at risk.

We found staff lacked compassion, and lacked the skills and competency required to deliver basic care safely to people. People were left without food and fluids for long periods of time, and their calls for help were frequently ignored by staff, leaving them in undignified and unsafe situations. Where people were cared for in bed and unable to move independently, staff failed to ensure they were turned to prevent pressure sores They also used inappropriate moving and handling equipment and techniques which put people at risk of injury and falls.

People were treated without any consideration for their personal wishes, and a complete disregard for their privacy and dignity. People were left wearing soiled clothes, and when personal care was given, doors were sometimes left open. People told us they did not feel respected. One person showed us where their clothes had been labelled with their room number. They told us that when they left the home they were going to buy a 'big bucket of Vanish.' Another person said. 'I was accused of not being very with it.'

In one area of the home people had been unable to leave the unit since March 2013 as the lift was broken. These people had been denied access to fresh air for four months, and furthermore there were no evacuation plans in place to get people to safety if an emergency had occurred.

Although some people spoke positively about their experiences in the home, one carer told us it was, 'hard at times because of the use of agency staff who do not always know people's needs.' In support of this comment, an agency worker said they often 'relied on instinct' and personal experience to provide care for people.

Our observations throughout this inspection identified examples of care delivery, where staff showed a complete lack of respect for people. We saw the activity coordinator engaged positively with people, and provided meaningful activities in one area of the home. However this practice was not consistently applied by care staff. We also found care records did not all reflect the care people needed, or promote continuity of care.

During this inspection we checked the issues relating to the environment which had previously raised concerns. Although some issues had been addressed, we found the lift, which had been out of order since March 2013, had still not been repaired. We also found the general environment continued to lack any visual or mental stimulation to enhance the quality of life for people with dementia in this home.

Prior to our inspection we had received information of concern about the dignity and care provided to people. During our visit, we identified significant concerns with the care, safety and welfare of people living at Meppershall Care Home.

We looked at the systems in place for obtaining people's consent to provide care and support, and how this was managed when people did not have capacity to make independent decisions. We saw staff spoke with people and offered them choices, but there was no evidence of people's mental capacity being assessed in line with their dementia needs, or how this had been managed.

We looked at the processes for managing infection prevention and control, managing medications, and also provision of a safe environment to meet people's needs. We found a number of areas where practice was unacceptable, and people living in the home were put at potential risk of harm.

From information of concern we had received, we looked at the staffing levels, as well as staff training and support processes. We identified that significant improvements were needed in these areas.

We looked at the quality monitoring systems within the home and found the provider had failed to ensure the regular assessment and monitoring of the quality of service provided.