'Unacceptable' care standards leads to enforcement action at Cambridgeshire care home

The Care Quality Commission (CQC) will take enforcement action against Hill House care home in Huntingdon after rated the home as inadequate.

The inspection took place from March to May and rated the care home as inadequate; meaning it will remain in special measures and is now subject to further enforcement action to protect people.

Hill House, run by ADR Care Homes Limited, is a residential care home providing personal care to adults, some of whom live with dementia.

This inspection was prompted in part due to concerns CQC had around potential risks in the service and to check on the progress of improvements they were told to make following their previous inspection when they were first rated as inadequate and placed into special measures.

Following this inspection, Hill House has been again rated inadequate overall. It has again been rated inadequate for all five key questions including how safe, effective, caring, responsive and well-led the service was.

The service has been told where CQC expect to see rapid and widespread improvements and the service will remain in special measures meaning it will be kept under close review by CQC to keep people safe whilst this happens.

CQC has also referred the home to local authority’s safeguarding team and taken enforcement action to protect people, which will be reported on when CQC are legally able to do so.

Stuart Dunn, CQC deputy director of operations in the east of England, said: “It is unacceptable to find that the same level of poor care is still being provided to the people who call Hill House home since our last inspection. This is despite us telling leaders where we expected to see rapid and widespread improvements and issuing them with a warning notice to focus their attention in the relevant areas. Leaders have allowed a poor culture to become normalised which was behind a lot of the poor care we saw.

“Staff didn’t always treat people with dignity and respect. They talked loudly about people’s personal care needs in front of others and used offensive language such as referring to people needing support to eat and drink as feeders instead of by their names. Some people told us they didn’t think staff cared about them, and they just wanted to finish their tasks quickly. People also wanted the staff to respect their privacy in ways such as knocking on their bedroom door instead of just walking in.

“Staff weren’t safeguarding people from abuse. For example, a staff member was supporting a person to eat, and continued to put food in their mouth even when they started to choke and cough. We have raised this concern with the local authority safeguarding team.

“Leaders didn’t support staff to learn lessons when things went wrong to prevent them from happening again. For example, someone had a fall and staff supported them back to bed instead of calling a doctor to assess if they were hurt. Leaders didn’t learn from this or take action, and as a result, another similar incident happened.

"People living at Hill House were relying on all staff members to act as their advocates, to help them live their best lives and it is unacceptable the people they relied on were treating them this way."

“All areas of the home including people’s bedrooms were visibly dirty with dust, cobwebs, and mould and dead insects. The kitchen was also dirty and stained, with out of date or unlabelled food items in the fridge putting people’s health at risk.

“We have told leaders where we expect to see immediate and significant improvement and are taking further enforcement action to protect people which we’ll report on when we’re legally able to do so. In the meantime, we’ll continue to monitor them closely to make sure people are safe while this happens and won’t hesitate to take further action if this doesn’t happen.”

Inspectors also found that:- Staff had training in the Mental Capacity Act however they were unable to tell CQC what this meant in relation to their job roles.- Staff didn’t manage medicines safely. Staff were carrying and dispensing multiple people’s medicines at the same time as well as not signing and checking each medicine given which increase the likelihood of mistake being made.- Staff weren't supporting people to move regularly or engage them in meaningful interactions throughout the day.- There were no details in people’s care plans on how to communicate with them if they didn't use verbal communication.- The management team weren't checking care plans and records to ensure people were being supported to stay healthy in line with their support needs.- Staff were unable to talk about what people might like to do with their time or what they were doing to support people to follow their interests and achieve their goals.

The full report can be viewed on the CQC website.