Four nursing homes in Cornwall have been placed into the special measures regime for struggling health and social care providers, two of which were recently featured in a television documentary.
The Care Quality Commission has published the full findings of its inspections of four nursing homes run by the Morleigh Group in Cornwall, noting that they “make horrifying reading” and that staff shortages were a “major factor”.
“These services were providing grim, shoddy and unsafe care”
All four homes – Clinton House Nursing Home, Collamere Nursing Home, Elmsleigh Care Home and St Theresa’s Nursing Home – have been rated “inadequate” and placed into special measures.
The regulator said it was also currently taking further action to protect the safety and welfare of all the people living at the homes.
CQC inspectors had visited Collamere Nursing Home at Lostwithiel on 10 October in response to concerns about the service.
Inspectors visited Elmsleigh Care Home in Par on 25 October to follow up on improvements required by a previous inspection.
Planned inspections of Clinton House at St Austell and St Theresa’s in Callington were brought forward after information was passed to the CQC by the BBC Panorama programme on 26 October.
Broadcast on 21 November, Panorama: Nursing Homes Under Cover featured film footage recorded secretly in the two homes by a reporter posing as a resident and two others working as staff.
The programme found evidence of cruelty and neglect, with staff rushed off their feet and the privacy and dignity of some residents often ignored.
“I would like to publicly apologise for the distress that our residents, their families and our staff have felt”
At Elmsleigh, CQC inspectors found one person who suffered from incontinence and was at risk of pressure ulcers, but was not routinely turned or checked by staff.
Records showed that for several days the person often received no personal care – exposing them to the risk of urine burns to their skin, said the CQC report. People sat in the same seat all day, with their meals left in front of them uneaten, even though most needed encouragement to eat.
Some appeared not to realise it was mealtime. Some people had sustained substantial weight loss but it was not clear what action had been taken to help them maintain a healthy weight. Although food and drink was monitored, no-one checked the records or took action to address concerns.
Meanwhile, at Collamere, the report noted that inspectors witnessed people with dementia who were calling out repeatedly for some time with no response. One person shouted out throughout the day and night, although records showed no medical help had been sought since 2015.
It was only after the inspection that their GP was asked to review their pain relief – and then they appeared to sleep without signs of distress.
Staff reported continued concerns about the laundry service. Inspectors showed a sample of worn, frayed and discoloured sheets and towels to the management team – who blamed staff for drying pillows in the tumble drier and for staff taking new towels for their own use.
At Clinton House, there were not always enough staff on duty, said the CQC report. Inspectors noticed one person in distress and crying for an hour and a half while staff walked by three times without speaking to the person to find out if they needed anything or to comfort them.
The management of medicines was not robust. One person had not been given one of their prescribed medicines for three days. Inspectors had to intervene when one person – who had previously been assessed at risk of falls – was left unattended nearly fell out of their wheelchair.
Lastly, at St Theresa’s, inspectors identified one person who had pressure ulcers, but had not been repositioned for eight hours. There had been a delay of five days in seeking specialist advice, said the regulator’s report.
Drugs were not being managed safely, premises and equipment were not maintained and the collection of soiled laundry from bedrooms and cleaning procedures did not ensure suitable cleanliness standards. Continence pads and net pants used to secure pads were shared communally.
Andrea Sutcliffe, the CQC’s chief inspector of adult social care, said: “These reports make horrifying reading – people in distress being ignored by staff; a person lying in a urine-soaked bed for two hours; people sat in the same chair all day with uneaten meals in front of them, and no help to eat or drink; someone needing medical attention waiting weeks to be referred to their GP.
“These and so many other examples show why we have rated each of these homes as ‘inadequate’ and are taking further action to protect the safety and welfare of the people living there,” she said.
“These services were providing grim, shoddy and unsafe care – the sort that no one should ever have to put up with,” she said. “I am sorry that people have had to endure this poor level of care.”
Ms Sutcliffe said the owner of Morleigh Group had previously been supported by Cornwall Council and Kernow Clinical Commissioning Group to make improvements in the wake of earlier visits.
“They failed to listen and take action and they allowed the services to seriously decline since our previous inspections when the homes were rated as ‘requires improvement’,” said Ms Sutcliffe.
“At Clinton House, Elmsleigh and Collamere, there were not enough staff to meet people’s needs properly. This has been a major factor in the serious decline and the failures we have seen,” she said.
She added: “Where services are ‘inadequate’ and fail to improve, and people are at risk, we will take enforcement action which ultimately can lead to the closure of a service.”
Patricia Juleff, owner of the Morleigh Group, said she wanted to “publicly apologise for the distress that our residents, their families and our staff have felt in recent weeks”.
In a statement, she said the group had undertaken a “detailed review” of systems and procedures over the past few weeks.
“Early in that review, staff numbers were increased in all of our homes and dismissals were made both since and prior to being notified by the producers of the Panorama programme,” she said.
Ms Juleff noted the internal review had found inconsistencies in medicine control, maintenance and staff training that were “now being addressed”.
However, she questioned why the CQC had given the provider an overall “inadequate” rating when the majority of areas checked had been judged to be “requires improvement”.
“We are naturally disappointed the regulator has now adjudged the four homes to be ‘inadequate’, despite 11 of the 20 areas assessed as ‘requires improvement’, with many of the findings confirming the areas we have already identified for improvement,” she said.
“Indeed, the CQC’s most recent inspections prior to Panorama – which took place as recently as this summer – find all four homes to be in the ‘requires improvement’ category,” she stated.
She added: “I completely disagree with the view of Andrea Sutcliffe, chief inspector of adult social care, in that we have ‘allowed’ the services to seriously deteriorate.”
The group also runs two other homes, at Brake Manor in St Austell and Tregertha Court in Looe, which are currently rated as “good” and “requires improvement”, respectively.