Residents at a Cumbrian care home with coronavirus were allowed to mix with those without the virus, an inspection has found.
The inspection, carried out at the end of January at The Old Vicarage in Askham-in-Furness, deemed that the home “requires improvement”.
The home was inspected by the Care Quality Commission regulator after concerns were raised about infection control practices and the management of the home.
Inspectors found that in both lounges of the residential care home for the elderly, people who tested positive for coronavirus sat alongside those who had tested negative, with no social distancing observed.
The CQC said “this put people at high risk of being infected”. Lateral flow devices were also left on the desk in the office, some showing a positive result.
“The company adopts a strict policy of infection control within the home. Unfortunately on the occasion of the visit, the home manager was absent having been diagnosed as positive for COVID-19,” said Geoff Slater, director at the home.
“This resulted in all home protocols not being fully adhered to and instances of residents “mixing” which should not have taken place. All issues have now been fully addressed and robust systems introduced so as to ensure that this never happens again.”
Inspectors also criticised the home for failing to report allegations of “abuse” in the home to the local authority.
“The allegation of abuse was made internally by a member of staff who complained of another member of staff speaking loudly to residents,” said Mr Slater.
“This matter was fully investigated and it transpired that the member of staff in question suffered from hearing difficulties. The CQC inspector was entirely
happy with the way that the matter had been investigated and the outcomes provided.
“Unfortunately, it is CQC directive that all allegations of abuse, however minor, should be reported to the local authority. We have since discussed this matter with the safeguarding team at Cumbria Social Services who confirmed that under their directions the matter would not have been required to be reported as it was considered to be a minor incident.”
The CQC team who inspected the home were also not required to prove their COVID-19 status to enter the home, the report said.
Inspectors only assessed whether the home was “safe” and “well-led” and deemed that the home “requires improvement” on both grounds.
Other key findings
- People told inspectors they felt comfortable and happy living in the home.
- Staff confirmed they had completed training on safeguarding vulnerable adults. There was a safeguarding policy and procedure, available to all staff in an electronic format. On looking at records, inspectors noted the provider had carried out an investigation following allegations of abuse; however, they had not reported the allegations to the local authority in line with safeguarding vulnerable adults procedures. This meant the local authority had no oversight of the investigation.
- Individual risks had been assessed and recorded as part of the electronic care planning system. However, environmental risk assessments had not always been carried out and there was no risk assessment seen to assess and manage an outbreak of coronavirus. The provider sent the CQC a copy of the risk assessment after the inspection.
- On a tour of the premises, inspectors noted instances of unfinished work. The visitors’ pod had been removed for urgent drainage work; however, inspectors were given assurances this would be reinstated the week after the inspection.
- There were sufficient staff deployed to meet people’s needs and caring interactions were observed throughout the visit. On looking at two staff files, the CQC noted there were gaps in the recruitment records. The registered manager said this issue would be addressed.
- People and relatives were complimentary about the leadership and management of the home. Whilst the registered manager and provider sent evidence of their checks, shortfalls in several aspects of the service were found during the inspection.
- People were consulted about their daily care; however, they had not been invited to complete a satisfaction survey during 2021 and there was evidence of only one residents’ meeting in September 2021.
- The provider and registered manager gave assurances they would make the necessary improvements to the service.
How do inspectors assess whether a home is safe?
Inspectors look for evidence that people are protected from abuse and avoidable harm. The home was rated as “good” in this area during the last inspection, but has since deteriorated to “requires improvement”.
This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.
How is a home deemed to be well led?
In this area inspectors look for evidence that service leadership, management and governance assures high-quality, person-centred care; supports learning and innovation; and promotes an open, fair culture.
At the last inspection, this key question was rated as good. Inspectors said it now “requires improvement”.
This meant the service management and leadership were inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.
