The Care Quality Commission (CQC), has rated The Amwell in Melton Mowbray as inadequate and placed it into special measures to protect people following an inspection in December.
The Amwell, run by The Amwell Care Home Limited, is a care home providing personal care for up to 88 older people living with physical disabilities or conditions such as dementia. This inspection was carried out due to concerns received around medicines management and a lack of management oversight.
CQC found five breaches of regulation related to care that didn’t meet individual needs, consent to care, safe care and treatment, nutrition and hydration, and management and oversight. CQC issued the home with warning notices to focus their attention on making rapid and widespread improvements in these areas.
The overall rating for the service, as well as the ratings for how safe and well-led the service is, have dropped from good to inadequate. How effective the service is has dropped from good to requires improvement. This inspection didn’t look at how caring and responsive the service is, which remain rated as good from their previous inspection.
The service has been placed in special measures, which means it will be kept under close review by CQC to keep people living in the home safe while improvements are made.
Craig Howarth, CQC deputy director of operations in the midlands, said:
“At this inspection, we found that The Amwell had several issues and leaders hadn’t developed solutions or listened to concerns about safety. However, they recognised they needed to make improvements and appointed a turnaround manager who had been in post one week before our inspection.
“Leaders didn’t make sure they employed enough staff with the right knowledge and skills. One relative told us staff leave residents in the lounge without supervision, leading to arguments and disagreements. Another relative told us they heard people regularly cry out for help from their rooms. This is unacceptable that people were being left in distress.
“Relatives had mixed feedback of the service. While some told us they felt their family member was safe, others expressed concerns about the treatment their family member received. Throughout our visit, we saw mobility aids out of reach for people who needed them, which meant that some people were at risk of falling.
“The home managed medicines unsafely, putting people at risk of harm. Some prescription items were out of date, and room and fridge temperatures exceeded the recommended range. Staff didn’t update medicine charts, making it unclear if people received their medication putting their health at serious risk.
“The turnaround manager was compiling a list of concerns and identifying areas needing improvement. They remained open, honest and realistic despite their limited time in post.
“We have told leaders where they urgently need to make rapid and widespread improvements and hope to see these plans deliver better experiences for people. We will continue to monitor the service closely through our special measures program. to make sure people are kept safe while that happens.”
Inspectors found:
- Staff couldn’t evidence that people were receiving drinks to stay hydrated as they hadn’t recorded this information.
- A local authority contact visit found that staff hadn’t sought medical attention for someone who had become unwell with a medical emergency.
- Staff didn’t meet Deprivation of Liberty Safeguards (DoLS) conditions for four people. One condition required detailed descriptions of responses when people declined support, but staff simply wrote declined with no other details.
- Inspectors found stained mattresses and bedding, rust in showers, ingrained dirt in mobility aids and unpleasant smells. The turnaround manager escalated these concerns and made necessary improvements.
- Staff spoke negatively about people within earshot of residents and relatives which wasn’t caring or dignified for the people who called The Amwell home.
- The home didn’t make sure that people’s care and treatment was effective because they didn’t discuss their health, care, wellbeing and communication needs with them. Staff couldn’t understand people’s needs because their care plans had several contradictions.
- Staff didn’t carry out people’s personal care frequently enough to promote good personal hygiene. Some relatives had concerns about their family members smelling strongly unpleasant.
- The home had a closed culture. Leaders’ lack of knowledge of issues in the service contributed to this, making people and relatives uncomfortable about speaking up.
- The home experienced inconsistent leadership with several managers over a two-year period. Staff had concerns about some of the previous managers and felt the leadership gaps caused problems.
- Senior leaders from across the service misunderstood the home’s challenges.
However:
- The home’s layout suitable the people who lived there well. People with mobility aids had enough space to move freely.
- People generally liked the food provided.
The report will be published on CQC’s website in the coming days.