CQC tells Liverpool nursing home to make immediate improvements

The Care Quality Commission (CQC) has told Finch Manor Nursing Home in Liverpool to make immediate improvements and kept it in special measures to protect the safety and welfare of people living there following an inspection in November and December.

Finch Manor Nursing Home is a care home with nursing care, and the only one run by Lotus Care (Finch Manor) Limited. It provides nursing or personal care support to people living with dementia or other complex health needs. There were 82 people living in the home at the time of this inspection.

This unannounced comprehensive inspection was carried out to follow up on concerns CQC found during the last inspection as well as check on new concerns. A number of safeguarding incidents were reported to CQC by both the provider and the local authority which raised concerns about people's safety and the management of the service.

Following this inspection, the service has again been 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.

CQC has also taken additional action, which will be reported on when legally able to do so.

Karen Knapton, CQC deputy director of operations in the north, said:

"It was worrying to find that the same level of poor care has remained at Finch Manor Nursing Home since our last inspection. We found leaders had still not taken action to address our serious concerns around people's safety and the quality of the care being provided. This is why we have taken further action against them which we'll report on when we're legally able to do so.

"We saw there weren't enough staff, and people who needed urgent help were waiting too long to have their call bells answered putting their health at risk. Safety equipment to help people clear their airways if they started choking, wasn't always available even though some people had been identified as being at a risk of choking.

"Medicines were also managed poorly, including diabetic residents being given insulin without checking whether it was safe to do so, and people running out of medications because the home had forgotten to order more. This placed people at serious risk of harm.

"It was concerning that poor systems meant they didn't learn from accidents and incidents of a similar nature like these to prevent them from happening again.

"The home relied heavily on agency staff to support the service which hampered efforts to build a consistent team who knew how to work well together for the benefit of people living there. People told us some agency staff didn't speak English well, so didn't understand their needs and how to support them.

"The care provided wasn't person-centred and didn't always respect people's dignity. For example, one person's door was left open while they were partially undressed. Another person sat for 20 minutes covered in wet food during lunch before staff assisted them in changing.

"We have told Finch Manor Nursing Home to make immediate, rapid and widespread improvements and will monitor them closely to make sure people are safe while this happens. If this doesn't happen we won't hesitate to take further enforcement action which can include closing them down."

Inspectors found:

• Incidents of neglect weren't always reported to CQC as required. This meant CQC didn't have a true picture of the amount of serious and significant failings in people's care
• Visitors to the home were given the security codes to freely access all areas of the home including people's bedrooms. This meant people weren't protected from unwanted visitors and the risk of possible abuse. Inspectors spoke with the chief executive officer about this and on the second day of inspection, action had been taken to address this
• The provider couldn't be sure staff were suitable to work at the home as satisfactory pre-employment checks weren't always completed
• Medicines were managed poorly. When some people's medicines changed following discharge from hospital or a medical appointment, staff didn't adhere to these changes and people sometimes received too many medicines
• The environment was not dementia friendly with confusing signage, clinical rather than homely rooms, and not enough tables and chairs to support everyone to eat their meals together if they wanted to. This meant people were missing out on valuable socialising opportunities
• Staff didn't always recognise or respond to people's basic needs. For example, one person sat in the lounge all morning, staff did not speak or check on them until lunch. CQC inspectors had to request a blanket for them, as they were cold
• People weren't supported to have maximum choice and control of their lives and staff didn't support them in the least restrictive way possible and in their best interests
• People's legal right to consent to and make decisions about their care and treatment hadn't been supported in line with the legal requirements.

However:

• Improvements to the environment and its cleanliness had been made. During this inspection the home was adequately clean.

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