Devon care home boss slams CQC over 'serious concerns' inspection

A Devon care home owner has hit out after it was rated 'inadequate' and placed in special measures for a second time over 'serious concerns' about the care residents receive.

Moors Park House in Bishopsteignton was reinspected in May and due to staffing recruitment issues, residents were sometimes said to be unable to get out of bed or have a bath or shower, or interact with other residents. A high number of medicines errors were noted, with some people not always receiving their medication.

Basic care was also said to be of concern, with one resident who needed repositioning every two hours, not being moved for up to 12 hours, according to their care records.

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The care home, run by Crocus Care, provides accommodation and personal care to up to 37 older people, some of who have dementia. In response to the publication of the report today, November 29, it says it is no longer an accurate reflection of life at the care home because the inspection was carried out six months ago and 'significant progress' has since been made.

It added that it believes the 'inadequate' rating it received was 'not appropriate' and will be asking CQC to review it. Criticisms have also been made by Crocus Care of the impact on care homes who receive poor ratings, stating it can be 'detrimental to the mental health' of employees and care home providers.

Moors Park House was previously inspected by health and social care regulator Care Quality Commission (CQC) in April 2023, and was put in special measures after being rated 'inadequate' due to concerns of safeguarding and the management of the service.

It was given six months to get its house in order or face further action. However, following another recent inspection by the CQC, it is still being kept in special measures to protect its residents because 'not enough action has been taken' to improve it. The overall rating for the home, as well as the areas of safe and well-led, have been re-rated as inadequate.

The rating for how effective the service is has increased from inadequate to good. Caring and responsive were re-rated as requires improvement.

In a statement issued today by the CQC, Catherine Campbell, CQC deputy director of operations in the south, said: “It was worrying to find that despite some minor improvements, the same level of poor care remained at Moors Park House since our last inspection. Leaders had still not taken enough action to address our serious concerns around the quality of care being provided.

“The service had a high reliance on agency staff which impacted care, especially when they hadn’t worked at the service before. Staff told us vacancies meant sometimes people didn’t get out of bed or have a bath or shower, nor did they get to spend quality time with other people at the home. Staff and the local authority had raised concerns about staffing levels with managers, but this hadn’t been addressed by leaders.

“We found the service was busy and saw several people waiting for staff to assist them. It was concerning to see people looking for staff and becoming frustrated because they wanted a drink or some reassurance, but no help was available.

“People still weren’t always receiving their prescribed medicines as they should. There was a high number of medicines errors, and staff couldn’t always be sure if people had received them correctly. However, we did see that staff gave them to people in a safe and caring way.

“People weren’t always protected from abuse and improper treatment. We found incidents where staff didn’t always identify allegations of abuse or make safeguarding referrals to the local authority in line with the services’ policy. This put people at risk of harm as incidents weren’t always investigated properly and lessons learned to help prevent them from happening again.

“The service’s records didn’t demonstrate people’s risks were always managed in line with their care plan. For example, one person needed repositioning every two hours, however their care records showed gaps of up to 12 hours.

“We have told leaders at Moors Park House where we expect to see immediate and significant improvement. 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.”

In the report, it is noted that inspectors also found:

• People’s personal needs likes and preferences still weren’t always fully assessed before they were admitted to the service.

• Most people had been supported to be dressed appropriately and had items that were important to them, such as personal jewellery. However, some people had overgrown fingernails with chipped varnish and dirt beneath the nails.

• There were no systems in place to monitor how much people drank potentially placing them at risk of dehydration.

• External agencies said that while staff demonstrated an intention to work openly and in partnership, the lack of management meant it was sometimes hard to do so.

• Staff saidthey had concerns about the consistency of the quality of care people received, including personal and continence care.

• Improvements had been made to people’s care plans and some contained good information, however, care plans lacked information about how staff could support people with their emotional needs

The service will continue to be kept under close review to make sure people are safe whilst improvements are made.

Paul Ewer, director of Crocus Care, said: "It is six months to the day since the inspection and the report, only released today, in no way reflects the way the service is currently. Moors Park House has been in a quality support process run by Devon County Council with regular visits to the service and regular meetings to discuss progress.

"The CQC Inspector has participated in these meetings and is therefore fully aware of the progress made over the past six months. A careful reading of the report does demonstrate improvements at the time of the inspection compared to previously, and while we acknowledge that there were occasions when processes were not fully effective, the intent was there.

"We also had a new manager in place, and they were developing. However, the CQC refused their application for registration, and ultimately, they left our employment four months ago, we took the step to employ an experienced turnaround consultant who is also a registered nurse, and they are now working as interim manager.

"Since that time the processes have been tightened up and at the most recent DCC review meeting also attended by the CQC inspector the significant progress in quality monitoring was acknowledged. We observe that although the report points to deficiencies in quality assurance, nevertheless residents and families were reporting general satisfaction with the service.

"In common with most other providers, and there is well publicised national shortage of care workers, we have experienced difficulties with staff recruitment, and this means a high agency usage. This is far from ideal, but we have continuously sought new staff. It seems unfair to criticise this.

"There were mitigating circumstances regarding the two service users who had to leave the service due to behavioural issues which were not apparent at admission."

Mr Ewer continued: "The consultant has analysed the report, which was prepared under the new single assessment framework, and believes the rating of inadequate is not appropriate and should instead be ‘requires improvement’. A request for a review of this rating will be made to CQC in due course now the report is published.

"There have been questions of inconsistent ratings raised by others in the past. We consider that the CQC, as has previously been the case with Ofsted, is behaving in an adversarial way with providers, and which is demoralising when people are trying their best to improve, often under difficult circumstances.

"CQC should be aware of the detriment to the mental health of those working in management at providers, and we are concerned there will be a similar tragedy, such has occurred with school inspections."