Kent care home rated inadequate and placed in special measures

The Care Quality Commission (CQC) has downgraded Temple Ewell Nursing Home in Dover from good to inadequate and placed the service into special measures following an inspection in May.

Temple Ewell Nursing Home, run by Crownwood Healthcare (Temple Ewell) Limited, provides residential accommodation for people requiring personal and nursing care. The inspection formed part of CQC’s ongoing checks on the safety and quality of adult social care services.

Inspectors found care had deteriorated and identified breaches of seven regulations relating to safe care and treatment, staffing, recruitment, consent, safeguarding, person-centred care and the management of the service.

The home has been rated inadequate for safe, effective and well-led, while caring and responsive have both been rated requires improvement.

Inspectors identified concerns about how injuries and risks were managed. CQC said people had developed unexplained bruising, pressure wounds and blisters while living at the home, but these had not been investigated or reported to the local safeguarding authority.

During the inspection, CQC also observed a person displaying signs of possible dehydration. Inspectors found there were no systems in place to monitor the person’s fluid intake or confirm whether they had been offered a drink.

Fire safety arrangements were another area of concern. Inspectors found evacuation plans contained inaccurate information and three people did not have an evacuation plan at all. CQC said a manager had signed the documents as correct one week before inspectors arrived.

Concerns were also identified around people’s choices and restrictions. People living with diabetes were not being offered the same range of desserts as others because diabetic pudding options had not been ordered, leaving yoghurt as the only option.

CQC also found some people’s movement had been restricted without appropriate processes being followed. This included the use of lap belts to keep people in their chairs without proper records showing how the decision had been made or who had agreed to it.

Inspectors raised concerns about pressure care for people with existing wounds. Four people were found lying on pressure-relieving mattresses set to the wrong weight, which meant the equipment may not have been effective in preventing further damage. Staff records indicated checks had been completed, but CQC found there was no system to verify them.

Medicines management was also highlighted. In one case, records stated that a pain patch had been administered when it had not. In another, unidentified tablets were found in a cupboard without records showing who they belonged to.

CQC found staff were not always provided with the guidance and training they needed. Some staff said they wanted additional training to support autistic people, but this had not been provided.

Inspectors also raised concerns about access to specialist support for autistic people and people with a learning disability, finding that some people had lived at the home for extended periods without effective management of access to the specialist support they required.

Catriona Eglinton, CQC’s deputy director for adult social care in Kent, said poor leadership had allowed significant and avoidable harm to occur and that leaders had failed to identify and act on risks.

CQC has now placed Temple Ewell Nursing Home into special measures, meaning the service will be closely monitored while improvements are made.

The regulator has also begun the process of taking regulatory action in response to its concerns. Temple Ewell Nursing Home has the right to appeal.

CQC said leaders have been told where immediate and significant improvements must be made and the service will continue to be monitored closely while this happens.

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