Bridlington care home rated 'inadequate'
The Lombrand Limited has been placed in special measures.
The Care Quality Commission (CQC) has rated The Lombrand Limited in Bridlington, inadequate and placed it in special measures following an inspection in January.
The inspection was carried out in response to concerns received about infection control within the service. However, during this inspection, further concerns were identified, and the inspection was extended to a comprehensive inspection to address all concerns.
The Lombrand is a residential care home providing accommodation and personal care. The home accommodates up to 21 people living with mental health conditions.
Following the inspection, as well as being placed in special measures, the overall care home rating has dropped from good to inadequate. The service was rated inadequate for the areas of safe, caring, responsive and well-led. It was rated requires improvement in the area of effective.
CQC’s head of adult social care inspection, Alison Chilton, said:
“When we carried out an inspection of The Lombrand, we found people’s care needs weren’t being met due to widespread and systemic failings throughout the service.
“It was concerning that we identified unnecessary restrictions such as people not being able to access the community, not being able to eat and drink at a chosen time and having limited access to their money and personal items. It was disheartening people confirmed such decisions had been made without appropriate conversations with them.
“There was chronic understaffing and an over-reliance on low numbers of existing staff who displayed low morale. This understaffing meant there were only two members of staff available to cover all care needs for people, including cleaning, cooking and medication. Staff wanted to spend more quality time with residents but simply didn’t have the time.
“The Lombrand failed to report all safeguarding incidents to the local authority. Additionally, staff told us they weren’t supported to raise safeguarding concerns and felt actively discouraged and fearful to whistle blow. Leaders must address these issues urgently as staff have valuable insights that can prevent people from coming to harm.
“Arrangements for visiting within the service did not align to government guidance and relatives told us they had not been kept up to date with visiting protocol. People who lived at the home had not always been supported and encouraged to maintain contact with their loved ones.
“Leaders now understand where urgent improvements must be made, and we will continue to monitor The Lombrand closely to ensure people are safe. If we are not assured people are receiving safe care, we will not hesitate to take further action.”
Inspectors found:
• People were at risk of harm due to poor infection prevention and control (IPC) practices and a complete failure to implement effective measures in response to the COVID-19 outbreak. From documentation reviewed, inspectors saw examples of people being restricted of their liberty without consent. Care provided to people was not individualised and did not always reflect people’s wishes and preferences.
• The provider had failed to follow local safeguarding arrangements to report all incidents to the local authority safeguarding team. This breached the organisation's own policy on reporting and responding to safeguarding concerns.
• Staff did not always recognise or record near misses and there was no opportunity for learning. For example, medication audits had identified that some medicines had been incorrectly supplied by the pharmacy, resulting in an overdose of prescribed medicines for one person but this had not been recorded.
• Areas of the environment needed addressing in order to be made safe. For example, one fire exit had been blocked which had not been identified by the provider as a risk. The provider ensured this was made safe following the inspection.
• Systems were either not robust enough to ensure enough numbers of suitably skilled and experienced staff were in place to meet the needs of people.
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