A REPORT has revealed a category of problems at a care home including legionella, verbal abuse, and a lack of staff and training – which inspectors said put people at risk of harm.
Remyck House in Aldershot is rated as 'inadequate' due to the numerous concerns that the Care Commission Quality (CQC) officers found.
The report, published on April 14, indicates that the risk of legionella in the home was particularly high. The protocol hasn’t been updated since 2016, nor a legionella training for staff, which should be updated if legionella bacteria is found during water testing.
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The registered manager told CQC that there were two bathrooms, one of which -including the shower room - was out of use due to the presence of legionella; therefore, 10 people had to use the remaining bathroom and shower room.
The house can accommodate 29 people and supports older people who are diagnosed with dementia. At the time of the inspection, there were 21 residents living in the home.
The house hasn’t been maintained or cleaned to adequate levels as officers found several areas of ripped or torn carpets, which were a trip hazard to people, and door frames and handrails worn and damaged.
The report said: “We saw bins for paper towels in the bathrooms lacking a cover so people could touch the contents.
“In the downstairs cloakroom, there was a discarded incontinence pad in the bin. The toilet had a sticky floor, some wet patches around the base of the toilet.
“The outside covered area by the front door was dirty, with mould and dirt on the chairs and cushions. The main lounge carpet was seen to be stained and dirty in places.
“In the downstairs cloakroom, the underside of the toilet raiser was rusty. A number of chairs were grubby and stained.”
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On the visit, CQC observed a person who had fluid oozing from their leg eating with others and scratching the wound while on the table.
The report said, “At lunch, they sat at a table with another person and were scratching their leg with their fingers or rubbing it with a tissue. A staff member encouraged them to eat after they had been scratching their legs. This was an infection control risk to both the person and others.”
Papers records showed that the person had no allergies; however, the electronic care plan indicated that he was allergic to penicillin.
Officers also saw how two staff members applied insulin without having the specific training to do so and how three people were regularly administered medicines which had sedative effects, and the medicine administration records (MAR) state that these medicines were only recommended “when required” or “sparingly”.
Care plans were not developed in relation to residents’ needs either.
Two people’s skincare plans indicate that people need to be moved every two hours to prevent the development of ulcers. However, records show that staff didn’t move the person as required, which left them at risk of developing pressure sores.
The staff’s lack of skills and competence was also a concern since, although staff have dementia and challenging behaviour training, they don’t know how to “safely manage people’s emotional reactions”.
The CQC officers saw that one man went to his bedroom with wet trousers, and the staff didn’t persuade him to change due to his level of aggression. His care plan indicated “Remain in wet pad” until he accepted to be changed.
Residents were also exposed to verbal abuse from other residents, resulting in two leaving the care home.
Staff had recorded 12 incidents of them experiencing ‘agitated’ or ‘challenging behaviour’ since December 2022 relating to this person.
Four people reported to CQC that they did not feel safe living in the home. A person said, “I’m a little bit careful who I sit with as they [other people] periodically throw things.”
Since the visit, management has provided alternative accommodation to the person.
The lack of staff was also a problem in the care home since residents could not spend quality time with the carers and ended up watching TV.
The activity co-ordinator plan worked four days a week, providing resident movements. However, on the three other days, no activities were offered to the residents. One person’s daily lifestyle plan said staff ‘go and chat’ ‘in free times.’
A person said to CQC, “That’s the trouble; she [activities co-ordinator] does a lot. I depend on her, and if she’s not here, I go back to my room and put the telly on.”
The house’s decoration didn’t support people with dementia since the colour of the walls does not allow people to differentiate corridors, making it difficult for them to know where they are.
“There had been insufficient consideration of the environmental needs of people with dementia when decorating the service.”
After the visit, some works has been done to repair and replace carpets.
Remyck House’s manager indicates that “a lot of work is being in place”.
“Improvements are on the way already. Staff training is being done, and changes to the environment such as painting and decoration are also being done”.
“We have a meeting with adults in social care. Action plans have already been sent to CQC. We aim to ensure we work everything out and improve on areas.”
He also told CQC that “action had been taken to arrange for re-testing of the water for the presence of legionella and for staff to update their legionella training”, and said that the water test had come back negative.
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