Shropshire care home vows to tackle ‘inadequate’ inspection

A Bridgnorth care home has said it has already made ‘substantial improvements’ after inspectors have threatened regulatory action following an inspection that found the facility ‘inadequate’.

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The Care Quality Commission (CQC) visited Danesford Grange Care Home in Kidderminster Road in June.

Run by MGC Care Limited, the care home provides accommodation for people requiring nursing care, older adults and people with a diagnosis of dementia.

But following their visit CQC inspectors downgraded the home from ‘good’ to ‘inadequate’ overall, as well as the ratings for safe, effective, and responsive. The rating for ‘well-led’ was also ‘inadequate’, declining from ‘requires improvement’, and caring fell from ‘good’ to ‘requires improvement’.

The service was found in breach of four regulations, relating to person centred care, need for consent, safe care and treatment, and governance, and the CQC has now begun the process of taking regulatory action, which MGC Care Limited has the right to appeal.

Amanda Lyndon, CQC deputy director of adult social care in the Midlands, said: “When we inspected Danesford Grange, we found a service failing to provide the expected standard of care, which put people at risk.

“Improper record keeping was a consistent theme throughout the service, as staff didn’t ensure key information was accurate or up-to-date. They also had care plans which were generic and sometimes conflicting, meaning people weren’t receiving person-centred care tailored to their needs. We found staff had also made errors in medication records which led to incorrect and missed dosages, with concerns regarding potential over and under dosing.

“We also saw staff didn’t always record incidents such as falls, and those that were didn’t result in a meaningful review or improvements being made. One person suffered 11 falls within a one-month period.

“It’s always a last resort for CQC to take action, but people using services should receive safe, effective and high-quality care that meets their needs.”

She said Inspectors found the service could not prove “equipment and the environment were consistently cleaned, putting people at risk of infection”.

Inspectors said maintenance issues and other potential hazards went unchecked, including damaged flooring, broken thermometers in bathrooms, and cluttered areas, putting people at risk of injury.

The service failed to demonstrate compliance with the Mental Capacity Act 2005, with capacity assessments and best interest decisions found to be incomplete, inconsistent, poorly evidenced or not in place. There was limited evidence decisions were being made lawfully or in people's best interests.

Inspectors also had significant concerns regarding pressure care and repositioning, including missed repositioning times, gaps in records, inaccurate documentation and a lack of effective oversight.

The CQC said that staff also did not always ensure people requiring specialist nutritional support received care that was consistently aligned with their assessed needs. Records showed prescribed supplements were not always recorded, preferred dietary options were not always provided and monitoring of food intake lacked detail. 

They also found that staff did not always protect people's rights as they used restrictions, including bed rails and coded door access, without clear evidence of decision-making and that consideration of less restrictive options had been explored.

In a statement, MGC Care Limited said they were already making “substantial improvements” to address the CQC concerns.

The statement said: “We take the findings seriously and remain fully committed to providing safe, effective, compassionate and person-centred care to everyone living at Danesford Grange.

“Since the June inspection, substantial improvements have been achieved across all of the areas identified by the CQC..

“A key part of this improvement has been the strengthening of the home's leadership. A new Registered Manager and Deputy Manager are now in post, providing competent, experienced and accountable leadership across the service. This has brought greater consistency, oversight and accountability to the day-to-day management of the home.

“The home is also working with an experienced care consultancy as part of a dedicated turnaround and improvement programme. This provides additional specialist expertise and independent oversight, supporting the management team to ensure that improvements are effectively implemented, monitored and sustained.

“Significant work has been undertaken across all areas highlighted by the CQC, including care planning and record keeping, medication management, falls and incident management, pressure care and repositioning, nutrition and hydration, Mental Capacity Act and best-interest processes, environmental and equipment safety, infection prevention and control, and governance and quality assurance.

“The improvements have included strengthening systems and processes, increasing management oversight, improving staff accountability and introducing more robust auditing and monitoring arrangements. The focus has been on ensuring that improvements are embedded into everyday practice and sustained over the longer term.

“We recognise that the CQC's findings may understandably cause concern for residents, relatives and those who support Danesford Grange. We want to reassure residents and families that the findings have been taken seriously and that substantial work has already been completed to address the concerns identified during the inspection.

“We are continuing to work constructively with the CQC and other relevant professionals and remain committed to providing evidence of the progress achieved.”