Damning CQC report reveals extent of nursing home failures

Understaffing, missed medication and poor hygiene were among the issues raised in a recently published CQC report into an ‘inadequate’ Lincoln village nursing home.

As previously reported, all residents were moved out of Eagle Nursing Home, which is based at The Old Rectory on the High Street in Eagle, after an inspection in June identified “serious concerns”.

An initial unannounced inspection took place back in April 2018.

Concerns were raised through monitoring by Lincolnshire County Council, which stated care at the home was “not adequate”.

This resulted in another unannounced inspection by the Care Quality Commission on June 6 and 7.

A report on The Lincolnite sparked a wave of complaints, including claims that a former resident was “dragged along the corridor from his bedroom and thrown into the lift”.

A former member of staff also revealed more details of the alleged “endemic” bullying of staff and residents.

The findings were published in a report on September 3 and the home is no longer operating and its registration has been removed.

Inspectors’ report

The Care Quality Commission has rated the service as ‘inadequate’ overall as well as in select areas including safety.

Key points highlighted by inspectors in the CQC report included:

  • People were not protected from risks associated with the environment and there was no signage warning about hazards.
  • Medicines were not managed safely and staff did not always follow the correct procedure.
  • One person’s medicine had not been dispensed by the pharmacy and the person went without their medicine for five days before an agency registered nurse identified the omissions.
  • The home did not comply with safe infection control practices, for example, a staff member was observed carrying a commode basin with urine without a lid from the person’s bedroom to bathroom further down the corridor. The staff member also didn’t wear gloves when emptying it.
  • Two residents escaped from the home, who had been assessed at medium risk of exiting the building unsupervised, but there was not an action plan in place to address how they would be prevented from leaving the premises and kept safe.
  • People who lived in the service and their relatives told us that there was not always enough staff on duty to meet their needs. Relatives also felt that staffing levels were poor, especially at night and weekends.
  • There was also a failure to employ sufficient numbers of suitably qualified, competent, skilled and experienced staff, which was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
  • On day one of CQC’s inspection there were 18 people living in the service who were lawfully deprived of their liberty.
  • Care plans did not always accurately reflect the care that people received. One person injured their legs when they became trapped between their bed rails and mattress, but they had not been risk assessed for the safe use of bed rails before or after the injury.
  • There was no dirty/clean laundry flow in the laundry room. For example, there were bags of soiled laundry stored on the floor. 
  • The provider was in financial constraints and was unable to pay their bills, which had an impact on the people who lived at the service.

Sanjiv Basu is the sole director of SSB Carehomes Limited, which ran the nursing home along with another in Gainsborough, but he did not respond when contacted by The Lincolnite.

As previously reported, his company owes over £300,000 to HMRC after being subject to a Company Voluntary Agreement (CVA).

According to Companies House SSB Carehomes Limited appointed an administrator on July 30 2018 and there was a notice of completion of the voluntary arrangement on August 31.