CQC takes action to protect people at Canterbury care home

The Care Quality Commission (CQC) has downgraded Saxon Lodge Residential Home Limited from good to inadequate and placed the service in special measures to protect people, following an inspection in July.

Saxon Lodge Residential Home Limited, run by an organisation of the same name, is a care home in Canterbury, Kent, which provides personal care for people, including people with dementia. There were 21 people living there at the time of the inspection.

CQC carried out this inspection as part of its monitoring of health and social care services.

At this inspection, CQC identified seven breaches of regulation relating to safe care and treatment, medicines management, providing person-centred care, treating people with dignity and respect, consent, complaints handling, safe staffing and overall management of the service.

CQC has downgraded safe and well led from good to inadequate. Responsive, effective and caring were downgraded from good to requires improvement.

CQC has placed Saxon Lodge Residential Home Limited into special measures which involves close monitoring to ensure people are safe while they make improvements. Special measures provides a structured timeframe so services understand when they need to make improvements by and what action CQC will take if this doesn't happen.

CQC has also begun the process of taking further regulatory action to address the concerns, which Saxon Lodge Residential Home Limited has the right to appeal.

Catriona Eglinton, CQC deputy director of adult social care in Kent, said:   

"When we inspected Saxon Lodge, we found a culture where people's needs weren't being met and where leaders consistently failed to listen to people and to act when concerns were raised.

"We saw staff didn't have the guidance they needed to support people safely when they became anxious or distressed, which meant some people were placed at avoidable risk of harm. In one example when someone became distressed, staff

didn't know how to handle the situation, which led to them frightening other people around them. Relatives told us they had been called to the home, sometimes during the night, to help calm their family member because staff didn't know what to do.

"Inspectors also had concerns about staffing levels. Leaders hadn't factored in emotional support for people when they planned staffing levels and this is particularly important for a home where people have dementia and some people experience anxiety and distress. We found staff's time was often taken up with tasks such as laundry or medication rounds, leaving gaps in areas such as the communal lounge, where we saw people wandering around or needing reassurance and no staff present.

"People and their relatives described seeing staff speaking to people in a derogatory way and arguing among themselves in communal areas. In one distressing example, when someone repeatedly asked when she could go home, a staff member told her she would get to leave the home when she died.

"We weren't assured managers appreciated the seriousness of these concerns or were taking action to address them. In one example, a relative raised concerns about an incident but staff claimed they were being racist.

"We have told Saxon Lodge's leaders where they need to make improvements and we will monitor the service closely to ensure people are protected in the meantime."

Inspectors found:

• The service wasn't managing people's medicines safely. Instructions for administering medicines were unclear and records were incomplete, meaning people were at risk of not receiving the medicines they needed.
• Managers weren't ensuring the service provided food in line with people's dietary requirements. Someone needed their food to be pureed but staff tried to support them to eat puree that was still lumpy, putting them at risk of choking.
• Leaders didn't always ensure there were enough staff or activities to keep people occupied and engaged. This meant people often spent their time looking at the television or walking around the corridors, lacking meaningful engagement.
• Managers hadn't ensured people who displayed distressed behaviours were kept safe or integrated. For example, staff told people not to sit beside someone who kicked out at people, which meant this person often sat alone in the lounge and was at risk of loneliness.
• Leaders weren't open to feedback or using concerns to make improvements. Relatives had made it clear they were not confident in how the service was supporting their loved ones but leaders hadn't acted on these concerns.