Care home still 'requires improvement'
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A care home was rated ‘requires improvement’ following an inspection by the Care Quality Commission.
Inspectors said the Little Downham home had not improved since a previous inspection.
During the most recent inspection of The Firs at Tower Farm, inspectors found that medicines were not always being managed safely and they discovered dirty equipment.
They also said staff were not always wearing personal protective equipment and there was a lack of social distancing.
Inspectors visited the home last August and in the light of the ongoing Covid-19 pandemic, concluded that “medicines were not always managed safely which increased the risk to people”.
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They added: "Some of the equipment used to administer medicines had not been cleaned; we found a tablet crusher in the trolley with yellow tablet residue.
"It is important the tablet crushers are cleaned between every administration to avoid cross-contamination.”
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The inspection also says "the fridge had been documented as being out of temperature range since July 10, 2020, with no action being taken to rectify the problem".
One rescue medicine (a medicine that may be needed quickly) was out of date (expired December 2019) in the fridge.
The report also notes that “some staff did not always follow current national guidance on when to wear personal protective equipment when supporting people".
In terms of preventing and controlling infection, the inspector said "social distancing within the service was not happening as people were often seated together".
It also noted that cleaning schedule records had not been updated since the start of the pandemic.
"Not all staff when asked could confirm they had been given advice about the changes to their cleaning schedule since Covid-19,” said the report.
“Our observations showed that staff were not seen regularly cleaning frequently touched areas.
"The Covid-19 infection control policy was last reviewed on March 11, 2020 and contained guidance that was no longer up to date with government guidance."
In relation to risk assessments and care plans, "some records lacked information to guide staff fully".
The inspector adds: "Audits had made some improvements to the service provided but had not identified the shortfalls found during this inspection.
"Staff had been trained on how to keep people safe from poor care and harm. However, there were delays in staff taking action and seeking advice when people had missed their medication.
"These delays had also not been identified in the governance monitoring of the service."
The inspector did however point out some strengths, including that "relatives of people who lived at the service told us that communication was good, and they felt listened to and involved in their family members' care decisions.
They added that "there were enough staff to meet people's care and support needs" and that "staff worked with external professionals to help people maintain their health and well-being".
Other positives highlighted included: "Recruitment procedures were in place to check whether a proposed new staff member was suitable to work at the service.
"The registered manager made sure appropriate people and organisations, such as the local authority safeguarding team, were informed when things went wrong.
"They gave people and their relatives opportunities to give feedback and make suggestions on the running of the service."
The CQC said they will again request an action plan for the provider "to understand what they will do to improve the standards of quality and safety".
They will also discuss with the provider "how they will make changes to ensure they improve their rating to at least good" and "work with the local authority to monitor progress".
At the time of inspection, The Firs was providing accommodation and personal care to 21 people at the time of the inspection.
In October of 2019 inspectors had noted one breach of regulation and that, although the provider completed an action plan after the last inspection "to show what they would do and by when to improve", this has not happened.
Prior to that follow-up, the care home was rated "inadequate" in May 2019.