Residents of Sussex care home had ‘unexplained injuries’ and were ‘at risk of harm’

The CQC has rated Homelands Nursing Home in Cowfold, West Sussex, inadequate and placed the home into special measures to protect people, following an inspection in January.

Homelands Nursing Home, run by Medicrest Limited, is a care home providing nursing and personal care for up to 42 people, some of whom are living with dementia

Homelands Nursing Home has two accommodation buildings. The Manor House supports people with nursing care and the Coach House supports people with nursing care and those who have advanced dementia.

Following this inspection, the overall rating for the home, as well as the areas of safe and well-led have moved down from requires improvement to inadequate.

The areas of caring and responsive have declined from good to inadequate. Effective has moved from good to requires improvement.

The service has been placed in special measures which means it will be kept under close review by CQC to keep people safe and it will be monitored to check sufficient improvements have been made.

CQC issued a warning notice following the inspection to focus their attention on making significant improvements around people’s care and treatment, safeguarding, and the management of the service.

CQC has begun the process of taking regulatory action to address the concerns, which Medicrest Limited has the right to appeal.

Neil Cox, deputy director of operations in the south, said: “During our inspection of Homelands we found that poor leadership had led to inconsistent care across its two residential buildings, the Manor House and the Coach House, which put residents at risk of harm.

“Leaders and staff didn’t recognise how to promote people's rights, choices or independence causing a restrictive culture within the Coach House.

“This meant the people living there weren’t being supported in a person-centred way where they were able to make decisions about their own care, and their right to consent wasn’t always being respected.

“Staff didn’t always respond to people’s needs and act quickly to minimise their distress.

“Staff didn’t always ensure people at the Coach House had access to call bells to request help and they didn’t always act when people requested help, such as getting additional blankets or hot drinks when people said they were cold.

“Vulnerable people were relying on all staff members to act as their advocates, to help them live their best lives and it is unacceptable the people they relied on were treating them this way.

“Leaders didn’t have an effective system in place to ensure people were protected from potential abuse.

“People had sustained unexplained injuries and been subjected to restrictive practices, but staff had failed to understand their duty to report these to CQC and the local authority safeguarding team. This is unacceptable.

“In addition, leaders didn’t always investigate or report incidents appropriately and hadn’t created a culture where staff could learn from incidents to try and prevent them from happening again.

“This included when people had been injured while staff supported them to move around the home, and when someone had become trapped in a bedrail.

“We have told Homelands where immediate and widespread improvements are needed to keep people safe.

“We’ll continue to closely monitor the home, including through further inspections, to make sure people are kept safe while these improvements are made.”

Inspectors found:

• Care plans were not personalised to account for people’s individual needs, preferences, and choices.
• Leaders hadn’t ensured there was enough staff to meet people’s needs. Some staff were working up to 72 hours a week and leaders had not always recruited staff safely or given staff the right training and supervision for their roles.
• People’s medicines weren’t always managed safely.
• Leaders lacked understanding of the Mental Capacity Act and how to apply it to people’s care. For example, CCTV was in use without consent because leaders felt residents would not understand its purpose.
• Leaders had not addressed safety and infection risks posed by ongoing building works at the site.

However, some people and their families told inspectors they were not aware who was running the service, but felt it was generally well-led.

A spokesperson for Medicrest Limited said: “Homelands Nursing Home and its provider are fully committed to addressing all areas of concern and have commenced a rapid and comprehensive improvement plan, ensuring that all residents continue to receive the highest standard of care in a safe and supportive environment.

“Our team is working closely with CQC, local authorities, and external specialists to ensure sustained improvement.

“Regular audits and governance meetings will ensure that all actions taken are effective and that the home remains in full compliance with regulatory standards.

“We deeply regret the shortcomings identified in the inspection such as the documentation process and are determined to restore confidence in the quality of our paperwork by moving to a digital system.

“We are proud of the care we give to our residents at Homelands Nursing Home.

“Regardless of the report's findings, we recognise and appreciate the dedication of our staff, who remain committed to delivering compassionate care to our residents.

“The safety, dignity, and well-being of our residents remain our highest priority, and we are committed to continue delivering the highest standards of care now and in the future.”