Resident at Nottingham care home forced to wear used incontinence pad overnight, inspection finds

A Nottingham care home has been placed into special measures after residents were found to have been neglected by staff.

Braywood Gardens, in Carlton, Nottingham, has been rated inadequate by the Care Quality Commission (CQC), and has been prevented from admitting new residents without CQC’s permission, following an inspection carried out in May.

At the time of the inspection, there were 88 people living in the home, which is operated by Runwood Homes Limited, and provides accommodation and personal care to older people, some of whom are living with dementia.

The inspection was carried out after people raised concerns about patient safety at the home.

The CQC report highlights a lack of strong leadership, and low staff numbers which contributed to issues around patient safety.

Staff were "too busy to help"

Greg Rielly, CQC deputy director of operations in the Midlands, said: "We saw one person try to stand but was unsteady on their feet.

"As there weren't any staff around to help, our inspector had to help them to sit back down, or they would have likely fallen over. When we brought this up with staff, they said they were too busy to help.

“We heard people often having to shout for staff to support them which didn’t always happen.

"One person told us they had complained that staff weren’t quick enough when they needed support to use the toilet.

"The staff member responded by telling them to use their incontinence pad and they would have to wait in their used pad until the morning when staff could support them. This shows staff didn’t always treat people with kindness or dignity."

Residents also told inspectors that they were worried about their safety, with altercations between residents not referred to the local authority safeguarding team.

Inspectors also found:

• People were at risk of their health needs not being appropriately supported, pressure related skin damage, poor moving and handling, and choking on the wrong texture diet.

• Staff didn’t always manage medicines well.

• People’s holistic needs were not effectively assessed to provide evidence-based care.

• People did not feel involved with reviewing their care plan.

• Staff did not always work effectively with external professionals, or within their own team.

• People felt that not enough activities were offered, and those activities that were offered were not what they would choose.

• People sat for long periods without any meaningful activity.

Following the inspection, Braywood Gardens' overall rating has dropped from requires improvement to inadequate. Its ratings for being effective and caring dropped from good to inadequate.

The home maintained its requires improvement rating for being safe and well-led, and its good rating for response.

The CQC has placed conditions on the service to prevent more people from being admitted without regulators' permission, until significant improvements have been made.

The service will be kept under close review, and the CQC says further action will be taken if it does not see rapid and widespread improvement.

Mr Rielly said: "We have told Braywood Gardens where we expect to see rapid and widespread improvements and will continue to monitor them closely to keep people safe while this happens.

"We’ve also told them they can’t admit any new residents until these improvements are made. We will return to check on their progress and won’t hesitate to take further action if people are not receiving the care they have a right to expect.”

"Immediate and robust plan put in place"

A spokesperson for Braywood Gardens said: “We can confirm that an immediate and robust action plan was put in place following the inspection undertaken by CQC.

"These findings were also identified by the provider and a managerial change was made which has instantly brought the service back to the high standard we have seen previously at Braywood Gardens.

"Co-working with Nottingham County Council (NCC) has been very productive and they too recognise the service is now providing the high level of care formerly seen.

"We are actively encouraging a return inspection visit from CQC where we expect the service to return to an overall Good rating.

"We take on board all findings raised by CQC and have worked tirelessly to instantly put these areas right. We are pleased to say the home is now in a very good position with exceptional leadership and staff.

"We thank our staff and the home manager for their efficient and professional response to see the service back to the expected standard and will work with all key stakeholders to see this maintained”

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