Inspectors say residents at ‘risk of harm’ at Wigan care home

Concerns were also raised about the way medicines were managed at Douglas Bank Nursing Home, in Appley Bridge, and an investigation had been carried out after “unexplained bruising” was found.

The Care Quality Commission (CQC) carried out an unannounced inspection in December and has recently published its report, stating the home “requires improvements” in all areas.

It was the fifth consecutive time it was given that rating, though was an improvement from the last inspection when a judgement of “inadequate” was given for safety at the home.

The report said: “People continued to be at risk of avoidable harm because the management of accidents and incidents was inconsistent. We found continued failings in relation to the management of people’s medicines.

“Staff did not always ensure people’s care plans and risk assessments were in place or updated in a timely way, this meant we could not be sure people were being supported in a person-centred or safe way.”

The CQC found the home failed to assess residents for the risk of malnutrition, choking, skin integrity, falls, use of bed rails and issues associated with their mobility. For example, one person had not been properly assessed following a fall which caused a head injury.

Medicines were not always managed in a safe way, including not always being stored in a secure area and allergies not being recorded.

The provider told inspectors during and after the visit that action was being taken to address these issues, including reviewing risk assessments and putting new processes in place.

A new general manager had started work 10 weeks earlier and was said to be “committed to improving people’s experiences and aware of the failures and had started to make improvements”.

She had carried out an investigation into unexplained bruises and skin tears and made changes to prevent further incidents, including staff training.

Inspectors found changes in people’s health needs were not always effectively recorded, action recommended by healthcare professionals had not been entered in enough detail into people’s notes, and the home was not following national best guidance for the management of falls.

Residents were “not always treated in a dignified manner”, some looked “dishevelled and unkempt” and their independence was “not always promoted”.

The report said: “People were not always supported in a timely way with their personal care needs, staff although well-meaning did not always use approportionate and respectful language. We heard people being told that it was their turn next to go to the toilet and language that was more appropriate to use with infants.”

The inspector said care plans were not updated when residents’ needs changed and quality assurance systems had been improved, but were still not identifying all failings.

The CQC found there was a “sufficient” number of staff working in the home and they were described as “kind and empathic”.

But the “high turnover” of staff and “increased use” of agency workers made it difficult to carry out training and more in-depth training was needed in some areas, the report said.

Inspectors were “assured” that measures were in place to prevent the spread of coronavirus and other infections, including social distancing rules and the use of PPE.

There was an “effective” process for ensuring important information was taken with residents if they were transferred to hospital.

Residents and their loved ones were involved in making decisions about their care and relatives expressed their “gratitude” at how staff had kept them informed when they could not visit during the pandemic.

Staff morale had improved and the new manager was promoting a “positive culture” to allow people to speak up and have a say in the running of the home.

The CQC has told the home to provide an action plan detailing how it will improve quality and safety, and will work with Lancashire County Council to monitor progress.

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