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Canterbury: High Meadow Nursing Home in special measures

By Emma Grafton-Williams

A nursing home plunged into special measures faces being shut down after care inspectors uncovered a catalogue of serious failings.

A damning report by the Care Quality Commission has given High Meadow in Old Dover Road the lowest grading possible in two out of five key areas, ruling it has routinely breached safety regulations.

It found staff had become so "desensitised" to the needs of its 28 elderly residents they often ignored their calls for help, leaving some waiting for pain relief and to use the toilet.

High Meadow Nursing Home in Old Dover Road, Canterbury
High Meadow Nursing Home in Old Dover Road, Canterbury

The situation was so bad inspectors who visited the home found themselves comforting agitated residents who had been calling out from their beds.

Now the manager of the home – which cares for people living with health needs such as dementia and Parkinson’s – has been given six months to turn it around.

The unannounced inspection in March followed one in January last year when the home was told it required improvement across the board.

But on their most recent visit, inspectors discovered standards had slipped even further, rating the home inadequate and placing it in special measures.

They uncovered a series of breaches of the Health and Social Care Act by a workforce which was understaffed and lacked essential training.

Residents, some of them receiving end-of-life care, were routinely ignored, with some waiting as long as 30 minutes to use the toilet.

The report reads: “Staff were not consistently caring and some had become desensitised to people’s calls for assistance.

“On several occasions inspectors went to see people because there were no staff available.”

The review made a number of care recommendations. Picture: Getty Images/Yang Wenshuang/iStockphoto
The review made a number of care recommendations. Picture: Getty Images/Yang Wenshuang/iStockphoto

One resident told inspectors: “Staff just don’t come to me; I call or press my buzzer but I’m just left for a long time.”

The relative of another said her mother often smelled of urine, telling how she was often made to wait to use the toilet.

Inspectors also discovered error-ridden food charts were being filled in retrospectively, and staff had little idea how to appropriately deal with a diabetic resident whose blood sugar levels were rising.

There was also little stimulation for residents who stayed in bed all day.

The report concluded: “The overall rating for this service is 'inadequate' and the service is therefore in 'special measures'.

“This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action.

“Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service.”

"Some staff had become desensitised to people’s calls for assistance... on several occasions inspectors went to see people because there were no staff available" - Care Quality Commission report

The registered manager of the home, Sarah Lejarde, declined to comment when approached by our sister paper the Kentish Gazette.

Staff had become "desensitised" to residents' calls for help, walking past rooms where people had been shouting for some time without offering words of comfort.

Some residents receiving palliative care called out for attention during the inspection but there were no staff within hearing distance.

On several occasions inspectors went to see people because there were no staff available.

One person said they were sometimes left waiting for pain relief because staff were busy.

Another said: “I can wait and wait and sometimes be very uncomfortable, but they don’t come or say they’ll be back in a minute and never come back”.

One person was served a cheese salad at lunchtime, but when inspectors visited them at 2.30pm they were asleep and the meal remained uneaten.

The person’s food chart was later documented to say they had been served roast turkey and vegetables at 12.30pm and that all the meal had been eaten.

A full bowl of cereal was removed from another person’s room after breakfast as they were asleep. Their food chart the following day showed "Cornflakes 100% eaten".

None of the staff had received training in specialist subjects such as diabetes, end-of-life care, wound care or nutrition.

The inspection found that a lack of specific training in these areas affected the quality and safety of the care.

During one lunchtime staff discovered the blood sugar levels of a diabetic resident were high.

With staff not planning to run another test until 4.30pm, inspectors were forced to step in to avoid an emergency situation.

High Meadow Nursing Home has been rated inadequate by the Care Quality Commission
High Meadow Nursing Home has been rated inadequate by the Care Quality Commission

Staff did not know to take their temperature to check for signs of infection or to encourage drinking more when blood sugar levels are high.

Residents were repeatedly heard asking to go to the toilet, with many waiting for at least 20 minutes and one more than half-an-hour.

One relative told inspectors: “Mum and other residents have to wait to go to the toilet, and that happens a lot.

"My main concern is about mum’s incontinence. Sometimes she smells of urine”.

Another relative said staff could sometimes be "dismissive" of people who asked to be taken to the toilet, prioritising other tasks.

During one lunchtime staff discovered the blood sugar levels of a diabetic resident were high.

"I can wait and wait and sometimes be very uncomfortable, but staff don't come or say they'll be back in a minute and never come back" - an elderly resident

With staff not planning to run another test until 4.30pm, inspectors were forced to step in to avoid an emergency situation.

The manager was alerted and a specialist nurse said the resident needed to be retested within an hour.

They were, and their sugar levels had risen again, forcing staff to call a GP.

Staff did not know to take their temperature to check for signs of infection or to encourage drinking more when blood sugar levels are high.

Staff were told not to give the resident pudding so instead gave them fruit, unaware of the natural sugar it contained and the effect it could have.

Residents sat and waited in the dining area for a promised game of bingo to start.

Staff kept saying that the game would begin shortly but it did not happen at all.

People told inspectors this often happened and they would be waiting for an activity which was then changed without discussion or did not go ahead.

Inspectors said it was inconsiderate, adding they observed people becoming bored and falling asleep while they waited.

The lack of social stimulation breached the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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