A LOCAL care home has been slammed by a health watchdog and rated as inadequate for a number of failings, including residents who needed constant staff supervision suffering "serious unexplained injuries."

Elmcroft Care Home, Brick House Rd, Little Totham, just outside Maldon, has been given an overall rating of inadequate by the Care Quality Commission following an inspection in May.

The watchdog carried out the inspection after concerns were received by the Care Quality Commission about the service. The care home was rated as inadequate in all areas that were assessed, these are the safety of the service, how effective it is, how caring it is, how responsive it is, and the leadership. The watchdog has ordered the care home to improve and it's been placed in special measures.

The report found that staff were not always aware of serious incidents which had taken place to prevent repeat incidents and embed good practice from lessons learned. A person had an unwitnessed fall and sustained multiple rib fractures, but post-fall observations were not consistently completed by staff, so the extent of their injuries were not noticed. 

The watchdog's report states: "People assessed to require 24-hour one-on-one care were not safeguarded, sustaining serious unexplained injuries despite records stating they needed constant staff supervision. A person with funding for 24-hour one-on-one care had sustained an unexplained fractured hip and an unexplained black eye in two separate incidents. There was also high level of unexplained bruising and skin tears amongst people more widely. 

"We found evidence of multiple injuries such as bruising and skin tears which had not been properly recorded as accidents and incidents. We had to raise an individual safeguarding alert with the local authority for a person at risk of suicidal ideation, and a further organisational safeguarding alert regarding widespread poor practice. We identified concerns relating to unexplained injuries and medicines which led the provider to raise two additional retrospective safeguarding referrals. During our assessment, the GP practice and health commissioners also made multiple safeguarding alerts."

The report also found that wardrobes were not fixed to walls in people's bedrooms, including those who independently mobilise, "placing them at the risk of potential crush injuries." The watchdog report states that, whilst the provider immediately took action to address this, it had not been independently identified.

The watchdog's report adds: "We saw staff providing well-intentioned but intuitive care, and interactions showed a lack of staff awareness in areas such as dementia care, supporting people exhibiting distress, infection prevention and control and understanding modified diets. We saw care staff were also being asked by the provider to complete ancillary duties such as washing and wiping dishes instead of kitchen staff, further impacting on staffing levels. We also found a staff member responsible for one-on-one care asleep on duty during our inspection site visit. After the assessment, the provider told us they would take action to reduce the length of shifts staff were supporting people with one-on-one care needs, to reduce staff fatigue.

"We identified concerns relating to sluice rooms, the laundry room, laundry closet and shared shower and bathrooms. This included unsafe waste disposal, clutter and items stored on the floor, paint peeling from walls and unclean shower chairs and drains. This placed people at the risk of infection. We observed a person's bedroom had a strong malodour on multiple days of inspection. Staff PPE practice was inconsistent and included staff members touching PPE face masks and serving food without performing hand hygiene, and a used face mask screwed up in a staff member's pocket. 

"Staff also did not have sufficient guidance to respond to people's immediate care needs, to reduce the risk of avoidable distress, pain, or discomfort. People's dignity was impacted, as there were insufficient staff to facilitate regular showers in line with people's preferences. There was a lack of user involvement in care planning, including information on people's life histories, aims and ambitions."

Mark Cloonan, director of Elmcroft Care Home Limited said: "We apologise for the failings highlighted in the Care Quality Commission's (CQC) report and would like to emphasise that since the assessment undertaken by CQC in May and June 2024, we have implemented urgent whole-scale actions to remedy failings referred to in the report. This has included appointing a new management team at the home, and a new regional director.  

"We are also working closely with the CQC and other key stakeholders, including the local authority, on bringing about root-and-branch changes to the home. This has included investing heavily in training for the team, adding subjects such as enhanced dementia, moving and handling, safeguarding, reporting and diversity training. The new leadership team has also prioritised supporting the team through transparent and open line management.

"We note CQC inspectors did find our care team trying their best to deliver safe, effective and dignified care. To support the team further, and in addition to increased training, we are reviewing all individual care plans for residents and working with residents and their families to improve communication. We are confident that, in partnership with the local authority and CQC, we have already made large-scale improvements at the home, and it remains our utmost priority to continue to do so."