The Care Quality Commission (CQC) has rated a Sussex care home ‘inadequate’, the worst rating, due to a lack of person-centred care and proper leadership at the six-bed property.

Greenways, a care home in Crawley, West Sussex, has been rated ‘inadequate’ by the CQC following an assessment carried out in February and March.

Greenways, run by Adelaide Care Limited, is a residential care home providing personal care to up to six people who have complex learning disabilities and care needs including autism and epilepsy.

As well as its ‘inadequate’ rating, it has been placed in special measures to protect the people living there.

The assessment was prompted in part due to concerns the CQC received regarding the quality of care at the home.

Following this assessment, the home’s overall rating has dropped from ‘good’ to ‘inadequate’, as have its ratings for being safe and well-led. Its ratings for being effective, responsive and caring have moved from ‘good’ to ‘requires improvement’.

With the home now in special measures, if the CQC doesn’t see rapid and widespread improvements, further action will be taken, the regulator said.

Furthermore, the CQC said it has taken further action against the provider, which will be reported on when legally permitted.

Natalie Reed, CQC deputy director of operations in the south, said: “When we assessed Greenways, it was concerning to see the lack of strong leadership displayed by the provider, Adelaide Care Limited and the culture it created didn’t enable staff to deliver person-centred care.

“We found that incidents and accidents weren’t always recorded in detail with actions taken on how to reduce the risk of them happening again. Staff weren’t consistently keeping records when someone diagnosed with epilepsy had a seizure. In another case, someone experienced heightened anxiety around another resident but details about this so it could be avoided in future, were lacking.

“The service wasn’t supporting people to live independently, and decisions weren’t always made in their best interest. Staff locked a resident into their living space for long periods of time, with no way for them to visually monitor their wellbeing while this occurred. This restrictive practice is unacceptable.

“In addition, we found people weren’t always supported to make choices about their care, including showering when they wanted, being able to use all of the communal areas freely, or helping to choose the food they would eat. One person’s care plan listed domestic tasks for them to complete and noted staff might need to prompt them if they refused, however we saw no guidance on the person’s right to decline or whether the activities benefitted their wellbeing.

“We were also concerned to find there wasn’t enough staff to support people and that their working hours were unsafe. Records showed some staff had worked 90-hour weeks with back-to-back shifts, which didn’t allow time for them to properly rest.

“We have told Greenways where we expect to see rapid and widespread improvements and will continue to monitor them closely to keep people safe while this happens. We will return to check on their progress and won’t hesitate to take action if people are not receiving the care they have a right to expect.”

The CQC also found:

• Not all staff had completed all mandatory training and staff supervisions were not identifying shortfalls in the care being provided;
• Leaders didn’t have effective systems in place to monitor and improve the quality and safety of the services provided. Risks were not always being identified, monitored, and mitigated;
• Medicine record-keeping wasn’t always safe. There was poor guidance for staff around when to give someone medicine that was meant to be taken as and when required. For example, staff guidance for someone who was prescribed paracetamol had the same wording as someone else who was prescribed an anti-psychotic medicine. This meant staff might not give a person medicine when they needed it;
• Health and social care professionals gave positive feedback about the service who said people were supported with compassion and skill. However, assessors found leaders and staff were not always giving accurate feedback about people’s care to health and social care professionals.