The home provided accommodation and personal care as a single package under one contractual agreement and was at full capacity at the time of the inspection.
Hilbre Manor was run by Brighter Bloom Healthcare Group, a care home company led by Thomas Donohue, operating three care homes in Wirral as well as a domiciliary care service. Brighter Bloom has since been wound up following a High Court decision in June.
The June 24 critical report by the Care Quality Commission (CQC) found the firm “was in breach of regulations relating to person centred care, safe care and treatment and good governance” and “was not following the principles of the Mental Capacity Act 2005.” The home was rated inadequate in two areas and required improvement in three others with an overall inadequate rating.
According to the CQC, steps had not been taken to ensure decisions were made in people’s best interests, care plans were not detailed, people’s independence was not promoted, and families weren’t always able to provide feedback.
The CQC said: “Relatives told us they had not attended any meetings to share information, however all residents said they would know who to speak to if they needed to raise any concerns.
“There were gaps in staff’s training, and we were not provided with one staff member’s training record, so we were not assured staff had the skills, knowledge and experience to support people safely.”
While there were positive interactions between permanent staff and residents, the CQC said: “There were mixed views from staff in relation to the support provided by the registered manager [Mr Donohue] who is also the nominated individual. Whilst some staff felt supported others did not feel listened to.
“Due to CCTV in the building some staff did not feel comfortable in speaking to CQC to provide feedback at the service.”
The report added: “One staff member told us the staff morale was low, and staff were leaving or looking to leave. There was little evidence of meaningful team meetings to allow information to be shared amongst staff and for joint decisions to be made to implement change.”
Inspectors said rotas showed no registered manager on site six days a week as they were working from home or elsewhere. Not all staff had training and one person, who Brighter Bloom told the CQC was a consultant and therefore not employed, was seen providing care to someone in the home.
The CQC said relatives spoke highly of the support provided in the home but “some people could not directly tell us about their experience.” The CQC said some residents were left waiting due to staffing levels, most relatives were unaware of care planning and relatives said they had not been involved in decision making.
The report by the CQC criticised the culture in the home, a lack of evidence of staff supervision, issues around safeguarding and a failure to carry out risk assessments. A lift was found to be operating without a valid certificate and furniture wasn’t attached to the walls.
Inspectors said there was a risk of high chests of drawers, storage cupboards, wardrobes and radiator covers “toppling over onto people particularly for people who mobilised around their room.” Water temperatures risked scalding people and sources of oxygen were also found stored close to heat sources. These issues were addressed by the home.
Brighter Bloom were also found to “not make sure there were enough qualified, skilled, and experienced staff.” The report added: “We identified there was not always staff on shift who were trained in first aid, this placed people at risk as staff would not have the skills to support people in an emergency.
“The staff were not deployed safely throughout the day and night to ensure peoples’ needs could be met in a timely manner. We observed people waiting for support to be provided for long periods of time, on one occasion we intervened and requested support.”
The home was also found to not manage the risk of infection well. The report said: “We identified used incontinent aids being disposed of using incorrect procedures and placed in bins not suitable for this type of waste. We identified a damaged bedframe and some unclean bedding.”
While some people’s rooms were personalised, the CQC said: “We identified areas within people’s bedrooms that were dirty or damaged. We saw some people’s clothing not being folded or put away appropriately into their own wardrobes.”
In response to the report, Mr Donohue told the LDRS the inspection “was not a fair or accurate reflection of the home at the time.” He added: “Prior to the publication of the draft report, Brighter Bloom Healthcare Group instructed Stephensons Solicitors to lodge a detailed factual accuracy submission challenging the findings of the inspection, including inaccuracies in the Section 31 notice.”
He said: “The factual accuracy submission clearly identified multiple regulatory areas where the home was compliant and included evidence from care plans, risk assessments, training logs, and family feedback.”
He claimed CQC staff had said the home had significantly improved since Brighter Bloom took over. A 2022 inspection rated the home “good.”
Mr Donohue said Brighter Bloom’s work to improve homes was further evidenced by the most recent draft CQC inspection of Hilbre House, another service operated by the company which he said used “identical governance systems which has been rated ‘Good’ in five key domains.”
He added: “This demonstrates that the care model implemented by Brighter Bloom was sound, and that the inspection of Hilbre Manor was unrepresentative due to timing and other procedural inconsistencies.
“We are proud of the dedicated staff team who worked tirelessly to support residents with complex needs at Hilbre Manor, often in challenging circumstances.”
A CQC spokesperson said: “All of CQC’s draft inspection reports are subject to a factual accuracy check which Brighter Bloom Healthcare Group had the opportunity to do. They sent in factual accuracy comments which were reviewed as part of our usual processes.”
The CQC’s website said: “If we have evidence that supports a point in the draft report, we are entitled to rely on this. If you dispute the point, but you have not provided any evidence in support, we may ask you to provide it.
“All factual accuracy responses will be reviewed by another member of CQC’s staff who is independent of the original assessment.”