A Knebworth care home has been given the lowest rating from a health watchdog after inspectors found several incidents where residents had “suffered harm or been exposed to a significant risk of harm”.

Care Quality Commission inspectors downgraded Monread Lodge to ‘inadequate’ after raising concerns that assessments of care needs were not up to date, there were open bins full of personal protection equipment and that a unit where residents with dementia live was not dementia friendly.

The care home in London Road provides residential, nursing, dementia and respite care to the elderly, and had previously been rated 'good' in 2018.

However, in a report published in December 2021, the home received an 'inadequate' rating, adding that the service was not safe or well-led.

The inspectors visited the home on two occasions in September, as well as speaking to staff and 14 relatives about their experience since the last inspection.

Inspectors criticised the leadership of the home, which included inconsistent care plans, difficult to read daily records and ‘copied and pasted’ records between different people.

In one case, inspectors say a nutritional assessment for one person had different people’s names on the same page.

Other concerns included the process of assessing people’s mental capacity and decision making did not meet the principles of the Mental Capacity Act.

The home’s operator, Maria Mallaband Care Group, said they were “confident” they are making the necessary improvements following the inspection.

During their visit, inspectors also noted two bathrooms had a “strong, unpleasant odour” with stained floors, and bins used to dispose of used personal protective equipment were “overfilled and the lid open”.

The inspectors also found that two people did not receive medicines administered at the correct times, which staff said was because they were at the end of the corridor “so that is when we get to them”.

The report said there were “not enough staff effectively deployed to meet people’s needs”, which meant people were not receiving the support to keep safe.

This included finding staff were not present “for most of the falls people living with dementia had in the communal areas”, and in one case staff were not present on any occasion when someone fell three times in five hours.

Health professionals who spoke to inspectors had a mixed view about how well staff enabled effective communication. One said staff “were not consistently following their advice”, although another said staff were “knowledgeable and referrals were made were appropriate and completed in a timely manner”.

The report, published on December 14, was also critical of the leadership of the home, and said there were “wide-spread and significant shortfalls in service leadership.”

The report read: “We found several incidents where people had suffered harm or been exposed to a significant risk of harm. The provider and registered manager had not followed their legal responsibility.

“Where something went wrong with people’s care, or had the potential to cause, harm or distress they had not kept the person, or their advocate informed.

“We found no evidence where managers had apologised, offered an appropriate remedy or provide support to put matters right.

“Management did not explain fully the short- and long-term effects of what had happened.”

Of the three areas assessed, the home was given an Inadequate mark for whether the home was safe and well led, with the question about whether the service was effective given a Requires Improvement grade.

During the inspection, the provider increased staffing in the dementia unit and began to review the dependency assessments in place to establish if this was accurately reflecting people’s needs and the staffing required.

In response to the report, the home’s operator Maria Mallaband Care Group said senior managers are working with the home to ensure improvements are made.

A spokesperson for the group said: “Senior managers are supporting staff at the care home in order to ensure that the necessary improvements are made and sustained.

“We are confident that we are making the necessary improvements and creating a positive care service since the initial inspection and look forward to demonstrating this at their next visit.”