Ixworth Dementia Village near Bury St Edmunds rated inadequate by Care Quality Commission for a third time before it closed last week

An Ixworth care home which has since closed was rated inadequate by a watchdog for the third time.

In a report published yesterday, the Care Quality Commission (CQC) inspected Ixworth Dementia Village, near Bury St Edmunds, from May 6 to May 17 and found that the care home continued to be in breach of regulations relating to risk prevention, medication administration and preservation of dignity and respect. However, improvements had been made to ensure the risk of infection was reduced.

The facility, run by Leaf Care Services, was shut last week after the care provider dropped its appeal following the CQC’s decision to cancel the service’s registration in November after an inspection, meaning it could no longer legally provide care at Ixworth Dementia Village.

At the time of the inspection, the facility, in Peddars Close, was caring for 12 people who were living with varying levels of dementia.

The CQC report found that the care provider still hadn’t made improvements to ensure risks were being effectively identified and mitigated against.

Staff were not allowed to contact emergency services or healthcare professionals without the permission of the registered manager – even if they were not at work. This delayed the process of seeking for help for people when they were unwell which placed them at significant risk of harm.

There wasn’t care plans in place to guide staff on how to care for people who had serious medical conditions

Fluid level charts did not show people had been given enough to drink. This meant people were at risk of dehydration.

Inspectors also found that several people had unintentionally lost weight and that the provider was not actively monitoring people’s nutritional intake. One person had lost 8kg and another person lost 6.6kg between January and April 2023.

On the first day of inspection, inspectors saw that people were offered lunch at 12 noon, followed by soup and sandwiches for dinner at 4.30pm. Residents were later offered two biscuits each at 7.30pm. The report noted that people had in the region of 16 hours before they ate again at breakfast the following day.

A relative said: "They have lunch at 12 noon but dinner at 4:30pm. They told me they would move this to later as its far too early, a long time before breakfast. [Family member] would never have eaten that early."

In relation to dignity and respect, inspectors found that people continued to not be stimulated, some people had signs of poor nail care with nails looking ‘ragged and dirty’, and people had their room number written in black pen on their clothing including their socks which was clearly visible and not respectful of people’s dignity.

Records relating to the administration of topical medicines (TMARs) were still not always being completed to show creams and ointments had been applied to people. Inspectors on the second day found that these records had been completed retrospectively – meaning there was a falsification of medical records.

There was also still concerns around staffing levels. However, the report noted that there was evidence staff were recruited safely and that Disclosure and Barring Service (DBS) checks were carried out.

The report also found improvements were made to ensure the risk of infection was reduced. All rooms had hand washing facilities and paper towels. Overall, the environment was cleaner.

After the facility closed, residents were to be moved into different care homes.

A tribunal was set for last week, but the care provider chose not to continue with the appeal.

Leaf Park Care Home, based in Great Yarmouth and run by the same provider, also had its registration removed in February of this year.

The provider has two other homecare services which have been rated as good.