• Home found to be “inadequate” for safety and leadership
  • Inspectors told there was no clear criteria for admission
  • Around a fifth (21 per cent) of residents were sent back into hospital

An NHS trust has been forced to spot purchase beds after it pulled out of a contract with a care home ahead of criticism from the Care Quality Commission.

East Kent Hospitals University Foundation Trust commissioned 28 beds from Ami Lodge in Deal to provide rehabilitation and support for patients coming out of hospital.

But a highly critical CQC report found the home did not have effective systems for identifying risks, did not adequately monitor patients who were deteriorating, had no incident reporting policy and did not keep appropriate records. It was judged “inadequate” overall and specifically for safety and being well-led, and has now closed.

The CQC inspectors visited Ami Lodge in November 2018 and the trust sent a letter mid-way through the inspection decommissioning the beds. The last trust-funded patients left at the end of December.

The home was inspected under the CQC’s hospital framework as a community services inpatient unit, to reflect the nature of the patients it was admitting, rather than under the framework used by the regulator for care homes.

The report found there were no “clear or formal eligibility” criteria for admitting patients to the 28-bed service, and confusion existed as to whether the trust and the home had a “trusted assessor” policy for determining whether patients were suitable for transfer.

Around a third of patients were not discharged from the home when expected, but inspectors were told there was no feedback from the trust on this or around compliance on key performance indicators. Weekly telephone calls with the trust to discuss these had been discontinued after March 2018 and the trust and Ami Lodge had not had a formal meeting since December 2017.

“The service did not engage collaboratively with or meet regularly with the commissioning NHS trust,” the report said. Quality visits by trust staff sometimes only resulted in verbal feedback with no written reports.

Although 21 per cent of patients admitted to Ami Lodge were transferred back to the acute sector, in two cases with possible sepsis, there was no learning or improvements made from this, the report said.

In a statement, the trust said: “We stopped commissioning beds at Ami Lodge from November last year because they did not have the type of beds that would meet the acuity of our patients. We have since used that funding to spot purchase beds from different providers.

“We have a clear service specification with all providers which includes eligibility criteria and key performance indicators, every care home is required to provide weekly updates and there are, at a minimum, quarterly quality visits.”

EKHUFT has struggled with capacity over the last few years, and had 53 delayed discharges per day in December 2018.

The owners of Ami Lodge did not respond to requests for comments.