Inspectors have condemned a group of carers in Devon who punished patients by treating them in an "abusive" and "degrading" manner.
Kazlum Support Limited in Crediton, which provides care to people living in their own homes, had its overall rating downgraded from 'good' to 'requires improvement' following an unannounced inspection in February.
The Care Quality Commission (CQC) had received concerns about allegations of abuse and a closed culture within its management. At the time of the inspection the service was providing personal care to 13 people.
Amanda Stride, CQC’s head of adult social care inspection, said: “Although staff understood how to protect people from poor care and abuse, they didn’t recognise their own behaviour could be abusive. Instead, staff decided they knew what was best for people and imposed restrictions on them, stopping them from spending their money on things, or from eating certain things, and limiting when they could use technology.
"Yet no assessments had taken place to determine whether this was in people’s best interests. Rather than supporting and encouraging people to live independently, staff were punishing them by withholding ‘treats’ - things people had bought with their own money - and making them apologise for behaviour staff felt was unacceptable.
"One person apologised for ignoring staff but was told sorry doesn’t mean anything and they would still lose a treat. In addition, people weren’t allowed to spend their day doing what they wanted. Instead, staff made them do tasks and follow house rules even when staff knew they preferred to do other things.
“When we pointed out staff were using outdated and degrading practices and institutionalised language when speaking to people, managers were defensive. The manager told us they’d reviewed all incident records, yet they hadn’t picked up on the fact staff were punishing people instead of encouraging them and hadn’t recognised this was abuse.
“The registered manager had little involvement in the day to day running of the service and staff said it could be difficult to raise concerns as the managers were friends which could make them feel like an outsider. All of this is indicative of a closed culture, which is when institutionalised practices are used and increase people’s dependence on the manager and staff.
“Following the inspection, we told the provider to make a number of improvements to ensure people receive safe care. We will continue to monitor the service to ensure that improvements are made and fully embedded."
A spokesperson for Kazlum Support Limited said: “We are naturally disappointed at the rating, although note that Kazlum Support Ltd retains its good rating for being caring and responsive, and we are working hard to ensure we quickly regain our previous ‘good’ rating.
"We are very grateful to our staff, service users and their families for their support and positive feedback to CQC.
"The pandemic has obviously been a hugely challenging time for the care sector, and we focused our attention on continuing to provide the best possible care that we could for our service users to enable them to enjoy the best possible quality of independent life during this particularly challenging time.
"We acknowledge that this may have been at the expense of systems and procedures, and we are taking swift action to address the concerns raised by the inspectors so that we can evidence to them as soon as possible that we have the necessary records to demonstrate the quality of the care that we provide
"We care very much about providing safe, effective, caring, responsive and well-led services to the people we support, and the wellbeing and safety of our service users remains our top priority. We are working closely with the local authority to ensure that legal frameworks are in place where the need for restrictions have been identified to keep people safe.”