Manager of troubled Wallasey nursing home struck off

Sandrock Nursing Home in Wallasey has been rated inadequate four times and placed in special measures by the Care Quality Commission since April 2021. Before this it had been in and out of being rated inadequate since June 2017 though it was rated as good in April 2019.

Now for her part in the failings, including shortcomings around management of medication and keeping residents safe, Karen Lea, has been barred from the care profession following a lengthy investigation by the Nursing and Midwifery Council (NMC).

A report released by the NMC detailed how Ms Lea was referred to the organisation by the CQC in February 2022 after concerns arose about the management of the Wirral home. She began working at the home in 2002 and became manager in 2011.

In April 2021, an infection prevention and control inspection began at the home. The purpose of this was to check that action had been taken to mitigate risks associated with the COVID-19 pandemic.

The report said “serious concerns” were identified regarding infection control and the management of infection control matters at Sandrock. The document said the CQC determined that the breaches presented a risk to the health, safety, and wellbeing of service users.

The home was permitted to continue with CQC registration subject to conditions, which included Ms Lea applying to de-register as the home’s registered manager, which was accepted in October 2022. A further inspection took place in December 2021 and January 2022 to determine whether sufficient improvements had been made.

However, in some areas such as medicines management safety declined further. The report said the NMC identified regulatory concerns in relation to Ms Lea including medication management, delivery of personal care, wound management, nutrition and hydration, end of life care, recruitment, staff support and training, and record keeping.

It said: “Although Ms Lea was not always the nurse or member of staff directly responsible for the alleged incidents, for the facts found proved unless stated otherwise the panel found that Ms Lea as the registered manager had overall responsibility to ensure that effective systems were in place to ensure that medication was administered safely, medication administration was recorded accurately, medication was stored safely, prescribed medication was in stock, PRN protocols were in place, care plans were adequate, recruitment processes were followed, that staff were appraised and supervised, allergies statuses were up to date, and that COVID-19 processes and procedures were followed.”

The panel was of the view that Ms Lea’s unprofessional behaviour had the potential to put resident’s at a real risk of harm and given her limited insight, the panel found that there is a risk of repetition. Members were of the view that Ms Lea remained liable to act in a way which could place patients at risk of harm, bring the profession into disrepute and breach fundamental tenets of the profession in the future.

The panel also found that Ms Lea remained liable to act dishonestly as she had not demonstrated any insight into her actions.

It was said Ms Lea’s misconduct covered a large number of varied concerns, which called into question her overall practice and management of the home. It was said the issues took place over a prolonged period of time and as a result of her failures there was a real risk of harm to residents.

Ms Lea was described as an experienced nurse and registered manager in a position of trust when the concerns occurred and there had been prior concerns at the home while she was manager that had been brought to her attention by the CQC on more than one occasion.

While not presented or represented at the hearings, Ms Lea sent a written reflection to the NMC detailing her regret and remorse. It said she understood that she was in a position of responsibility to ensure the safe and effective running of the home.

The document said as manager, Ms Lea would not have been in a position to be regularly completing individual care records or delivering care. She would also not be able to complete daily audits of all care records.

The registered nurses employed will have individual responsibility for their daily duties. Ms Lea said she was not in a position to be completing individual care records, delivering personal care, wound management due to her role overseeing the home, which was “far too large for her” to be undertaking the daily clinical activities of the staff nurses.

Despite this, the NMC panel felt given Ms Lea was home manager caring for particularly vulnerable residents, they were put at risk of harm for a prolonged period of time. The panel found that this behaviour is fundamentally incompatible with her remaining on the register.