An understaffed care home for people with learning difficulties has been ordered to improve after an inspection uncovered several failings including a broken electrical box which fell on a resident's head.

St James Mews care home in Dartford has received an overall rating of "Inadequate" – the lowest possible rating – and has been placed in special measures.

A recent unannounced inspection was undertaken by the Care Quality Commission (CQC) after concerns were flagged with the sector's watchdog.

The care home is run by Sequence Care Limited, which caters for up to nine people, predominantly those with a learning disability or autistic people. It says it is taking the matters "very seriously" and is working hard to "rectify the issues identified".

It comes after inspectors found residents living at the gated facility off Spital Street were not supported and were at risk of harm.

Inspectors noted the service relied heavily on agency staff who weren’t familiar with the people who lived there and hadn’t been trained to carry out essential tasks. This included managing epilepsy, choking risks, and diabetes and constipation management.

According it its report, staff did not know what action to take if a person had a seizure, and the manager was unable to locate the cupboard where the emergency medicine was for one person with epilepsy.

The watchdog also found physical conditions inside the care home were of concern.

For example, there was broken flooring causing a trip hazard and a broken electrical box which a person told inspectors had fallen on their head.

It had been repaired with tape and was still loose when inspectors visited but when this was flagged with the area manager they were unaware it was broken.

Overall the care home, which had recently seen a change in management, had not been consistently or correctly reporting incidents to the CQC or the local authority.

One incident had failed to accurately detail there had also been an accusation of physical abuse.

The relative of the service user felt the registered manager did not take the concerns of abuse seriously when they raised them.

The service had also failed to raise a safeguarding alert when a person who lived at the service expressed they felt unsafe and worried.

Guidance for staff regarding best practice, including positive behaviour support (PBS) plans, were not always clear and easy for staff to follow.

Plans included conflicting information over the use of physical restraint and the manager did not know what guidance their staff were following.

However, despite the issues identified the CQC report did note some efforts from management to address issues.

It also found people were able to take part in activities and pursue interests that were tailored to them.

For example, one person really liked horse riding and staff were able to support them to do this weekly, while another who enjoyed fitness was helped to access a local gym.

Following the CQC's visit, the overall rating for the service has declined from good to inadequate.

"Where people experienced constipation there was nothing in the care plans to tell staff what action to take."

The home’s ratings for being safe, effective and well-led have also declined from good to inadequate, and its ratings for being caring and responsive to people’s needs has fallen from good to requires improvement.

The CQC has told the provider to take action to address the concerns identified.

The service is now in special measures, which means it will be monitored closely, both by the watchdog and the local authority’s safeguarding team.

It will be re-inspected again to assess whether sufficient improvements have been made.

Hazel Roberts, CQC’s head of inspection for adult social care, said: “When we inspected St James Mews, we found the manager had recently left and the provider didn’t have enough oversight of the service to ensure it was being managed safely and effectively.

“We had concerns that the provider wasn’t effectively managing the risks to people living with conditions such as epilepsy, choking risks or diabetes. Where people experienced constipation there was nothing in the care plans to tell staff what action to take.

“The provider didn’t have enough competent and skilled staff to care for people safely. They relied on agency staff who weren’t familiar with people living in the service and hadn’t been trained to support people.

The inspection chief also addressed concerns from permanent staff who said they "didn't feel fully supported".

"They told us they were concerned incidents could escalate when untrained staff were supporting people, so they had to be continually alert and prepared to support people in the best way they could," she added.

"This was particularly stressful when several people needed support at the same time.

“Although the provider took some steps to address these issues following our inspection, further improvements still need to be made."

A spokesperson for Sequence Care Group said: “We have taken action to ensure that we are addressing all concerns raised in a recent CQC inspection of St James Mews.

"We would like to assure residents and their families that we take these matters very seriously and will work hard to rectify the issues identified.”