Those living in care on Romney Marsh have been unlawfully restrained, locked out of kitchens and given no access to toilet paper, an inspection found.

Others were 'sent to their rooms', banned from reading magazines, and one service user broke their finger during an incident which included the use of restrictive physical interventions.

The Care Quality Commission (CQC) has now rated Cranmore and Stepping Stones, both in New Romney and both owned by Flarepath Limited, inadequate following the inspections last month.

At Cranmore, a residential care home providing personal care to six people with a learning disability, autistic people, or those with complex needs, inspectors found staff would speak to people in a derogatory way, for example, calling them 'silly' and saying people 'threw paddies'.

In addition, people had been unlawfully restrained using incorrect techniques and there was no evidence that welfare checks had been completed on people following these episodes.

People's human rights had not been upheld, with examples of people having no curtains in their bedrooms, which infringed on people's dignity.

People had unnecessary restrictions placed on them, such as not having access to toilet paper and being locked out of the kitchen.

Staff were also not trained in positive behaviour support, and punitive practices such as not allowing people to get magazines due to behaviours were used, says the CQC.

These poor approaches to supporting people increased the use of physical restraint.

At Stepping Stones, a residential care home providing personal care to four adults with a learning disability or autistic people, inspectors found people and staff were at risk of harm from inappropriate restrictive physical intervention.

People with behaviour that was challenging were not supported in line with current best practice regarding the use of physical intervention.

People were also not supported in line with current best practice in Positive Behaviour Support; the provider failed to recognise the use of seclusion when people were ‘sent to their bedrooms’.

The provider also had not notified the local safeguarding authority and CQC of all safeguarding concerns - one person had broken a finger during an incident which included the use of restrictive physical interventions this had not been investigated or reported externally.

'The reports for Stepping Stones and Cranmore make for distressing reading...'

The inspectors also found a negative closed culture at the service, this placed people at risk of psychological abuse, and said "staff lacked the understanding, skills and knowledge to support people with learning disabilities and complex needs".

Staff treated the people in their care "like children" and failed to give them the choice and control over their lives.

Inspectors also found the garden was littered with dangerous objects, such as broken chairs and uneven surfaces.

Following the inspections, both Stepping Stones and Cranmore were rated inadequate overall and also rated inadequate in relation to whether they were safe and well-led.

The CQC has imposed urgent conditions upon both services.

The conditions restrict new admissions into the services and require the management to ensure their infection control practices are immediately improved.

At Cranmore, the provider must also ensure that they effectively manage risks in relation to any potential safeguarding issues, and assessments must be carried out to ensure the environment is safe for its intended purpose.

This includes the safe storage of fire extinguishers and trip hazards.

The CQC has asked for written documentation from the provider setting out how it will ensure these changes are made.

Deborah Ivanova, deputy chief inspector for people with a learning disability and autistic people, said: "The reports for Stepping Stones and Cranmore make for distressing reading.

"Clearly neither service is meeting the underpinning principles of right support, right care, right culture or providing people with safe care.

"People with learning disabilities and autistic people have the right to support that meets their needs and enables them to live their best lives.

"Those running services should be doing everything in their power to ensure that this happens.

"In this case, one person living in Stepping Stones said they would rather be in hospital than in the service, because they would get better care. This is not acceptable under any circumstances.

"We have taken the action we feel is appropriate and expect significant improvements are made with immediate effect.

"We will continue to keep both services under review and will re-inspect within six months to check to see whether improvements have been made.

"If improvements have not been made at that point, we will decide what further enforcement action we will take in accordance with our legal powers."

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