A care home that was placed in special measures by inspectors could be closed if it does not improve.

Calderdale Retreat in Greetland was rated “inadequate” following an unannounced comprehensive inspection in September.

A follow-up unannounced inspection in December found the home, which is operated by TLC Care Management Ltd, was still “not providing safe, effective or well-led care” and identified continued breaches in regulations in a damning report.

The Care Quality Commission (CQC) has warned that the home will be kept under review and, if needed, could be escalated to urgent enforcement action.

The report states: “Where necessary, another inspection will be conducted within a further six months and if there is not enough improvement we will take action to prevent the provider from operating this service.”

Inspectors found that the home, which provides residential, nursing and dementia care, was inadequate in its safety, effectiveness and leadership.

The management of risks to individuals was poor, care documentation was poorly or inaccurately completed, there was a lack of management oversight of risks, and staff lacked direction and clear leadership.

During their December visit inspectors found 14 out of 19 people on the nursing unit were still in bed. There was a strong odour of faeces and urine in some people’s rooms, and one incontinent person had to wait 90 minutes for support.

In addition people shouting repeatedly for help were not attended to. A staff member told inspectors there was nothing wrong with one person and that they “just wanted attention.”

Staff informed inspectors that there were not enough staff to meet people’s needs in a timely way. There were concerns that agency staff were not properly inducted or introduced.

Medicines management was found to contain errors, with medicines administration records (MARs) filed in a folder labelled “building certificates”. This and other evidence demonstrated a continued breach of the Health and Social Care Act 2008.

There were concerns in relation to staff training and competency and people’s diet and nutrition. Only half of the 14 people in bed on the nursing unit had access to a drink; some people had no drink in their room and some people had drinks out of reach.

Recording of people’s dietary intake on the dementia unit was completed from staff memory, a long time after the meal.

No drinks or snacks were offered to people on the nursing unit in the morning or afternoon, leading relatives to express concern about family members’ meals, drinks and snacks.

Concerns over inadequate management included no leadership or direction and no prioritising of people’s care on the nursing unit, and no analysis of accidents.

One person’s care record detailed 17 falls since the inspectors’ visit in September, but no care plan had been completed or the risks reviewed.

The Examiner contacted TLC Care Management Ltd for a comment but did not receive a response.