An elderly woman was left suffering with a broken leg for two months before staff at an Ormskirk care home spotted her injury.

Courtfield Lodge off Marians Drive was reported to the Care Quality Commission (CQC) after they received 'information of concern' leading them to launch an unannounced inspection of the home on May 20.

The resident complained of pain and difficulty walking due to the injury back in December however the fracture went undetected by staff until February 2019.

A number of allegations of patients having "unexplained injuries" were also reported to the watchdog prior to the inspection.They made another unannounced visit to the care home on June 3 during which ongoing concerns over safety were identified.Improvements to prevent and control the spread of infection at the care home were also required, inspectors said, with soiled underwear found "inappropriately stored in communal toilets."

The residential home which provides accommodation for 70 people aged 65 and over - some of whom have dementia - was rated 'inadequate' by the CQC after it was found to be unsafe.

Inspectors wrote in their report, published last week: "There had been a rapid decline in the quality of the care at the home.

"There had been instances when people had suffered significant injuries and deterioration of their conditions however staff had not always recognised a deterioration in people's conditions and sought medical attention in a timely manner.

"Before the inspection we received concerns regarding concerns regarding the management of risks associated with falls, head injuries, the lack of medical attention and monitoring following injuries and the security of the building.

"One person had experienced a fall and a fractured leg in December 2018. Despite the person complaining of pain and a deterioration in their walking, the fracture was not detected until February 2019."

Prior to the inspection, the CQC also received 'allegations of neglect' with some patients being reported to have unexplained injuries.The report added: "People were not adequately protected from the risk of abuse. While people told us, they felt safe and were satisfied with the care and support they received, before the inspection we were informed of safeguarding concerns for neglect which had been investigated by the local authority.

"This included allegations of neglect by failing to seek medical attention in timely manner and some people having unexplained injuries which had not been reported to safeguarding authorities."

A number of residents, inspectors were told, suffered injuries when they were able to leave the care home without the knowledge of staff.

The report added: "People were not adequately protected from risks of leaving the home without escort.

"Before the inspection, we had been made aware of an incident where a person left the home without staff knowledge.

"During the inspection we were given assurance that this had been resolved. However, soon after the inspection we were notified of another incident where a person had left the building without staff knowledge.

"There was no guidance on how to monitor people at risk of absconding. This led to repeated incidents of people absconding and suffering injuries in some cases. We asked the provider to take immediate action to resolve this risk."

Medicines were also found to be managed unsafely, with eight people failing to receive their medicines in the way they were prescribed.

The report added: "People's medicines were not managed safely because staff did not follow safe and best practices in medicine management, storage and administration."One staff member recorded that people had received their medicines when they had not been given.

"Four people were prescribed topical creams to manage sores, skin dryness and infections, however we found their medicines were sealed and unopened, yet staff had signed that they were applying the creams."

Inspectors also found: "500 paracetamol tablets which were being disposed of when they were still in date and still prescribed to the person. This was because there was no system to carryover medicines and to stop ordering medicines if there was enough stock."

Courtfield Lodge commented: "We would like to apologise to all our residents, their family and friends for having fallen below the standard of care that we expect all of our care homes to provide."The wellbeing of our residents is of paramount importance to us."We have taken on board everything that CQC have stated in their inspection report and are working closely with CQC to address all the shortcomings in an open and transparent manner."Since the inspection in May and June 2019, a new management team has been put in to place and significant progress has been made.

"We will continue to make further improvements and will monitor the progress, to ensure that it is maintained."