A Stevenage care home which was inspected a month before a fatal fire needs to improve across the board, according to the newly-published report.

Woodlands View Care Home, off Magpie Crescent, has received ‘requires improvement’ ratings in every field from Care Quality Commission inspectors – based on a visit four weeks before the fatal fire on February 3.

There were 112 residents at the time of the unannounced visit in January, which came a month after HC-One Ltd took over the home from Bupa.

The inspectors found medicines were not always managed safely, that not everyone received care in a person-centred way, and that feelings about the activities provided were mixed.

It was found that people were not confident they would receive feedback from the manager if they made complaints.

The inspectors also wrote that there were not always sufficient staff to meet needs in a timely way. The report quotes some residents as saying they could not always have baths and showers when they wanted, blaming the lack of personnel.

The report says that two people had to wait up to an hour to use the toilet, with the result that one was incontinent. Another waited over an hour to be repositioned to ease back pain. “They only received assistance when we requested staff support them,” the inspectors wrote.

Some staff were overdue for training updates, the report adds.

Positive comments included that staff addressed residents with respect and kindness, and that confidentiality and personal dignity were promoted.

Responding to the report, an HC-One spokesman said: “The health, safety, and wellbeing of everyone we look after are our main priorities.

“We take all feedback from the CQC very seriously, and since the inspection back in January we have implemented a robust action plan to directly address the regulator’s concerns.

“Medicine administration procedures are being routinely audited, and we continue to have the right numbers of staff to meet our residents’ dependency needs.

“The home is being actively supported by our wider regional team and we look forward to welcoming the CQC back to the home in the near future to show them the progress we’re making.”

The inspectors noted the fire that had happened since the visit and said the CQC was working with other agencies on the investigation, which continues.

Early enquiries have indicated the involvement of an oxygen cylinder in the room of the man who died, who was in his 80s.

A second person who was taken to hospital in the wake of the fire also died, it has now been confirmed to the Comet.