Failings at a Rickmansworth care home has led to management being told that "action is needed" after an unannounced watchdog visit.
Chalfont Court, in Uxbridge Road, provides accommodation and nursing care for up to 46 people, some of whom have dementia, learning difficulties, mental health conditions or physical disabilities and are over the age of 65.
Inspectors from the Care Quality Commission (CQC) visited the home on May 16 and May 20 and the report was published last month.
Inspectors witnessed one instance in which a resident was sat in a wheelchair with a lap belt fastened across them and left for a "considerable amount of time" without being asked by staff if this was what they wanted.
There was also a chronic lack of understanding among staff about dementia, which is a condition many of the reisidents at the nursing home have.
The CQC report states that one member of staff told inspectors: "Where people have dementia, we assume they do not have capacity to consent."
Another staff member said: "This is a dementia unit so people don't have capacity, but sometimes we allow them to do things."
Inspectors found that: "This suggested a culture of misunderstanding around matters relating to consent for people who may lack capacity."
Inspectors found that action was needed in areas such as the care and welfare of people who use the service, the consent to care and treatment, safeguarding people who use services from abuse, cleanliness and infection control, support given to workers, records, and assessing and monitoring the quality of service given.
Units in the kitchenette areas were found to be scorched and scalded and some of the areas behind the signs were damaged and needed replacing.
Residents also sometimes shared slings, which could pose a risk of cross-contamination, and people’s records were not kept in a safe manner.
Richard Scarth, regional director for Care UK, which manages the service, said: "We always take any concern raised by CQC extremely seriously and are sorry that the inspection report found that the home is not up to the high standard that we expect and the residents of our homes deserve.
"We have submitted a comprehensive action plan to the CQC and have already started work to implement that plan. For example, a new manager has been appointed to run the home, there is a substantial training programme underway for team members and we will shortly be investing in new carpets and kitchenettes to improve the surroundings.
"During their inspection, CQC inspectors did also find much to praise and we were pleased that they noted that residents were treated with care and respect, that team members at the home provided care and support in a way that promoted dignity and privacy."