In the United Kingdom, gaining real insight into what goes on inside care homes is increasingly difficult. However, troubling patterns of staff shortages, exploitation, rough handling, inadequate training, and unexplained bruises on elderly residents continue to surface. These are not isolated events but warning signs that the government must urgently investigate. With public funds at stake and lives in jeopardy, the question remains, who is really watching over our most vulnerable citizens?
This investigative report uncovers widespread and long-standing failures at Lincoln House Care Home, operated by Castlemeadow Group, a company that also manages several other care facilities including St Johns House, The Paddocks, The Mayfields, Highfield House, and Wyndham House.
The 2021 death of Margaret Smith, a vulnerable elderly resident who disappeared from the home and was later found dead, cast a national spotlight on Lincoln House. However, this tragedy was not an isolated incident. Investigations reveal a pattern of neglect and regulatory breaches dating back more than a decade, including chronic understaffing, falsified care records, poor medication management, lack of safeguarding protocols, and repeated failures to meet even basic standards of hygiene and dignity. These issues were repeatedly flagged by the Care Quality Commission (CQC), yet little appears to have changed.
Inspection Reports Tell a Different Story
Though Lincoln House is currently rated “Good” by the CQC, our analysis of CQC inspection data between 2011 and 2022 reveals a recurring pattern of failure and noncompliance. Over this eleven-year period, inspectors repeatedly identified serious issues including inadequate staffing levels, poor leadership, inconsistent safeguarding practices, and substandard care environments. These findings indicate that the home’s current rating may not accurately reflect the sustained risks faced by residents especially during the years leading up to the 2021 death of Margaret Smith.
- Safety: Rated “Not Safe” in several inspections
- Effectiveness: Frequently marked as “Not Effective”
- Responsiveness: Found to “Require Improvement” across multiple assessments
- Leadership: Scored only moderately, despite serious lapses in care delivery
These recurring issues directly contradict the facility’s current public rating and suggest either regulatory delay or poor follow-through on past inspections.
CQC Inaction Raises New Questions
What’s even more alarming is that for several months now, the CQC has not updated the public report on Lincoln House Care Home. As observed by our team, the official CQC site lists the home as “Under Review”, a status that has remained unchanged for an extended period.
This lack of updated regulatory information not only limits public awareness but potentially endangers lives. It also raises serious concerns about the transparency and responsiveness of the regulatory body itself. If inspection data is withheld or delayed, how can the public make informed decisions about care facilities?
The Death of Margaret Smith: A Preventable Tragedy
In June 2021, Eastern Daily Press reported that Margaret Smith, an 87-year-old resident, had been missing for 48 hours from Lincoln House Care Home. Her disappearance, which occurred late at night, triggered an urgent and highly coordinated search involving more than 300 volunteers, military personnel, and emergency services. Tragically, her body was discovered several days later, not far from the facility where she was supposed to be under 24-hour supervision.
At the time of her disappearance, Lincoln House had already been cited for serious failings by the Care Quality Commission (CQC) following inspections in both 2019 and again in 2021. These reports highlighted critical concerns, including chronic staffing shortages, inadequate staff training, weak leadership, and dangerously slow response times—all of which are fundamental to ensuring resident safety.
Feedback collected from residents and families during this period painted an even more disturbing picture: a recurring pattern of neglect, missed care routines, and long delays in attending to basic needs. The warning signs were numerous, consistent, and well documented, yet no meaningful corrective action was taken. Margaret Smith’s death was not just a tragedy. It was a foreseeable failure.
Dr. Sanjay Kaushal: The Leadership Dilemma
Adding another layer to this troubling story is Dr. Sanjay Kaushal, the owner of Lincoln House Care Home and a sitting board member of the Norfolk Care Association, an organization that exists to uphold standards in the care sector.
Dr. Sanjay Kaushal was appointed to the board of directors on January 9, 2020. This period is especially notable when examined in the context of Lincoln House Care Home’s ongoing regulatory decline. In the years following his appointment, the care home received a series of poor assessments from the Care Quality Commission (CQC), exposing serious failures in care, safety, and oversight. During this same timeframe, Margaret Smith, one of the home’s most vulnerable residents, went missing and was later found dead under deeply concerning circumstances.
This overlap raises serious ethical and governance questions. How can a person entrusted with shaping regional care policy preside over a home facing consistent regulatory failure? Is it acceptable for someone in such a position to remain unaccountable while the lives of elderly residents are placed at risk?
Stonewalling and Silence from Management
In pursuit of balanced reporting, Care Ledger contacted several members of Lincoln House Care Home’s management team to clarify current operations and offer them a right of reply. These individuals included Victor Zak (Senior), Cheryl Ann Mortimer, Patricia Almeidia, and other senior staff. To date, no response has been received from any of them.
This silence speaks volumes. When those entrusted with the care of society’s most vulnerable refuse to engage in transparency, it points to a deeper culture of secrecy—one that prioritizes reputation over responsibility and accountability.
This is not just neglect. It is a deliberate withholding of information from the public and from families who have entrusted Lincoln House with the safety and dignity of their loved ones.
The tragedy at Lincoln House Care Home is not simply the story of one woman’s death. It is the consequence of a broken system, a failure of leadership, a failure of regulation, and a failure of ethics.
The care sector cannot be allowed to operate in secrecy. The public has a right to know the truth. Our elderly deserve better. They deserve dignity, protection, and accountability.
