A South London care home has been criticised after bedroom doors were left wide open while some residents were sleeping and not fully clothed. Kingston Care Home has been told to improve again by the care watchdog after inspectors heard patients shouting for carers when there weren't any in sight.

The inspection by the Care Quality Commission in June found patients at risk of harm as there weren't enough "competent" staff. The home was rated "requires improvement" – the same rating it was given in June 2021. Inspectors said most bedroom doors were left "wide open" meaning vistors could see patients sleeping, with some not fully dressed.

Staff said the doors being open made it easier to check patients who wanted to stay in their rooms. But the report said: "We observed several people shout from their rooms to gain the attention of care staff. In some instances, there were no care staff visible which made some people call out even louder."

Inspectors were concerned patients wanted "more human contact than they were getting" as they often called out when carers walked past. They said most patients stayed in their rooms and areas of the home needed cleaning. One patient said: "We have call bells. Sometimes they don't leave it near to me as they know I will use it."

Another said: "There are normally enough staff during the day but it's a different story at night. You don't call them because you know they are too busy and probably won't come for a while." The report said call bells were "mostly" answered on time but some patients called out instead and weren't heard easily due to the building's layout.

The report said: "People had not always experienced consistently good care because of high staff turnover, use of agency care staff and changes in management. There was not a manager registered with the Care Quality Commission.

"A deputy manager was in charge and was being supported by a regional manager. Some agency care workers did not have the same level of knowledge and experience of their roles as permanent staff which sometimes caused people to experience poor care delivery."

But the home, with around 67 patients, was praised for supporting patients to live independently. Patients were "happy" with staff who treated them with respect. One patient said: "The carers and nurses are very good. It's a good home. We are treated with respect." A family member added: "All of the staff are nice. I'm always welcomed. I see them with my relative and they are kind and patient."

Inspectors are monitoring the home on Jemmett Close after finding multiple breaches of rules during the inspection. A spokesperson for provider Four Seasons Healthcare said: "We are disappointed that the home remains below the standards that we and the CQC expect and are supporting the team in the home to address the areas highlighted for improvement.

"After the inspection in June, we swiftly implemented an action plan which we have shared with the CQC. We have also appointed a home manager, in line with the recommendations. The safety and wellbeing of our residents and colleagues remain our main priority."