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A care home has been plunged into special measures after inspectors made an unannounced follow-up visit to find it had got worse.
A team from the Care Quality Commission (CQC) found Valley View in Rochester "required improvement" in September 2021.
And the latest inspection has rated it "inadequate" with management failing to comply with a raft of measures to get the service up to standard.
The Maidstone Road home provides residential, nursing and personal care for up to 33 residents, including those with dementia.
The provider has now been given six months to make "significant improvements" and, if not met, enforcement procedures could lead to the cancellation of its registration.
Among the areas to remain of concerns are staffing levels with not enough employees to cover afternoon and night shifts.
This led to clients having to endure delays for attention, one having to wait two hours for a commode. And some were forced to wet their beds.
Between 6pm and 7pm nobody was designated to the communal area leading to people calling out to be taken to the toilet or their room.
It had been recommended the provider sought reputable advice to assess the number of staff required to meet people's needs and aid employment of staff. This was not carried out.
Other areas still not up to standard were management of medicine and the running of the service remained "inadequate".
The provider had also failed to notify the CQC of incidents.
It had been noted previously that risks around constipation had not been well managed – and this had not been rectified.
One person had not opened their bowels for 18 days and was not offered laxatives until 14 days without a motion.
A culture of bullying and intimidation towards new staff had not been redressed.
But feedback from residents and families did produce complements, including friendly manner of staff and their respect for clients' privacy.
The food menu also received favourable views.
The findings are: Safe – inadequate; Effective – requires improvement; Caring – good; Responsive – good; Well-led – inadequate.
Amanda Chadwick, Valley View's registered manager, said: "Obviously the rating by CQC was disappointing but in the three months since the inspection in November we have been working very hard within the team and with our professional advisors to address all the issues raised and restore the service to full compliance with the regulations as soon as possible.
"We continue to receive positive feedback from our residents about their experience of Valley View and I am confident the home is performing well and providing a valuable service to the local community."