Bank Hall Care Centre

Bank Hall Care Centre is a residential care home providing personal care for up to a maximum of 56 people. The service provides support to older people and people with dementia. At the time of our inspection, there were 36 people living in the home. Accommodation is provided in two interlinked buildings known as Bank Hall and Scarlett House.

People’s experience of using this service and what we found

People told us they felt safe living in the home, and they were happy with the service provided. Staff understood how to protect people from harm or discrimination and had access to safeguarding adults’ procedures. There were sufficient numbers of staff deployed to meet people's needs and ensure their safety. The provider had an appropriate procedure for the recruitment of new staff. Minor shortfalls in the pre-employment checks were addressed immediately by the registered manager. Individual and environmental risks had been assessed and managed. People were protected from the risks associated with the spread of infection. The premises had a good standard of cleanliness throughout the building.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's needs were assessed prior to them moving into the home. There was ongoing training for all staff. Staff were supported with regular supervisions and were given the opportunity to attend regular meetings. People were supported to eat a nutritionally balanced diet and to maintain their health.

People were happy with the way the service was managed and staff told us they enjoyed working at the home. The registered manager and nominated individual carried out a series of audits and checks to monitor the quality of the service and help ensure people received safe and effective care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

The last rating for this service was good (published 16 June 2021). The last comprehensive inspection of the service was published 15 May 2018.

Why we inspected

The inspection was prompted in part due to concerns received about the management of medicines, staff and the home; the cleanliness of the home; record keeping; the quality of the food and staff training. A decision was made for us to inspect and examine those risks.

We found no evidence during the inspection that people were at risk of harm from these concerns. Please see the safe, effective and well-led sections of this full report. This report only covers our findings in relation to these key questions. For those key questions not inspected, we considered the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bank Hall Care Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service and what we found

People told us they felt comfortable and safe living in the home. The manager and staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. Systems were in place to ensure lessons were learnt from any incidents and the management team understood their responsibility to be open and honest when something went wrong.

There were sufficient numbers of staff deployed to meet people's needs and ensure their safety. The provider operated an appropriate recruitment procedure. People received their medicines safely and on time. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. The home was clean in all areas seen and staff followed safe infection control practices.

The provider had systems to check the quality of the service and to monitor staff practice. People's views about the service were sought and acted on. The manager and staff worked with external professionals to ensure people received prompt and coordinated care.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at the last inspection

The last rating for this service was good (published 11 May 2018).

Why we inspected

This was a planned inspection based on the previous rating.

This report only covers our findings in relation to the key questions Safe and Well-Led. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the all reports’ link for Bank Hall Care Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

We found the following areas of good practice:

The registered manager had established infection prevention and control procedures which were understood and followed by the staff team. All staff had completed training on the use of personal protective equipment (PPE) and participated in the weekly testing programme. The service had plentiful supplies of PPE and stocks were carefully monitored. We offered advice in relation to signage and the stock of PPE in the staff changing room. The home had a satisfactory standard of cleanliness in the areas seen. The registered manager explained a refurbishment programme had been postponed at the onset of the pandemic.

People isolating in their bedrooms had their own dedicated staff who provided a support bubble to meet their needs, including their meals and social support. Although visiting was subject to government restrictions, the registered manager and staff had found different ways to enable people to maintain contact with their relatives which included the use of technology and window visits. The atmosphere in the home was warm and calm.

The provider’s infection prevention and control policies and procedures were up to date and an audit had been carried out. The provider had also developed a Covid-19 contingency plan, which set out the continuity of the service during the current pandemic.

Further information is in the detailed findings below.

Bank Hall Care Centre is a care home which is registered to provide care and accommodation for up to 56 older adults and older adults living with a dementia. People in care homes receive accommodation and nursing care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The accommodation is provided in two interlinked premises Bank Hall and Scarlett House. Bank Hall - is a single storey former hospital, which has been adapted to provide residential accommodation. It is registered to accommodate up to 36 older people. All the bedrooms offer single occupancy and 11 have en-suite facilities. There are three lounges two having conservatory areas. There is a separate dining room and a hairdressing ‘salon’. Additional seating is provided in the entrance hallway. Scarlett House - is a two storey purpose built extension linked to the Bank Hall building, but with its own entrance. It is registered to accommodate up 20 older people with a dementia. All the bedrooms are single with en-suite facilities. There is a lounge with a joining dining area and a separate conservatory. A passenger lift provides access to the first floor accommodation. At the time of the inspection there were 27 people accommodated in Bank Hall and 11 in Scarlet House.

At the time of the inspection there was no registered manager at the service. However the manager, who had worked at the service for over 10 years had applied for registration. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. Following the inspection we were informed the manager had achieved registration with the Commission.

At our last inspection on the 25 and 26 January 2017 the overall rating of the service was ‘Requires Improvement’. We found progress was needed with medicines management, checking systems and provider oversight of the service. We therefore made recommendations on these matters.

During this inspection we found there were no breaches of the regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014. Sufficient improvements had been made. However, although we found medicine management processes to be safe, we again found some shortfalls which were in need of attention. We have therefore made a further recommendation on this matter.

During the inspection we were provided with information which gave us some cause for some concern about people’s well-being and safety. These matters were proactively and appropriately responded to by managers; however on writing this report the concerns were still under investigation. We have asked the provider to inform the Commission of the outcome of the investigations.

People told us they felt safe at the service. Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Training had been provided on safeguarding and protection matters.

Arrangements were in place to ensure staff were checked before working at the service. We found some checks had not been properly completed. But the area manager took swift action to make improvements.

There were enough staff available to provide care and support for people. Staffing levels were kept under review and changes made to ensure they were sufficient.

Systems were in place to ensure staff received ongoing training and development; action had been taken to monitor and achieve completion of the required training and development.

Arrangements were in place to promote the safety of the premises, this included servicing and checking systems. We found the service to be clean in the areas we looked at.

People were happy with the accommodation. There were adaptations and equipment to assist people with mobility and orientation. We found there was a good standard of décor and furnishings to provide for people’s comfort and wellbeing. People had personalised their rooms and had been asked for their choice of colour schemes and furnishings in communal rooms.

People’s needs were being assessed and planned for before they moved into the service. People were supported with their healthcare needs and received appropriate medical attention. Changes in people’s health and well-being were monitored and responded to.

Each person had a care plan, describing their individual needs, preferences and routines. This provided guidance for staff on how to provide support. People’s needs and choices were kept under review.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems at the service supported this practice.

People made positive comments about the caring attitude of staff. They said their privacy and dignity was respected. Throughout the inspection we observed staff interacting with people in a kind, pleasant and friendly manner. They were respectful of people's choices and opinions.

There were opportunities for people to engage in a range of group and individual activities. People were keeping in contact with families and friends. We found visiting arrangements were flexible.

People said they were satisfied with the variety and quality of the meals provided. We found various choices were available. Support was provided with specific diets. Drinks were readily accessible and regularly offered. We found some aspects of meals provision would benefit from review and these matters were positively responded to during the inspection.

People spoken with had an awareness of the service’s complaints procedure and processes. They indicated they would be confident in raising concerns.

We found there were management and leadership arrangements in place to support the effective day to day running of the service. The manager had made a number of improvements and the area manager was providing ongoing support.

A variety of audits on quality and safety were completed regularly. Arrangements were in place to encourage people to express their views and be consulted about Bank Hall Care Centre, they had opportunities to give feedback on their experience of the service.

Bank Hall Care Centre is registered to provide care for up to 56 people. It specialises in the care of older people and older people with a dementia and does not provide nursing care. The accommodation is provided in two interlinked premises Bank Hall and Scarlett House. The service is near to Burnley town centre. There are accessible gardens around the premises with garden furniture. There are car parking spaces for visitors.

Bank Hall - is a single storey former hospital, which has been adapted to provide residential accommodation. It is registered to accommodate up to 36 older people. All the bedrooms offer single occupancy and 11 have en-suite facilities. There are three lounges two having conservatory areas. There is a separate dining room and a hairdressing ‘salon’. Additional seating is provided in the entrance hallway.

Scarlett House - is a two storey purpose built extension linked to the Bank Hall building, but with its own entrance. It is registered to accommodate up 20 older people with a dementia. All the bedrooms are single with en-suite facilities. There is a lounge with a joining dining area and a separate conservatory. A passenger lift provides access to the first floor accommodation. At the time of the inspection there were 25 people accommodated in Bank Hall and 18 in Scarlet House.

At the time of the inspection the service was not managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The area manager, who was previously the registered manager at the service, was providing management cover.

At the previous inspection, we asked the provider to make improvements in relation to risks to people’s well-being, safety and security, assessing and managing risks to individual’s and monitoring and improving the quality of the service provided. We received an action plan from the provider indicating how and when they would meet the relevant legal requirements. At this inspection we found sufficient improvements had been made. People told us they felt safe at the service and they made positive comments about the care and support they experienced at Bank Hall Care Centre.

We found people had mixed views on the availability of staff support. Action had been taken to recruit additional staff and staff work patterns had been reviewed and adjusted to provide people with safe care and support. However, we made a recommendation on ensuring staffing arrangements were effectively monitored and adjusted in a timely way.

There were some good processes in place to manage and store people’s medicines safely. We found some improvements were needed; we have therefore made a recommendation about the management of medicines.

People had mixed views on the quality and variety of the meals provided. We found various choices were available, but some people thought there was a lack of variety. Drinks were readily accessible and regularly offered. We saw some people were not supported with their food in a dignified way; this matter was dealt with during the inspection. However, we made a recommendation on effectively supporting people living with a dementia with meal choices and their nutritional needs.

Recruitment practices made sure appropriate checks were carried out before staff started working at the service. Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Staff confirmed they had received training on safeguarding and protection.

The service was working within the principles of the MCA (Mental Capacity Act 2005). We observed examples where staff involved people in routine decisions and consulted with them on their individual needs and preferences. Staff spoken with described how they involved people with making decisions and choices. Discussion meetings were held and people had opportunity to complete satisfaction surveys.

During the inspection we observed staff involving people in routine decisions and consulting with them on their individual needs and preferences.

People’s needs were being assessed and planned for before they moved into the service. Everyone had a care plan, which had been reviewed and updated. Information was included about people’s background history, their likes, dislikes, preferences, routines and how they communicated. Risks to people’s well-being were being assessed and managed.

People spoken with indicated they were treated well by staff. They said their privacy and dignity was respected. Throughout the inspection we observed staff interacting with people in a kind, pleasant and friendly manner. They were respectful of people's choices and opinions.

People were supported with their healthcare needs and received appropriate medical attention. Changes in people’s health and well-being were monitored and responded to.

There were opportunities for people to engage in a range of suitable group and individual activities. People were keeping in contact with families and friends. We found visiting arrangements were flexible.

There were systems in place to ensure all staff received regular development and supervision. We found some training was overdue but action had been taken to address this matter.

People spoken with had an awareness of the service’s complaints procedure and processes. They said they would be confident in raising concerns. We found records were kept of the complaints and the action taken to rectify matters.

There were systems in place to monitor the quality of the service and evidence to show improvements were made as a result of this. Because there were shortfalls which ought to have been identified and put right without our involvement, we have made a recommendation about the provider’s checking systems.

We found people experienced some good care and support. They told us they were treated with respect. However, we found progress could be made in engaging with and occupying people with dementia.

People were getting support with their healthcare needs and they had ongoing attention from health care professionals.

However, we found some progress was needed with care assessments and care planning to make sure people receive effective care and support.

People were being involved as far as possible in planning their care and were enabled to make decisions about matters which affected them. People were encouraged to maintain and develop their independence skills.

People told us they liked the staff. We found arrangements were in place to supervise, support and train staff. However, some arrangements for training needed to be developed.

People said they were satisfied with the clean and comfortable accommodation provided at the service. However, we found some improvements were needed in one shower room.

We found improvements had been made with the staffing arrangements at Bank Hall and Scarlett House. Staffing levels had increased and action was being taken to recruit and train new staff.

However, we found there was low staff morale at the service. There had been several changes in the staff team. Some staff indicated their workloads had increased. This meant there may be a lack of appropriate support for staff to ensure they provide effective care for people using the service.

People were being involved as far as possible in planning their care and were enabled to make decisions about matters which affected them. People were able to maintain their independence skills. However, we found there were not enough opportunities for meaningful activities and interactions.

People were getting support with their healthcare needs and they had ongoing attention from health care professionals. However we found care records were not always up to date and complete, which meant peoples' needs and choices may not be known and properly planned for.

Most people had no complaints about the services being provided at Bank Hall. They knew how to raise concerns and were confident they would be dealt with.