Bank Close House

Updated 22 April 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by three inspectors. An expert by experience carried out telephone calls to relatives after the onsite inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Bank Close House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 26 October 2021 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection-

We reviewed a range of records. This included five people’s care records and multiple medicine records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We spoke with a health care professional who regularly visited the service. We also spoke with the cook, domestic support, the quality manager and provider.

After the inspection

Our expert by experience contacted seven relatives to seek their views on the care the person using the service had received. The inspector spoke with five care staff.

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 22 April 2022

About the service

Bank Close House is a residential care home providing personal care for to up to 27 people. The service provides support to people over 65 with dementia or physical needs. At the time of our inspection there were 14 people using the service.

The accommodation is set in two buildings connected by a glass walkway. There are two communal seating areas as well as two dining areas, several bathrooms and toilets throughout the building. Bedrooms are spaced out on the upper floor of the main building or in the extended building to the rear of the property.

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

The provider had made improvements however these had not yet been embedded. There was currently no registered manager. The provider had ensured a daily presence of a quality manager from the provider’s other locations and business arrangements.

We saw that audits had been completed; however, in some instances they had not identified areas of improvements or checks to ensure a consistent approach. However, in other areas they had been used to make direct changes and monitor improvements.

Staff we spoke with felt their views were not always listened to, especially in relation to staffing and deployment. The provider had recognised this and was in the process of improving communication.

People’s views had been considered for meal choices, however there was a lack of daily activity options for people to engage in. This had been impacted upon by the reallocation of staffing but was being addressed with a consistent number of staff being recruited.

Risk assessments had been completed and risk mitigations were in place. However, some information had not been detailed in all areas of the care plans, but the impact was minimal due to detailed handovers.

The home followed the required guidance in relation to COVID-19, however some areas of the home had not been maintained around equipment and people’s bedrooms. These were addressed immediately during the inspection.

There was enough staff to support people’s needs, however the staff had not always received the required training for their role or the details of completed training had not been recorded.

Medicines were managed safely. However, the stocks for boxed medicines had not been regulated as part of the audits, to cross reference with administration.

Relatives commented positively about the care, their relative received, reflecting kind and caring staff.

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

Rating at last inspection and update; The last rating for this service was requires improvement (published 5 August 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. We found some improvements had been made however, the changes had not always been embedded.

No areas of concern were identified in the other key questions. We therefore we did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same, Requires Improvement. This is based on the findings at this inspection.

Why we inspected

The inspection was prompted in part due to concerns received about infection control and management support. A decision was made for us to inspect and examine those risks.

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 see what action we have asked the provider to take at the end of this full report.

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

Follow up

We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.