Bankfield

Updated 28 June 2023

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.

This was a targeted inspection to check whether the provider was ensuring the proper and safe management of medicines.

Inspection team

The inspection team consisted of 2 inspectors.

Service and service type

Bankfield 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. Bankfield is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. we used this information to plan our inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We reviewed 6 medication records and all controlled drugs records. We looked at records for the management of topical creams and as required medicine such as pain relief. We spoke with the registered manager, the deputy manager, a senior care worker and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 28 June 2023

About the service

Bankfield is a residential care home providing accommodation and nursing care for to up to 47 people over the age of 65 and/or living with dementia. At the time of our inspection there were 18 people using the service.

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

People were not always supported safely. Risks were not always identified, assessed, and monitored. Safeguarding processes were not always followed. Accidents and incidents were not always recorded. Recruitment processes were not robust. Agency workers did not have robust checks and inductions recorded. Medicines were not safely managed.

Consent was not legally obtained for care and treatment. Staff did not receive training to safely use the medicines system at Bankfield. Staff were not receiving regular supervision and appraisal. Assessments had not considered people’s cultural needs. One person was left with a drink in front of them for three hours without any prompting to drink it. People had been moved into rooms with less facilities than they previously had and without consultation.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff were kind and caring but lacked time to spend with people. There had been multiple staff changes and regular use of agency staff which meant people lacked familiarity. People told us they did not always get a bath as the lift had been broken and the bath was on the first floor. Care records confirmed, people were not accessing the bath.

Care plans lacked detailed information and were not created or reviewed with people and their relatives. No complaints had been formally received by the provider but relatives told us, they had tried to contact the directors but were not responded to. Activities were available and people spoke positively about the activities coordinator. However, we were told, the activities coordinator was often used to fill care shifts.

The provider lacked oversight of the improvements needed to be made in the home. Audits completed had not highlighted the concerning information we found at this inspection in relation to medicines safety, safeguarding, care planning and risk assessing and the recruitment and retention of staff. The manager was not always open and transparent with us and there had been no consultation with people and staff about increases in care fees. The provider had failed to improve over the previous four inspections.

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 inadequate (published 14 December 2022). At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 Bankfield on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to person- centred care, need for consent, safe care and treatment, safeguarding service users from abuse and improper treatment, good governance, staffing, fit and proper persons employed and fees at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures