Archived: Bankhouse

Bankhouse is a specialist extra care housing service providing personal care and support to 38, people 27 of whom receive personal care in a purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant's own home. People's care and housing are provided under separate contractual agreements. Not everyone who used the service received personal care.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Although audits identified issues in relation to record keeping, these had not always been acted on in a timely manner. We have made a recommendation about the records management at the service. People did not always receive a service that was safe. Staff were not always given robust guidance to follow to keep people safe.

People’s medicines were administered as intended by the prescribing G.P. Staff were aware of how to report safeguarding incidents and received safeguarding training. Sufficient numbers of suitably vetted staff were deployed to keep people safe. The provider took steps to ensure lessons were learned when things went wrong.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

People spoke positively about the management of the service. Records showed the registered manager was keen to work in partnership with other stakeholders to drive improvements. People’s views were sought.

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

Rating at last inspection

The last rating of this service was good (published 6 September 2018).

Why we inspected

We received concerns in relation to COVID-19 practices and staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

The overall rating for the service has changed from Good to Requires improvement. This is based on the findings at this inspection.

While we did not find concerns around COVID-19 practices and staffing levels we did find evidence that the provider needs to make improvements in other areas. Please see the safe and well-led sections of the report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bankhouse 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 re-inspection programme. If we receive any concerning information we may inspect sooner.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

People using the service lived in flats in a purpose-built building in the London borough of Lambeth. At the time of the inspection there were 48 people living within the service, 22 of which received personal care.

The service was registered with the CQC on 17 July 2017 and has not previously been inspected.

There was a registered manager in post. 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.

People were not always safe as the service employed one staff member during the night period. People and staff expressed their concerns regarding suitable staffing levels at night. We made a recommendation the provider review their staffing levels, to ensure people were safe.

expressed their concerns.

People were protected against the risk of abuse as staff had a clear understanding of how to identify, report and escalated suspected abuse. Staff received ongoing training in safeguarding and confirmed risk management plans gave them clear guidance on mitigating identified risks. Accidents and incidents were reviewed and managed in a way that lessons were learnt to minimise the risk of repeat incidents.

People received their medicines as intend by the prescribing pharmacist. Where people required support with their medicine management, this was provided. People were encouraged and supported to access healthcare professional services to monitor their health and well-being.

People were protected against the risk of cross contamination as the provider had systems and processes in to effectively manager infection control.

People were supported by staff that received ongoing training to enhance their skills and experiences. Staff also reflected on their working practices through regular supervisions with senior staff. People received support from staff that had undergone robust pre-employment checks to ensure their suitability to the role. We received mixed feedback from people about staff that supported them. People confirmed not all staff were as caring and compassionate as they could be.

The service was aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). People’s consent to care and treatment was sought prior to being delivered. 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 were supported to access sufficient amounts to eat and drink. We received mixed reviews about the evening meals provided by an external catering company. Issues identified by the registered manager were actioned and people were encouraged to share their concerns about the meals provided with the catering company in the form of a meeting, that took place during the inspection. People were supported to maintain their independence.

People’s care plans were person centred, and reviewed regularly with input from people. Activities were provided by the service and people were encouraged to participate. People were aware of how to raise a complaint. Complaints were fully investigated in a timely manner.

People’s preferences in relation to end of life care were documented. People who currently chose not to discuss end of life care had their decisions respected. End of life care plans were reviewed regularly to reflect people’s changing needs and views.

People and the staff spoke positively about the management of the service. The registered manager carried out regular audits of the service to drive improvements. Quality assurance questionnaires were completed by people to share their views. Issues identified were then actioned.

The registered manager actively sought partnership working with other healthcare professionals and services to drive improvements and enhance people’s lives. The registered manager understood and met their regulatory responsibilities.