Bankfield House Care Home

At our last inspection, we found five breaches of regulation. At this assessment, we found that some improvements had been made. The provider was no longer in breach of regulations relating to safeguarding and people’s nutrition and hydration. However, there were continued breaches of three regulations relating to the delivery of person-centred care, safe care and treatment, and good governance within the service. We have asked the provider to submit an action plan in response to the concerns identified during this assessment.

Staff did not always provide care in a way that was safe, particularly for people who required support with moving and handling. While staff understood people’s needs, care records were not always accurate or consistent with guidance on how care should be provided. Improvements in relation to medicines records were needed. There were some shortfalls in recruitment processes; however, these were addressed immediately by the registered manager. There were not always enough staff to meet people’s needs, and not all staff had completed training relevant to their role. Appropriate systems were in place to safeguard people, and learning from incidents had been embedded.

Assessments and care plans were in place and were reviewed regularly. Staff worked together to meet people’s needs and sought support from healthcare professionals when required. However, further work was needed to ensure that consent to care was consistently obtained before support was provided.

Care was not always provided in a way that met people’s needs. For example, we observed that people did not always receive sufficient reassurance when they became distressed during moving and handling. It was not always clear that care plans were being followed, for example in relation to repositioning to protect skin integrity or providing additional support for people at risk of weight loss. Further consideration was needed to ensure people experienced dignified end-of-life care, particularly those living in shared rooms.

The registered manager had introduced a range of systems for oversight and governance. While some improvements were noted, these systems were not always used effectively. For example, care plan audits had been completed but had not identified inconsistencies or inaccuracies in records or checked whether care plans were followed through review of daily records. Not all relevant information known by staff about people’s needs was reflected in care plans. Medicines audits were completed; however, these were generic and lacked sufficient detail to identify the concerns we found. The registered manager was open to feedback and responded promptly to address concerns.