Banksfield Nursing Home

Updated 14 December 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.

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.

Inspection team

The inspection was carried out by 3 inspectors, one was a medicines inspector and an Expert by Experience. 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

Banksfield Nursing Home 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. Banksfield Nursing Home is a care home with 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 recently registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the 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. We sought feedback from the local authority and commissioners who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who lived at the home and 7 relatives about their experiences of the care provided. We spoke with 7 members of staff including the registered manager and the company’s director of operations. We reviewed a range of records both on site and remotely. This included 9 people's medications and care records, accident and incident records and staff recruitment records. We looked at a variety of records relating to the oversight of the quality, safety and management of the service.

After the inspection

We remotely accessed peoples electronic care records. We continued to seek clarification from the management team to validate evidence found. We looked at training data and quality assurance records.

Updated 14 December 2022

About the service

Banksfield Nursing Home is a care home providing personal and nursing care for up to 42 people aged 65 and over. At the time of this inspection the service was supporting 27 people. The service provides dementia care on the ground floor and nursing care is provided on the upper floor.

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

The provider had not addressed all of the issues we found at the last inspection, we found the systems in place to manage and oversee people’s medicines were unsafe which placed them at risk of harm.

Safeguarding processes were in place to protect people from the risk of abuse. Staff were aware of procedures and had received training and knew what actions to take. Staff had been recruited in a safe way. The manager made sure enough staff were on duty throughout the day and night based on an assessment of people’s needs. However, some feedback we received indicated some people thought the home was short staffed at times.

We looked at infection prevention and control measures under the safe key question. We were assured the infection prevention and control practises were satisfactory.

People made decisions about their care and their rights were protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Training records for staff showed they had completed the required training to meet people’s needs. Referrals to other professionals were being made to support people’s health needs. People and their relatives told us their health had improved while at the home. People were complimentary about the food they received and told us their individual needs were catered for.

People and their relatives told us they were satisfied with the care provided and they found staff were very caring, kind and respectful. There were a variety of activities available to people and these included activities for those, at risk of social isolation, when cared for in bed or who chose to stay in their rooms. Actions had been taken to respond to complaints and used to improve people's experiences.

The provider and manager had responded to and addressed most of the concerns we found at the last inspection. Various audits had been undertaken to monitor the quality and safety of the service. However, medicine audits and oversight did not identify the concerns we found during the inspection. Staff and people told us the improvements made since the last inspection of the service were making a positive difference.

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 8 September 2022) and there were breaches of regulations. At this inspection we found the provider remained in breach of those regulations.

At our last inspection we recommended that the provider ensured the call bell system was fully functional and reliable and oral hygiene assessments and oral care were consistently completed. At this inspection we found the provider had acted on improving oral care assessments and providing the necessary equipment to completed oral care. The recommendation made about the call bell system was partially completed as the provider had ensured the current call bell system was functioning. The provide was also in the process of identifying the most appropriate new system to install.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 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.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safe management and oversight of medicines 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.

Follow up

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