Bank Hall Farm

Updated 17 August 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

This inspection was carried out by two inspectors and a pharmacist inspector.

Service and service type

Bank Hall Farm 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. Bank Hall Farm 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 22 June 2022 and ended on 5 July 2022. We visited the service on 22 June; 28 June and 5 July 2022. One of these visits occurred outside of normal working hours.

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

During the inspection

We spent time with five people who used the service. We spoke with six family members on the telephone to gain their views on the care that people received. We spoke with 14 members of staff including the manager; assistant manager; care and ancillary staff and members of the providers senior management team.

We reviewed a range of records. This included five people's care and medication records. We looked at the recruitment records of three staff; training records and records relating to the management of the service. We reviewed the care plans of four people using the service and other records relating to the management of the service.

Updated 17 August 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Bank Hall Farm is a registered care home providing personal care to six people living with a learning disability and/or autism at the time of the inspection. The service can support up to seven people.

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

Right Support: Further Improvements were required from the provider to ensure staff received all of the training they needed and to ensure an appropriate level of management and oversight of records. Further Improvements were required from the provider to ensure staff received all of the training they needed and to ensure an appropriate level of management and oversight of records.

Since the last inspection, the provider had made a number of improvements to the living environment for people living at Bank Hall Farm which improved safety and made the service more homely; further improvements were planned. Family members spoke positively of the improvements already made.

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. People were supported to take part in activities of their choice outside of their home and spend time with their families.

Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights.

Further improvements were needed to develop people’s care planning documents. Care plans did not always reflect the service they received from the staff team and did not always demonstrate the underpinning principles of Right support, right care, right culture. However, people were supported by staff who knew them well. Risks to people were identified and where possible reduced. People had access to health care professionals. Medicines were managed safely; and family members felt that their relatives were safe at the service. Appropriate checks were carried out when recruiting new staff to support people.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

The provider had an Autism strategy in place to promote positive care and support for people using the service. The senior management team had developed an on-going action plan to make improvements within the service. Staff were aware of the improvements required and were confident that the recent changes had improved the service. Family members felt involved in decision making around their relatives' lives.

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 08 March 2022) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made, however the provider remained in breach of regulations.

This service has been in Special Measures since 29 December 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

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.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

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

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 continued breaches in relation to staff training, management and oversight of care records at this inspection.

Please see the action we have told the provider to take at the end of this report.

We have also made a recommendation the provider follow and continually monitor the service against current best practice regarding fire safety in care homes.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.