Banbury Heights Nursing Home

Updated 14 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.

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 completed by 2 inspectors 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

Banbury Heights 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. Banbury Heights 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 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 reviewed the information and feedback provided to us by the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and 5 relatives about their experience of the care provided. We spoke with 10 members of staff including, the registered manager, deputy manager, nominated individual, operations manager, director, maintenance staff, nurses, and care workers.

We reviewed a range of records. This included 10 people’s care records and multiple medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 14 June 2023

About the service

Banbury Heights Nursing Home is a residential care home providing personal and nursing care to up to 58 people. The service provides support to older and younger people with dementia, physical disabilities, sensory impairments, mental health needs, learning disabilities or autism in one adapted building, over 3 floors. At the time of our inspection there were 47 people using the service.

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.

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

Right Support:

People were not always supported to have maximum choice and control of their lives and staff did not always 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 did not always have the information required to provide safe, effective care. Care plans and risk assessments did not always contain relevant, up to date information within them.

People were supported safely with medicines. We found improvements had been made to medicines management.

People were supported by staff who had been safely recruited. The provider completed police checks and gained references for staff prior to them starting work. Staff received an induction and training.

Right Care:

Risks to people had not always been mitigated. We found concerns with risk associated with skin pressure damage, health conditions and supporting people with distress or anxieties.

Unexplained bruising had not been investigated or mitigating strategies implemented to prevent the risk of reoccurrence.

Staff had received appropriate training to understand people’s individual needs and to follow the providers policies and procedures.

Right Culture:

Systems and processes were not always effective in ensuring the registered manager and provider had oversight of the service.

Systems were in place to gain feedback from people, relatives, and staff. Staff told us they felt supported within their roles and people told us they felt safe.

The registered manager and provider were open and transparent throughout the inspection. Updated records and new procedures were implemented immediately after the inspection. However, these will require time to become embedded into practice to reduce risks.

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 14 May 2022) and there were 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 the provider remained in breach of regulations.

Why we inspected

We received concerns in relation to safety and oversight. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has not changed from requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Banbury Heights Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to risk management and management oversight 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.