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West Bank Care Home Requires improvement

We are carrying out a review of quality at West Bank Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 December 2018

West Bank Care Home is registered to provide accommodation and personal care for a maximum of ten people who have mental health needs. At the time of our inspection there were six people living at the home.

The service did not have a registered manager in post since it was run by a sole provider. However, the provider employs two care managers to manage the service on a day to day basis. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

West Bank is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This inspection took place on 23 October 2018 and was unannounced. Our last inspection took place on 12 December 2016 and at that time we found a breach of Regulation 20A (Requirement to display performance assessments) of the Health and Social Care Act (2008) Regulated Activities 2014 Regulations.

Policies and procedures ensured people were protected from the risk of abuse and avoidable harm. Staff told us they had regular safeguarding training, and they were confident they knew how to recognise and report potential abuse. However, we found the provider had not always reported safeguarding incidents to the Commission as required.

Overall, people’s medicines were managed safely and people told us they received their medicines at the right time. However, we found staff administering medicines had not completed competency assessments. This was not in line with National Institute for Health and Care Excellence (NICE) guidance. In addition, no protocols were in place for medicines prescribed on a 'As required' (PRN) basis.

There were enough staff to support people when they needed assistance and the provider followed a robust recruitment procedure to ensure only people suitable to working in the caring profession were employed. Suitable arrangements were in place to make sure staff were trained and supervised.

People’s needs were assessed before they moved into the home. However, the assessment documentation we looked at was not sufficiently detailed and did not show how the provider concluded the staff team had the necessary skills and resources to meet people’s needs.

Each person had a care plan in place which provided staff with the information required to provide appropriate, care treatment and support. People’s care and support was kept under review and where appropriate, they were involved in decisions about their care.

The atmosphere in the home was relaxed and from our observations, it was clear staff knew individual people well and were knowledgeable about their needs, preferences and personalities.

There was a limited range of leisure activities for people to participate in, including both activities in the home and in the local community. However, more could be done to ensure people enjoyed a full and active life. People told us they enjoyed the meals provided and were involved in menu planning.

Most risk assessments were well completed. However, in one person’s records we found the risk assessment relating to smoking was not sufficiently detailed and had not considered all the risk factors. In addition, the fire risk assessment and evacuation plan required updating.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act 2005 (MCA).

We saw the complaints policy was available. The policy detailed the arrangements for raising complaints, responding to complaints and the expected timescales within which a response would be received.

There w

Inspection areas

Safe

Requires improvement

Updated 6 December 2018

The service was not consistently safe.

Overall, people’s medicines were managed safely. However, staff administering medicines had not completed competency assessments and there were no protocols in place for medicines prescribed on a ‘As required’ (PRN) basis.

Risk assessments relating to personal risk and the environment were not always sufficiently detailed.

There were processes in place to ensure people were protected from the risk of abuse and staff were aware of safeguarding procedures. However, the provider had not always reported safeguarding incidents to the Commission (CQC) as required.

Effective

Requires improvement

Updated 6 December 2018

The service was not consistently effective.

People received support from healthcare professionals to maintain their health and wellbeing when it was required.

The service was compliant with the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Pre-admission assessments were not sufficiently detailed and did not show how the provider had concluded staff had the necessary skills and resources to meet the people’s needs.

Caring

Good

Updated 6 December 2018

The service was caring

People told us they were supported by staff who were kind and considerate and respected their privacy and dignity.

Staff knew individual people well and were knowledgeable about their needs, preferences and personalities..

The service provided compassionate care and support to people and their families at the end of their life.

Responsive

Good

Updated 6 December 2018

The service was responsive

Care plans were in place to ensure staff provided care and support in line with people’s preferences.

There was a limited range of activities for people to participate in, including activities in the home and in the local community. However, more could be done to ensure people enjoyed a full and active life.

People felt confident they could raise concerns and complaints and these would be listened to and dealt with promptly.

Well-led

Requires improvement

Updated 6 December 2018

The service was not consistently well-led.

Systems were in place to assess and monitor the quality of care provided. However, they were not always sufficiently robust and had not identified some shortfalls in the service highlighted in the body of the report.

There were systems in place to seek the views of people who used the service and others and to use their feedback to make improvements.