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Inspection carried out on 7 August 2018

During a routine inspection

This inspection was carried out over two days on the, 08 and 13 August 2018. Our visit on the 08 August was unannounced and we held telephone discussions with family members on the second day.

Bankfield Road is a ‘care home’ for Adults with learning disabilities at the time of our visit six people were living in the 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. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At the last inspection in August 2015 the service was rated Good. At this inspection we found the service remained Good.

Bankfield Road provides accommodation and personal care and support for up to six adults. The accommodation is provided on the ground floor of the premises only. Communal spaces including a lounge; dining room and two bathrooms. There is a car park provided for visitors and staff. The home is situated in a quiet residential area of Widnes, close to shops and amenities. At the time of our inspection six people were living at the service.

The home has a manager who has been registered with CQC since 2015. A registered manager is a person who has registered with the Care Quality Commission 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.

The registered provider had systems in place to monitor the quality of the service provided.

Staffing levels were in line with the dependency tool, however rotas need to be clearer to identify which staff are available to provide hands on care and support to make sure residents needs and activities can be met by those on duty.

Procedures were in place to identify risks and assessments clearly instructed staff how to manage the risks associated with providing support and daily living.

Policies and procedures and training were available to staff to minimise harm to those living in the home. Staff knew how to recognise and report the signs of abuse which helps to keep people safe.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People had access to healthcare services for example from the district nurse, optician, dietetic services, health screening and the GP and were supported to attend hospital appointments as required.

People were involved and supported to attend activities they enjoyed.

Further information is detailed in the findings below.

Inspection carried out on 16/01/15

During a routine inspection

The inspection took place on 16 January 2015. The service was last inspected in September 2013 when it was found to be meeting all the regulatory requirements which apply to this type of service.

Bankfield Road supports six adults with a learning disability and physical disability. The service is owned and managed by Community Integrated Care [CIC], which is a non-profit making organisation. Staff members are on duty twenty-four hours a day. The six people who live in the home have resided there for many years.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

We found that Bankfield Road provided a personalised service to the people who lived there. Staff provided people with support which was tailored to their individual needs.

The staff were well-trained and told us that “refresher” training was provided annually.

There were good systems in place to protect people from harm. Staff had a good knowledge of people’s individual needs and of what people liked or disliked and of how they wished to live their life. Care plans were person-centred and staff told us that person centred thinking was as important as the planning. It meant that support staff held person-centred values, and a belief that a person must have control in areas such as who supports them, what they do with their day, being listened to, and making decisions about their lives.

We found the staff had clear understanding of supporting people when they lacked capacity, including the requirements of the Deprivation of Liberty Safeguards and in the implementation of best interest decisions and capacity assessments.

Discussions with staff members identified that they felt happy and supported and worked well as a team. They told us that the manager was most supportive and she led by example. Comments included; “I have joined a good staff team. Everyone is supportive; we are encouraged to gain as many qualifications as we can. We work together as a family. We get quality supervision and always work together as a team.”

The service had a robust quality assurance system in place which used various checks and audit tools to monitor and review the practices within the home.

The inspection took place on 16 January 2015. The service was last inspected in September 2013 when it was found to be meeting all the regulatory requirements which apply to this type of service.

Bankfield Road supports six adults with a learning disability and physical disability. The service is owned and managed by Community Integrated Care [CIC], which is a non-profit making organisation. Staff members are on duty twenty-four hours a day. The six people who live in the home have resided there for many years.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

We found that Bankfield Road provided a personalised service to the people who lived there. Staff provided people with support which was tailored to their individual needs.

The staff were well-trained and told us that “refresher” training was provided annually.

There were good systems in place to protect people from harm. Staff had a good knowledge of people’s individual needs and of what people liked or disliked and of how they wished to live their life. Care plans were person-centred and staff told us that person centred thinking was as important as the planning. It meant that support staff held person-centred values, and a belief that a person must have control in areas such as who supports them, what they do with their day, being listened to, and making decisions about their lives.

We found the staff had clear understanding of supporting people when they lacked capacity, including the requirements of the Deprivation of Liberty Safeguards and in the implementation of best interest decisions and capacity assessments.

Discussions with staff members identified that they felt happy and supported and worked well as a team. They told us that the manager was most supportive and she led by example. Comments included; “I have joined a good staff team. Everyone is supportive; we are encouraged to gain as many qualifications as we can. We work together as a family. We get quality supervision and always work together as a team.”

The service had a robust quality assurance system in place which used various checks and audit tools to monitor and review the practices within the home.

Inspection carried out on 5, 10 September 2013

During a routine inspection

We met everyone living at the service during our visit and we also spoke to three relatives via the telephone.

One person living at the service told us they were happy and liked the staff providing their care.

The three relatives we spoke with were very happy with the service and the standard of care provided. They made various positive comments such as; "it is first class, they always keep us informed�, �brilliant, we are informed about everything and anything. Our relative is very happy there� and "delighted with it, care is tailored to our relatives needs and I have a lot of faith in them.�

The relatives we spoke with told us that that they had no concerns about the way their family member was being cared for at the home.

The family members we spoke with were very positive about the staff members working at Bankfield Road, comments included; �staff members are very conscientious�, �good relationships, fantastic, superb.�

From the staff record we looked at we were able to see that the staff currently working at the home had been appointed correctly.

The manager was able to show us the staff training records she was keeping and the staff members we spoke with all confirmed that their training was up to date.

The home manager talked to family members on a regular basis. This meant that information about the quality of service provided was gathered on a continuous and on-going basis with direct feedback.

Inspection carried out on 5, 6 December 2012

During a routine inspection

We met everyone living at the service during our visit and spoke to three relatives via the telephone. We used a number of different methods to help us understand the experiences of people using the service. This was because people living at Bankfield Road had different ways to communicate which meant they were not all able to tell us about their experiences. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing support to help us understand the experience of people who could not talk with us. People living at the service looked content, happy and comfortable with the staff supporting them.

One person told us they liked living at the service and they had recently been to Blackpool and were looking forward to going out later in the day. They told us they liked the staff and they could regularly speak to them. Relatives were overall very happy with the service and the standard of support provided. They made various positive comments such as: �We want our relative to have the best life possible and here they go on holiday something they had never done previously.�;� The bedroom is beautiful the home is always kept nice� and �Everything is fine I�m made up.�

We had also contacted the local authority contracts and monitoring team for Halton Social services before we visited the service. They shared a detailed report from their recent reviews of the service.

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Inspection carried out on 22 February 2012

During a routine inspection

The people who used the service were unable to verbally communicate their views. From our observations the people who used the service appeared relaxed and happy with the staff supporting them.

Relatives spoken with said they were happy with the care and support provided. They described staff as friendly and caring. They said that their relatives were happy living at the home. They said they have nice bedrooms and a clean home and they take part in activities they enjoy. Some comments made were:-

�It�s a first class service. My relative is beautifully looked after.�

�The service is pretty good. My relative is very well cared for and goes out a lot. We are kept well informed and we are asked our views.�

�I�m made up with the service. It�s very good, my relative is looked after very well and they have a lot of trips out and holidays.�

Health professionals spoken with said that referrals were made to them when people needed support with their health needs and that staff gave appropriate support when health care advice has been given.

Halton Borough Council visited the service in November 2011. They reported that the home continued to provide a warm and homely environment. The feedback from families was very good and positive. No concerns were raised. At the time of their visit the manager was overseeing another Community Integrated Care service and an acting manager had been appointed. Halton Borough Council identified a number of improvements to be made. An action plan had been submitted to Halton Borough Council that identified how these shortfalls were to be addressed.

Halton Local Involvement Network (LINk) had no information concerning this service.

*LINKs are networks of individuals and organisations that have an interest in improving health and social care services. They are independent of the council, NHS and other service providers. LINks aim to involve local people in the planning and delivery of services.

Reports under our old system of regulation (including those from before CQC was created)