Bankfield House Care Home

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to how people received personalised plans of care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always ensure people were at the centre of decisions about their care and treatment. They did not consistently work in partnership with people to agree how to respond to changes in their needs.

People did not always receive care in line with their assessed needs and preferences, including in relation to personal care and moving and handling. We observed that people were not always well presented, including instances where appropriate nail care had not been provided. Staff did not always consider people’s comfort when delivering care, for example when supporting people to reposition. The registered manager responded positively to this feedback and told us they had ordered additional equipment, including chair slide sheets and in-situ slings, to improve people’s comfort when being supported.

We found several examples where care plans contained conflicting information about people’s needs. We raised this with the registered manager, who took immediate action to address these concerns. Care records did not always include sufficient detail, for example when people became distressed. Further work was needed to ensure staff maintained accurate, complete, and contemporaneous records. The registered manager told us they were working with staff to improve the quality of daily records and had introduced a new approach to recording when people became distressed.

People were mostly satisfied with the support they received. One person told us, “I sometimes feel a bit isolated, up here on the first floor, out of the way a bit. If it’s something I feel I can do, I will join in sometimes. They do take me out, and they are going to redecorate my room soon.”

There were some shortfalls in how the provider understood and responded to the diverse health and care needs of people and the local community. As a result, care was not always joined-up, flexible, or supportive of people’s choice and continuity of care.

Care was not always provided in a way that met people’s needs, for example in relation to maintaining skin integrity and supporting people with mobility. While people had appropriate pressure-relieving equipment in place, this was not always used when people were supported in wheelchairs. Further work was needed to ensure care plans and risk assessments were accurate, detailed, and up to date. However, staff generally demonstrated a good understanding of people’s needs.

The registered manager reported having positive relationships with external healthcare services, and records showed that referrals were made appropriately when additional support was required.

The provider supplied appropriate, accurate, and up-to-date information in formats tailored to individual needs.

The registered manager demonstrated a good understanding of how to support people with specific communication needs, including those who were visually impaired. They told us they were arranging for a specialist team to provide training to staff on supporting people with visual impairments.

Information was available within the home, including the complaints procedure, and details about actions taken in response to feedback using a ‘You said, we did’ board. A service user guide was in place, which explained how the service could adapt information to meet people’s needs. Newsletters containing updates about the home were also shared with relatives.

The provider made it easy for people to share feedback, raise concerns, and make complaints about their care, treatment and support. Staff involved people in decisions about their care and communicated any changes made as a result of feedback.

There were processes in place for people and their families to share their views about the service. Surveys had been completed and analysed, and identified improvements were added to the registered manager’s action plan. Meetings were held with people and their relatives, and feedback indicated that people felt able to approach the registered manager and raise concerns. One person told us, “There are some staff members I can talk to. I'm always voicing my opinion!”

The provider ensured that people could access the care, support and treatment they needed when required.

Staff reported positive relationships with other professionals, and records showed that people were supported to access the services they needed, including medical care. The service had also developed links with a local dentist to support people with their oral health.

The registered manager gave examples of how they supported people, including those who did not regularly use communal areas. People told us they were supported to access services when needed. However, we observed a delay in a referral being made for a person to receive a specialist assessment. When we raised this with the registered manager, they took immediate action to ensure the referral was completed.

Staff and leaders did not always actively seek or respond to information about people who may be at greater risk of inequality in their experience or outcomes. As a result, people’s care was not always tailored to meet these needs.

Feedback from people about support to remain mentally and physically active was varied. Some people raised concerns that there was limited stimulation. Although there was an activity worker in post, there were extended periods where people remained in communal areas with only the television for stimulation. One person told us, “There aren’t many activities, we sit most of the time. Sometimes they do the odd thing.” Another person said, “There are a lack of facilities for getting out of this place. I haven’t got any access to do anything. I can't even go for a walk without asking.”

We observed some group activities taking place during our visits. One person commented, “The activity worker does a lot of the activities. We do painting, knitting, crocheting, games, and a man comes in to do wheelchair and armchair exercises. Periodically, they bring in animals.” While some people enjoyed these activities, there was limited evidence to show how activities and mental stimulation were tailored to meet individual needs, particularly for those who chose to stay in their rooms.

Some people told us they preferred their own company. One person said, “I don’t really do the activities. I quite like my own company. A lot of the staff will pop in my room for a chat though, so I don’t get lonely.” Another person commented, “There are activities, but they aren’t my scene. Now, if they put a snooker table in my room, that’d be a different story!”

Sone staff commented that improvements were needed to ensure everyone had equal access to meaningful activities and appropriate mental and physical stimulation.

The registered manager told us that people were supported to go out on a one-to-one basis, and that the activity worker’s hours were flexible to better meet people’s needs. They also said they were building links with local faith groups and supporting people to access community groups.

People were not always supported to plan for important life events, so they had sufficient time to make informed decisions about their future care, including at the end of their life.

While care plans relating to end-of-life care had been developed and contained some detail, it was not always evident that people and their families had been involved in meaningful discussions about their wishes and preferences. The registered manager told us they respected people’s choices not to engage in these conversations.

At the time of our visit, one person was receiving end-of-life care. The registered manager shared some positive examples of how they were supporting this person as they approached the end of their life.

We discussed the challenges of providing end-of-life care for people living in shared rooms. We asked the registered manager to consider how the views and wishes of both people sharing a room, and their families, could be respected to ensure people experienced privacy and a dignified end of life.