Archived: Bankwood Care Home

We found the following examples of good practice.

¿ There were clear signs up in reception and around the home to communicate the visiting status of the home and COVID-19 precautions.

¿ During the summer the service had utilised various garden areas for visits outside and through glass windows. The service was establishing an indoor visiting room set up with garden access, a Perspex screen and hands-free sanitizer in place ready to receive visitors when allowed.

¿ All visitors to the service were booked in advance, had temperature checks and completed a questionnaire and were supplied with full Personal Protective Equipment(PPE).

¿ While families were not able to visit, they were sent emails and newsletters. Phone calls or other social media calls were used to keep people in touch. Social media calls were also used by health care professionals such as physiotherapists, all calls were booked in a diary to ensure staff could assist people to keep in contact with families and attend virtual appointments.

¿ The home was well ventilated and there were lots of areas for people to relax. Staff had promoted social distancing in communal areas by spacing out chairs in the dining area and lounges.

¿ Any people admitted to the service were isolated on arrival in line with government guidance to reduce the risk of COVID-19 infections. Twice daily temperature checks were performed on all people living at the service to identify signs of illness early.

¿ The service kept a log of COVID-19 testing performed on staff and people living at the service.

¿ The activity coordinator was supporting people in their rooms if isolating and was assisting activities for small groups of people socially distanced in communal areas.

¿ The management team had colour coordinated the home to minimise the risk of cross infection. Staff were allocated to work in zoned area of the home to minimise movement. Staff worked long shifts over less days, due to the location of home. This meant that people were exposed to contact with fewer staff.

¿ The home had a good supply of PPE, with stock kept in stations around the home in plastic wipeable boxes so staff did not have to walk far to obtain it. There were specific areas to don and doff PPE. All bins were covered, and waste was isolated for 72 hours before disposal.

¿ The service had a lead person and link staff for infection control. They assisted with staff training, audited infection control practice and performed spot checks on staff to ensure compliance with guidelines. Staff had received extra training on handwashing and PPE usage.

¿ The home was clean and tidy and had adapted cleaning to best practice guidelines. Equipment was cleaned during the day and at night. Deep cleaning had been increased and rooms were being decontaminated on a regular basis. Extra staff had been employed to ensure domestic and laundry duties were covered.

¿ The home had used agency staff when staff were self-isolating. These staff were provided with training and block booked to ensure they only worked in one area for a specific time to minimise the risk of cross infection.

¿ The management team received support from regional managers and other managers within the company to discuss concerns, best practice and changes in guidance. The registered manager told us how hard staff had worked to support people despite their own anxieties about COVID-19.

We found the following examples of good practice.

¿ The provider ensured guidance was provided through a detailed prevention and protection plan.

¿ Each location had been risk rated by the provider using a traffic light code to ensure the required safety measures were followed at each stage to reduce the risks of cross infection.

¿ Staff took on lead responsibilities in relation to infection control, these linked into national guidance and the providers overarching plan.

¿Additional time had been allocated to ensure the home was cleaned on a rotational basis to minimise the risk of infection.

¿ Staff had received training in the appropriate use of personal protective equipment (PPE), and the provider had ensured they had enough supplies.

¿ Risk assessments had been completed for the staff on site or returning after shielding or a period of isolation. These ensured measures were taken to minimise the risks, this included any additional risk for people in the BAME or other high-risk groups.

¿ Any visitors had been risk assessed and arrangements were in place to support rotational visits for larger families.

¿The home was moving towards a bespoke indoor visiting space. This will encompass the option of a ‘cuddle’ curtain to give people some personal contact in a safe way.

¿ The provider was supportive and had developed a programme to focus on people’s skills and how to support them with any areas of stress or pressures.

¿ The registered manager was passionate about the home and championed how the staff team had pulled together to ensure all measures were in place and continuously followed.

¿ Measures were in place should anyone have a Covid positive outcome, to ensure appropriate guidance was followed to reduce the risk of transition.

Further information is in the detailed findings below.

Bankwood Care Home is a care home that can provide personal and nursing care to up to 40 people. At the time of the inspection they were providing support to 35 people, some of whom were living with dementia.

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

People were protected from abuse by staff who understood how to identify and report any concerns. The risks to people's health, safety and welfare had been assessed, recorded and plans put in place to reduce these. Staffing levels enabled people's needs to be met safely, and ensured people received consistent and reliable care. The provider and management team sought to learn from any accidents or incidents involving people. The service was clean and followed infection control principles.

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.

Peoples needs were assessed appropriately, the service worked with other health professionals to ensure people's needs were met effectively. People were supported to maintain a balanced diet.

Staff were caring and treated people with dignity and respect. People's confidentiality was protected, and their information was stored safely.

People who used the service and their family members knew how to report concerns, they told us they had confidence any concerns would be listened to by the service.

People and staff told us that the management team was approachable, and the service was well led. The registered manager had good oversight of the service and completed regular audits in order to drive improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

Good (report published 19 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re inspection programme. If we receive any concerning information we may inspect sooner.

Bankwood Care Home provides personal and nursing care for up to 40 people. It is situated in the residential area of Duffield and the accommodation is arranged over four floors. There is a passenger lift to provide access to each floor. At the time of our inspection there were 38 people using the service.

There was a registered manager at the service. 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.

People felt safe at the service. Staff had a good understanding of how to recognise the signs of abuse and knew how to report it.

Risks relating to people's care were assessed and reviewed each month. Staff were familiar with risks associated with people‘s care but records did not always show that control measures that had been put in place to minimise risks to people had been carried out.

People could be assured that safe recruitment practices were followed. There were sufficient staff to meet people's needs. Staff received training and supervision to support them to carry out their role.

The service followed the requirements of the Mental Capacity Act 2005 (MCA). The recording of consent and best interest decisions meant the service complied with the MCA Codes of Practice.

People enjoyed their food and were provide with a varied and balanced diet. People's health needs were met and they had access to external professionals as required.

Staff were kind and caring and understood people's needs. People were involved in decisions about their care. People's privacy and dignity was respected.

There were scheduled group activities that took place. The activities coordinator spent time getting to know people and arranged for activities and events specific to their interests to take place.

Complaints were investigated and responded to. There were monthly meetings held with people at the service to encourage them to provide feedback about the service.

Systems were in place to monitor and improve the quality of the service. Quality assurance questionnaires were sent out to people and their relatives. Audits in relation to the service and the care they provided were carried out and issues identified were acted upon.

People and their relatives spoke highly of the registered manager. Staff commented on how dedicated the registered manager was to her role and people at the service. Staff told us they enjoyed their roles and found the management approachable. Staff all shared the same vision for the service.

Is the service safe?

People told us that they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

We spoke with staff about Deprivation of Liberty Safeguards (DoLS). This applies to all care homes. The manager told us that there had been no applications and showed us the policy and procedures they followed. They told us that staff had received relevant training and had access to the policy and procedures. Staff told us that they had received this training.

One person told us, 'I am happy here. Everyone is very helpful. I can say the staff are very nice. I feel safe here'.

We saw that the service was safe, clean and hygienic. The home had an effective infection control system. Equipment was well maintained and serviced regularly, so preventing any unnecessary risks. Staff told us how they worked to prevent infection and told us how they would manage an outbreak at the home.

Is the service effective?

Comments from people included, 'I like it here. The staff are so good. When I first came here I couldn't do some things for myself. I can now do things again for myself, the staff have really helped'.

People explained how their care and welfare needs were met. People told us that they had support with health appointments and felt that the service was flexible. One person told us, 'If I am not feeling well the staff will call a doctor'.

Is the service caring?

We saw that staff communicated well with people and were able to explain things in a way that could be easily understood. We saw that they did not rush people in the home. Relatives we spoke with said they felt the care was very good. One relative told us, 'I have only excellent things to say about the home'.

People were treated with respect and dignity by the staff. We saw that people were given choice in their care and all the relatives we spoke to told us they were very happy with the care.

One relative told us, 'My dad is really content here. Everyone is so helpful'.

Is the service responsive?

The home had appointed two activities co-ordinators after people had requested more activities. People told us that they now have a range of activities, often helping them become involved in their community. They told us that they had been on trips and out to the local park. We saw the activities co-ordinator on the day of our inspection lead a therapy session with 10 people. A relative we spoke to at the session told us this helped her father with his social skills and his memory.

People we spoke with told us they were involved in decisions about their care.

We saw that there was a complaints policy at the home. People told us they found the manager very approachable and would not hesitate to raise any issues or complain.

Peoples care needs had been reviewed at least every six months. We saw that when people's requirements had changed the provider had responded and reviewed their care needs.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service well-led?

We found that there was an effective system to regularly assess the quality of service that people received. We found that the views and opinions of people using the service and their carers, family and relatives were also regularly recorded.

People, their relatives, friends and other professionals involved with the service had completed an annual satisfaction survey.

We saw the home had systems in place to make sure that managers and staff learnt from any accidents, complaints, whistleblowing or investigations. This reduces the risks to people and helped the service to continually improve.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality care service at all times.

People we spoke with were very happy with the care provided. Comments included 'It couldn't be any better', 'Excellent', 'I am very pleased with the food' and 'it's a very happy sort of place'. One relative we spoke with described it as a 'lovely care home' and that 'staff are really good'.

We saw that appropriate checks had been made to ensure that the premises were safe. A person who used the service told us 'they have improved the building quite a lot. It's very nice'.

Staff we spoke with told us that they felt supported. We found that the majority of staff were up to date with mandatory training. One person who used the service told us 'staff are very helpful and nice, they will do anything for you'.

The provider had a complaints system in place. There had been no formal complaints since our previous inspection. There were regular meetings with people who used the service and their relatives to gain feedback on the service provided.

We saw that accurate and appropriate records were maintained. We found that some records of care provided were kept where all people could have access to them. The provider assured us that these would be moved to ensure that all records were kept securely.

person said "I do what I want when I want". We found that people were receiving the care and treatment that they needed and that they enjoyed a good social life at the home.

The staff working at the home were recruited safely. The staff spoke positively about working at the home and were clear about the standards that were expected of them.

We found that the provider had systems in place to assess and monitor the standards at the home and action plans showed that they address items that came to their attention. Meetings had been held with the people who lived at the home and their relatives and they were asked for their opinion on the services they received.