Bunkers Hill Care Home

Bunkers Hill care Home, is a nursing home providing accommodation and personal care for up to 78 older people, including people living with dementia and people with nursing care needs. At the time of our inspection, there were 69 people living at the service.

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

Staff deployment did not consistently meet people’s individual needs. People told us they often had to wait for assistance and one unit did not have sufficient staff. The provider was in the process of completing a new dependency tool, but increased staffing levels and reviewed staff deployment immediately.

We found some equipment used by three people were not fully working. These items were replaced by the provider with immediate effect. We found medicines management expected best practice guidance was not consistently followed. This had not impacted on people’s safety and the provider had a monthly medicines audit that showed shortfalls and actions were taken when required.

Staff were aware of their role and responsibilities to protect people from abuse and avoidable harm. However, they had not always followed the provider’s safeguarding policies. Action by the management team was taken to address this.

Risks associated with people’s needs had on the whole been assessed and action had been taken to mitigate risks. The provider’s audits and checks had identified care plans and risk assessments needed reviewing to ensure they were sufficiently detailed, and action was being taken to address this.

Infection prevention and control measures were in place to reduce risks and the service was found to be clean and hygienic.

Staff had been safely recruited and received ongoing training and support. Training needs were regularly reviewed, and gaps were discussed with staff and additional training planned. People felt staff were competent and understood their individual needs.

The providers policies and procedures reflected best practice guidance and recognised assessment tools were used. People confirmed they were supported effectively with their health conditions and accessed external health care services. Recommendations made by external health care professionals were implemented.

People were happy with the quality and choice of meals. Staff knew people’s dietary needs and preferences.

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.

People were positive about the approach of staff and found them to be caring and kind, and independence was promoted, and overall dignity respected. People and or their relatives and advocates were involved in discussions about how care was provided. People’s end of life care wishes had been discussed and planned with them.

People and visitors had access to the provider’s complaint procedure and complaints had been fully investigated and action taken to make improvements where required.

People’s social history, cultural and spiritual needs, interests, hobbies, and pastimes had been discussed and recorded. People received opportunities to share their experience of the service.

A new governance framework had recently been introduced. The provider and registered manager understood and met their registration regulatory requirements.

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

Rating at last inspection

The last rating for the service was good (published 5 June 2019). Since then the provider has changed its legal entity.

Why we inspected

This inspection was completed due to the provider’s registration history.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Visiting procedures were robust to reduce the risk of COVID -19 to people living at the service. All visitors were required to have a negative COVID-19 test, their temperature taken and wear personal protective equipment (PPE) before entering. In additional, professional visitors were required to show their COVID-19 vaccination passport before being allowed in the service. The provider was also adhering to the governments latest visiting guidance to enable people to receive visitors.

Staff and people using the service were participating in the COVID-19 testing and vaccination programme. Systems and processes were in place to monitor this. A risk assessment for staff identified as being at increased risk to COVID-19 had received a risk assessment.

Staff had received refresher training in infection prevention and control best practice guidance. Information and ongoing government guidance in the management of COVID-19 was shared with staff.

A COVID-19 care plan and risk assessment had been completed for people living at the service. This provided staff with guidance about how to safely meet people's individual needs.

The service was clean and hygienic and infection prevention and control, best practice guidance was maintained. This included regular cleaning of high touch areas. Hygiene and cleanliness of the service was monitored daily.

Isolation, cohorting and zoning was used to manage the spread of infection. This meant people self-isolated in their bedrooms where necessary. We observed staff wearing the correct PPE throughout our inspection.