Bankfield House Care Home

On this page

• 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

People did not always receive person centred care. People were not always receiving care that met their needs and was in line with their preferences. People’s care plans were not always up to date with the most relevant information. It was not clear who had been involved with the planning, managing and making decisions around people’s care, including care and support at the end of their lives. We identified a breach of regulation in relation to the provision of person-centred care.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We were not assured people were receiving person-centred care at Bankfield House. Staff did not have access to detailed information about people’s individual needs relating to their emotional, spiritual and social needs and preferences as this information was not included in care documentation.

One staff member told us they had been told by the management team to read people’s care plans when they started to work at Bankfield House so they could get to know the person before delivering care. However, the care plans we reviewed did not include detailed information about people’s individual preferences and how they would like their care and support delivered.

We observed some staff knew people well, however, we also found some staff were not aware of people’s preferences. We observed staff did not always know how people liked their drinks and food. One person was served their drinks in a spouted beaker; however, there was no information throughout their care plan that they preferred, or required, their drinks to be served in a spouted beaker. Our review of care plans demonstrated a lack of information about the person, their life and what was important to them. We observed the hand held devices used by staff throughout the day only contained basic needs and task information for staff to follow.

People’s care was not always delivered in a way that met their assessed needs. For example, a person who was considered to be at high risk of pressure damage to their skin, and had previously had an area of sore skin, was not being repositioned according to their care needs and they were not using a pressure cushion to protect their skin from the risk of damage. People mostly received care from a regular staff team.

We saw from the supplied training matrix that most staff had received training in specific conditions that may affect people at the home, such as, dementia care and diabetes awareness. Staff told us care had improved recently with the new staff team. One person told us, “Care is fine at the minute, it was awful before. It is getting better.”

Feedback from one visiting professional told us that they previously had concerns about how the service worked with them and cared for people. However, they told us improvements had been noted recently since the new management team were in post.

Care documentation was not always accurate and reflective of people’s current needs. The language used in care plans was not always appropriate to describe the person and their needs, for example, one person who often became distressed due to their condition was described as “may be confrontational and rude.” We found there was no meaningful audit of the person’s care and whether the care plan was appropriate for their needs. We found daily note recordings about people were sparse, generic and not person-centred.

We found paper files containing personal and medical information was kept in the senior’s office on a main thoroughfare and we found the door to this wedged open throughout our 3 days of site visits. This meant people’s information could be accessible and not always kept confidential. We requested a copy of the home’s service user guide and this was sent over to us; however, this consisted of a one page template and did not contain any detailed information for people about the service or what they could expect from living at Bankfield House.

The home manager was not aware of the legal requirement to provide information under the Accessible Information Standard (AIS). The AIS is a law which aims to make sure people with a disability or sensory loss are given information they can understand, and the communication support they need. We did not see any information was provided to people at the home in alternative formats.

The home manager told us staff had received online training in communication with people; however, this specific training was not recorded on the training matrix. The home manager told us they were just starting to develop a newsletter to give to people and their families along with other ways of providing information; however, they were not yet in place. Records did not demonstrate how people were involved in the home and how information was provided to them or their families.

There was no regular survey conducted with people and their families that ensured and enabled all people living at the home to contribute to giving feedback and having meaningful input into how the service was run. Only one person we spoke with told us they had completed a survey, they told us, “I didn’t complain about much but I would like it better if they [staff] came quicker in a morning and when I need the toilet.”

The home manager told us they used feedback from the complaint and compliments folder as an avenue for information. They told us they spoke with families when they started their employment at Bankfield House. However, complaints documentation and we did not find evidence of good communication with people at the home.

At the time of our site visits, systems and processes were not in place to seek meaningful feedback from people, their relatives and staff. We found the home manager had responded to our requests for service user feedback by sending out surveys after our site visits. The information sent to us after the site visits told us that feedback given by people and visitors at the home was all positive. There was a lack of evidence that a consistent approach was taken to involving people in their individual care and within the service more widely. We found where people had communication care plans in place, these were generic and not person-centred.

People did not raise any concerns with us about accessing care and support when they needed it. However, we found people did not always experience timely access to health professionals. We found people were not always supported to access additional health services when required. For example, we found staff had not been proactive in ensuring a person received input from a dietician when they were losing weight.

The home manager told us they were not aware of anyone in the home who had faced discrimination either within the service or when trying to access other services or the community.

We did not receive feedback form partners in this area.

There was no formal, robust escalation process in place to ensure that people accessed additional care and support services when this was needed. We found one person stayed in their room and did not access the communal areas. The person told us this was due to them disliking the moving and handling process, they told us, “I stay in my room because I don’t like being moved on the hoist.” This meant the person was disadvantaged due to their disability and did not have equitable access.

People did not raise any concerns with us about discrimination either within or outside of the home. We did not see that any 1-2-1 activities were provided for people who did not access communal areas because they were cared for in bed or they chose to stay in their room.

The home manager provided us with an equality and diversity policy and procedure; however, this only addressed employees and did not apply to people living at Bankfield House.

People’s care records did not always demonstrate attempts had been made to actively engage with people to ensure their needs and preferences could be met whilst addressing any protected characteristics. Most staff had received training in equality, diversity and human rights.

There was no-one at the service experiencing end of life care at the time of our inspection. We found people were not always consulted on their preferences and routines on general day to day living at the home. Therefore, we were not assured that people would receive person-centred and individualised care at the end of their life.

The home manager told us that received training on end of life care. We were sent a copy of the home’s end of life care planning policy and procedure.

The registered manager told us they would discuss end of life planning with families and people would have an end of life care plan in place. However, in the care plans we reviewed, we only found generic care plans and none of them had been personalised to reflect people’s individual preferences and wishes. The home manager confirmed that end of life plans and advanced care plans were not yet in place at the home.