Bank House Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We found on-going concerns in relation to the safe management and administration of people’s prescribed medicines. These issues had been shared with the local authority safeguarding team and were currently under review. The manager had identified additional training and development was required for those staff responsible for people’s medication. The manager was also liaising with the supplying pharmacy and GP surgery to resolve some of the issues identified. Policies and procedures were in place with regards to safeguarding people from abuse. Relevant servicing and checks of the environment and equipment had been completed. Sufficient numbers of staff were available to support people’s needs. These were kept under review to ensure enough staff were provided to meet people’s changing needs.

This service scored 53 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People we spoke with felt staff had the knowledge and skills to support them in the manner they wanted and needed ensuring their needs were met. People and their relatives felt able to make requests / raise any issues with the manager and staff and were confident they would be listened to.

Outcomes following safeguarding reviews were shared with staff to assist learning and improve standards of care. This was done through supervisions, handovers and team meetings. The registered manager also reviewed any accident and incident reports which then identified any additional training needs for staff.

The registered manager was establishing a programme of staff training, supervision, and support so information and learning could be shared with the team. Learning lessons sheets were being introduced to record the outcome to any concerns and ‘what could be done differently’. Learning lessons sheets have been introduced which detail the outcome to any concern and ‘what could be done differently’. Where necessary, changes are made to the care plan or additional monitoring records completed. These are reviewed and audited by the manager to ensuring learning has been implemented. Daily walkaround completed including observations of staff, these too are recorded, any issues identified are addressed with the team through the systems above.

People told us if they were unwell staff would ensure the GP and other healthcare professionals would be called in to see them. People’s relatives said they were kept informed of people’s changing needs and any additional health care support required. One relative told us, "Communication with the care home is very good they will ring if there are any concerns or issues."

Staff were aware of how to respond to people's changing needs. One member of staff told us, "You can spot the signs when people are not well. That’s what is good about working consistently. We use the hospital passport, which is sent with people when they attend hospital."

Stakeholders and partners were involved with the care people received. This included during the initial assessment process, or if people needed to be referred to their service for additional support.

There was regular communication with GP surgery, with weekly visits made by the physician associate and GP to help monitor people’s needs. Senior staff supported all visits and reviews of people so that information discussed/shared can be included within the persons care records and action required responded to.

People told us they felt safe living at the home. One person said, “I feel very safe here, I am happy to be here, and all the girls are nice. The staff look after me well.” A relative added, "My mum seems very happy there. I feel she is very safe there and I am happy that she is there.”

All staff seemed happy at the service and talked about good teamwork and support from the registered manage through regular monthly supervision meetings. Staff understood about safeguarding and said they did not have any concerns about working at the home.

We observed staff attending to the needs of people and taking them to the bathroom when they needed support. Some people needed to be hoisted on and off chairs and this was done in a very caring, dignified, and safe way.

Safeguarding policies and procedures were in place and any concerns were reported to the local authority for further investigation. The registered manager was assisting the local authority with outstanding safeguarding enquiries. DoLS (Deprivation of Liberty Safeguards) applications were made as needed. Staff were completing training in safeguarding, DoLS and MCA (Mental Capacity Act) to enhance their knowledge and understanding.

People's consent was sought and their capacity assessed as necessary , for example regarding the use of bedrails and covert medicines etc. One person said, “I do everything for myself shower, dress etc I am very independent. I can walk to the shops etc I just tell them, and they know where I am going.” A relative added, - "We recently had a discussion about (person's) epilepsy and how to manage that.”

Staff understood how to manage risk. One member of staff said, "We have one lady who can’t walk so we stand her up with the help of her frame. We have good communication with the families." We discussed the risk management process with the registered manager. We were told where people are able to be involved they would do so. People’s relatives would also be spoken with to seek their views. Daily handovers were completed on each shift change and group/individual supervisions held to discuss any practice issues. For example: poor M&H practices were identified. This was addressed by manager and additional training provided

We saw relevant equipment in place to aid people’s mobility to ensure their safety. Items include wheelchairs, walking frames, sensor mats, pressure aids, call bells and profiling beds. A review of records showed relevant checks completed by the maintenance man. Whilst observing lunch we saw staff ask people their consent, involving people in making decisions about what they wanted and needed.

Electronic care planning systems were in place which contained risk assessments for each person. The record included a pre-assessment and care planning document which highlights any areas of risk. Information is sought from all parties – person, relative or appropriate appointee, social workers. All assessments were kept under review and updated where necessary. Any areas of learning were shared with the team in team meetings.

The people we spoke with during the inspection did not make any comments about the home environment.

We spoke with the maintenance person as part of the inspection. All maintenance checks were completed, although they were aware certain improvements also needed to be made around the building. These were reported to the provider as needed.

We saw improvements had been made to the home environment, for example to the lounge area which had been painted. There was a smell of urine in parts of the home, although this was addressed during the inspection.

We found all relevant safety checks of the environment had been completed and were up to date, although further work was required to enhance the standard of accommodation provided for people.

People told us there were enough staff to care for them safely. One person said, "The staff are really good they work really hard and it’s a big place to look after.” A relative also told us, “I do think there are enough staff around and they are very friendly and caring."

The feedback we received was that staffing levels at the home were sufficient. One member of staff said, "I feel we have enough staff most of the time unless someone phones in sick at the last minute. We use the occasional agency . Regular staff do extra shifts to cover for absence. They try and work it between themselves. When they arrive a couple of people are already up. Others need help getting up during the morning. At handover decide between themselves how the work will be allocated."

Staff appeared to know people well. People living at the home and their and family members were very complimentary about staff and felt there were generally enough staff around.

The provider ensured there were enough staff employed to care for people safely. Staffing rotas were in place. Everyone we spoke with said there were enough staff to deliver the care people needed. A dependency tool was also used to calculate staffing numbers. Staff were recruited safely, with all the necessary procedures followed including interviews, seeking references and carrying out DBS checks. Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

People told us they felt the home was clean and tidy. One relative said, “It’s always clean and tidy and you see the cleaner doing her job which is good.” A person living at the home also told us, “They wash our clothes and keep them clean.”

The registered manager was aware that a number of areas within the home need attention and redecoration including new flooring and furnishings etc. These had been incorporated in the homes improvement plan. The local infection control team from Bury Council had visited the home in February 2024 and identified areas for improvement. Further spot checks were planned to check progress was being made in these areas.

The home was tidy and noticeably cleaner and brighter in the large lounge/dining room. Housekeeping staff were on duty throughout the day and the home was free from malodors, apart from 1 identified area. This was being addressed. PPE was readily available and used by staff when completing tasks. We saw staff wearing gloves and aprons while assisting with food/care tasks, which they removed afterwards. People looked clean and well-cared for and were appropriately dressed.

There was a designated housekeeping and laundry staff in place. Infection control audits have been introduced and training provided by Bury Council.

People told us staff supported them to take their prescribed medicines. One person said, “The staff give me my medication when I need it and there is always staff around that you can call on.” A relative added, "She doesn't want to take her medication so now they put it in her food which I have agreed to.”

The registered manager and provider were both receptive to our feedback about the shortfalls regarding medication. During the inspection, they confirmed the actions they would take to address the concerns we identified. This included carrying out extra competency assessments, providing further training and seeking advice from the GP surgery.

At this inspection, we continued to identify concerns in relation the safe management of people's medication. This included poor practice regarding storage, records, stock levels, PRN (when required) protocols, time sensitive medication and covert medicines. This meant there was a continued breach of regulation 12 (Safe Care and Treatment).