CQC report explained · a nursing home
What the CQC found at Bank House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2023
Rated Inadequate and remains in special measures; inspectors found serious problems with safety, medicines, records and management.
The inspection was unannounced and took place on 27 June, 3 July and 10 July 2023. Inspectors spoke with people living at the home, relatives and staff. They reviewed medicines, care plans, health and safety, recruitment and management systems.
They found serious risks were not being managed properly. Medicines were not always given as prescribed. Fire safety, legionella controls, falls monitoring and support for people with swallowing difficulties needed improvement. Some care records were incomplete or contained conflicting information.
The home was also not meeting legal requirements for safeguarding, consent, governance and safe care. People and relatives often praised the staff and said they felt treated with dignity, but the inspection could not assure CQC that care was consistently safe, effective, caring or responsive.
The overall rating fell from Requires Improvement to Inadequate. Safe and Well-led were rated Inadequate, while Effective, Caring and Responsive were rated Requires Improvement. The home has remained in special measures since June 2022.
Staff recruitment
The provider completed checks before staff started work, including Disclosure and Barring Service checks and references.
“The provider carried out pre-employment checks to reduce the risk of unsuitable staff being employed.” from the report
People’s dignity and choice
People said staff asked permission before helping them and supported their choices about daily routines and independence.
“People told us they had choice and control over their daily routine.” from the report
Activities
The new activity worker had made a positive difference. People were offered group activities and individual activities in their rooms.
“Work was ongoing to help ensure people's social needs were met.” from the report
Working with health professionals
The home worked with health professionals involved in people’s care, including a weekly visit from a physician associate.
“A physician associate, linked to the local GP surgery, visited weekly to review people's clinical needs and help minimise hospital admissions.” from the report
Medicines
seriousMedicines were not always administered as prescribed. Records did not accurately match stocks, and staff were seen preparing medicines before administration.
“Medicines were not always administered as prescribed.” from the report
Health and safety risks
seriousFire safety and legionella risks were still not properly managed. Falls were not analysed well enough to reduce the risk of further incidents.
“There were shortfalls in the management of risk relating to fire safety and legionella.” from the report
Swallowing and choking support
seriousStaff did not always follow speech and language therapy guidance. Records did not confirm that thickener was given as prescribed.
“Staff did not always follow the speech and language therapist's guidance when supporting one person to eat.” from the report
Care records and consent
needs fixingCare plans lacked detail or contained conflicting information. Best-interest decisions did not fully show that the right people had been involved.
“Records did not fully evidence that certain decisions made in people's best interests had been assessed in line with the MCA and the appropriate individuals had been involved.” from the report
Management oversight
seriousThe home had no registered manager, and its audits and governance systems did not identify or correct repeated problems.
“An effective governance system was not in place.” from the report
Safeguarding
seriousSystems for reporting and responding to safeguarding concerns were not always followed, and some allegations were not notified to the correct agencies promptly.
“Allegations of abuse had not always been notified to the correct agencies including CQC in a timely manner.” from the report
- 01What has been completed to address the medicines problems, including inaccurate medicine records and medicines being prepared before administration?
- 02What immediate action has been taken on fire safety, legionella controls and the new falls monitoring process?
- 03How do you now make sure speech and language therapy guidance is included in care plans and followed at every meal and drink?
- 04When will a registered manager be in post, and how will you show that governance checks identify and correct problems?
- 05How are relatives now involved in best-interest decisions, care plan reviews and regular feedback meetings?
This was an unannounced inspection covering all five key questions, including medicines, care plans, health and safety, recruitment, infection control and management systems. This explanation was written from the published report of 29 September 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2022
Rated Requires Improvement and placed in special measures; inspectors found some safer care but serious weaknesses in leadership, care planning and activities.
This was an unannounced focused inspection on 1 November 2022, with inspection activity ending on 28 November 2022. Inspectors spoke with people living at the home, a visitor and staff. They checked medicines, care plans, health and safety, infection control and recruitment.
Some improvements had been made since the last inspection. People told inspectors they felt safe and well cared for. Hygiene, safeguarding, recruitment, medicines administration and healthcare support had improved. However, health and safety actions had not been completed quickly enough, and some medicine records and storage checks still needed attention.
The home remained Requires Improvement for Safe and Responsive, and was Inadequate for Well-led. Care plans did not properly describe people's needs and wishes. People also reported too few activities or opportunities for stimulation. The management systems were not yet strong or established enough to show sustained improvement.
The previous overall rating was Inadequate and the home was already in special measures. The overall rating has improved to Requires Improvement, but the home remains in special measures because an Inadequate rating was found in a key question over two consecutive comprehensive inspections.
People felt safe
Everyone inspectors spoke with said they felt safe. Staff were observed providing support in a dignified and safe way.
“All the people we spoke with said they felt safe here and the staff attended to their needs when they needed them to.” from the report
Improved hygiene
Inspectors found that hygiene standards had improved and were assured that infection risks were being managed.
“During this inspection we found hygiene standards had improved.” from the report
Better recruitment checks
The home had improved its recruitment oversight. Required information and checks were in place before new staff started.
“Management and oversight of recruitment processes had improved ensuring relevant information and checks were in place prior to new staff commencing employment.” from the report
Kind practical support
Inspectors saw staff supporting people safely and respectfully when using equipment and receiving personal care.
“We observed examples of good care being provided, for example when assisting someone to the bathroom or when hoisting someone from a chair.” from the report
Weak management systems
seriousAudits and checks were not fully embedded. The home could not yet show that improvements were sustained or that management responsibilities were clear.
“Formal audits and checks, in line with the provider policy, needed embedding to evidence effective and robust governance systems were in place to make the necessary improvements.” from the report
Health and safety actions delayed
seriousRequired actions from health and safety checks, including fire safety and legionella work, had not previously been dealt with promptly.
“The provider had failed to take timely action to address areas of health and safety, to ensure people were kept safe.” from the report
Care plans lacked detail
seriousCare plans did not fully describe people's needs, wishes or changing conditions. Some records were also not stored securely.
“Care plans were not sufficiently person centred and failed to capture people's assessed needs.” from the report
Too few activities
needs fixingPeople said they had little entertainment, stimulation or variety. Inspectors saw limited interaction between people and staff outside care tasks.
“People told us there were no activities or opportunities offering stimulation and variety to their day.” from the report
Medicine records and storage
needs fixingChecks did not include refused medicines, some storage temperatures were above 25°C, and records did not always show that prescribed creams had been applied.
“Room temperature checks, where medication was stored, needed monitoring as at times this exceeded 25°c, which may impact on the effectiveness of the medicine.” from the report
- 01What specific health and safety actions from the fire safety and legionella checks have now been completed?
- 02How are you making sure each person's care plan records their current needs, wishes and end-of-life preferences?
- 03What regular activities and social opportunities are now available, and how are residents involved in choosing them?
- 04How are medicine storage temperatures, refused medicines and topical cream applications recorded and checked?
- 05Who is responsible for each improvement, and how will you show that the changes have been sustained?
This was an unannounced focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings carried over. This explanation was written from the published report of 17 December 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Bank House Care Home
8 rated inspections over 7 years: the service has slipped, from Requires improvement to Inadequate.
- September 2023Inadequatecurrent ratingdown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2022Requires improvementup from InadequateSafe: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2022Inadequatedown from Requires improvementSafe: InadequateResponsive: Requires improvementWell-led: Inadequate
- June 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016Goodup from Requires improvementSafe: GoodEffective: GoodResponsive: GoodWell-led: Good
- May 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2015
Registered with the Care Quality Commission on 29 October 2015.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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