CQC report explained · a nursing home
What the CQC found at Bank House Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risks were not always fully assessed or acted on. Medicines were not always managed safely, although there were enough staff and the home was clean and tidy.
- Effective?
- Requires improvement
- The home did not always follow the Mental Capacity Act, and assessments did not always accurately reflect people's needs. Staff training and support with food, drink and healthcare were positive areas.
- Caring?
- Good
- This question was not inspected during this visit, so the report gives no current rating.
- Responsive?
- Good
- This question was not inspected during this visit, so the report gives no current rating.
- Well-led?
- Requires improvement
- Management systems and audits were not effective enough to identify concerns and drive improvement. Records were not always kept clearly, and people, relatives and staff had not been asked for their views about the service.
What inspectors found, February 2024
Rated Requires Improvement; inspectors found concerns about risk assessments, medicines, people's rights and the home's oversight.
This was an unannounced inspection on 20 December 2023. Inspectors spoke with six people, staff and the registered manager, observed care, and checked care records, medicines records, staff files and management records.
The home was not always safe or effective. Risks were not fully assessed, some care plans conflicted, and medicines were not always given or recorded safely. The home had also not applied for Deprivation of Liberty Safeguards for everyone who needed them.
There were enough staff, staff had suitable training, the home was clean and people were supported with food, drink and healthcare. However, audits and records did not reliably identify problems or make sure they were fixed.
The overall rating changed from Good at the last inspection in 2018 to Requires Improvement. The inspection focused on Safe and Well-led, and was widened to include Effective after concerns about the Mental Capacity Act were found.
Clean home
The home was clean and tidy, and staff followed infection prevention and control practices.
“People were protected from the risk of infection as staff were following safe infection prevention and control practices.” from the report
Food and healthcare
People were supported to eat and drink enough, and the home involved healthcare professionals when needed.
“People were supported to eat and drink enough to maintain a balanced diet.” from the report
Learning from incidents
The registered manager reviewed incidents and made referrals or changes when needed to help keep people safe.
“The registered manager reviewed all the incidents to see if change in people's care could keep them safe.” from the report
Approachable staff
People and staff described the registered manager and staff as kind, supportive and approachable.
“People living at the home and relatives told us that the registered manager and staff were kind and approachable, and the service was well managed.” from the report
Risks not fully assessed
seriousCare plans did not always identify people's needs, equipment or risks. Some risk assessments conflicted, and raised flooring created a trip hazard.
“Some risk assessments contained conflicting information, meaning staff could not be sure of the safest way to keep people safe.” from the report
Medicines not always safe
seriousSome medicines were given at the wrong time, as-needed medicines were not always properly recorded, and staff had not always checked that crushed medicines were suitable to mix with food.
“People were supported to receive their medicines in a way that was not always safe.” from the report
People's rights
seriousThe home had not applied for DoLS for everyone who needed them. Staff did not always fully consider whether people with cognitive impairment could make their own decisions.
“The registered manager had not fully understood the requirements of the MCA and had not applied for DoLS for everyone that needed them.” from the report
Weak oversight and records
seriousAudits did not consistently lead to action, and care records included unclear changes, duplicated assessments and notes that were not dated.
“The providers audits had not been effective in driving improvements in the home.” from the report
Environment needs repair
needs fixingSome wallpaper was damaged or peeling, and some flooring was raised. The registered manager said action had been taken after the inspection.
“There were a number of areas where wallpaper was either damaged or peeling and therefore needs attention.” from the report
New staff safeguarding training delayed
needs fixingNew staff did not always receive safeguarding training promptly during induction.
“However, this had not been prioritised for new staff, so there was a delay in them getting information on how to recognise concerns and raise them” from the report
- 01What changes have been made to ensure every person's risks, pressure-area needs, nutrition risks and equipment are correctly recorded and reviewed?
- 02How are medicines now checked, including medicines given before food, as-needed medicines, and medicines crushed or mixed with food?
- 03Which people now have DoLS applications or other lawful arrangements in place, and how are best-interest decisions recorded?
- 04What actions were included in the provider's improvement plan, and how is progress being checked?
- 05How are people, relatives and staff now asked for their views about the care and improvements at the home?
This was a focused inspection of Safe and Well-led, widened to include Effective; Caring and Responsive were not inspected and their ratings were not given in this report. This explanation was written from the published report of 29 February 2024 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, June 2018
Rated Good; inspectors found safe, kind and personalised care, with medicines management improved since the previous inspection.
This was an unannounced inspection. Inspectors observed care, spoke with six people living at the home, seven visitors and staff, and checked care plans, medicines records, recruitment files and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe care, kind treatment, personalised support, activities and effective oversight.
At the previous inspection, medicines were not managed safely and the home breached the regulations. This inspection found that medicines were stored and given safely, records were accurate, and the breach had been resolved.
Medicines improved
The home had corrected the medicines problems found at the previous inspection. Inspectors found accurate records and safe ordering, administration and disposal.
“At this inspection we found that medicines were stored and administered safely.” from the report
Kind, personal care
Staff knew people's histories, preferences and families. They offered choices, respected decisions and supported privacy, dignity and independence.
“Staff were kind and caring and knew people's background, relatives and their likes and dislikes.” from the report
Good food and drink support
People had choices, could personalise meals and were encouraged to drink enough. Modified texture food and specialist advice were provided when needed.
“People were offered a choice of food and the meal was personalised to their individual likes.” from the report
Effective management
The registered manager and provider used audits, staff meetings and feedback to monitor care and make changes when needed.
“Audits to monitor the quality of care were effective in driving improvements.” from the report
When-needed medicines
needs fixingInspectors said staff might not give some medicines prescribed for use when needed in a consistent way. Care plans did not explain clearly enough how decisions should be made.
“When people had been prescribed medicines to be given on a 'when required' basis they may not be given these medicines in a consistent way by the care staff.” from the report
Medicines hidden in food
needs fixingThere was little information in some care plans about how medicines hidden in food should be given, although inspectors observed that this was done safely.
“Similarly, when people were given medicines hidden in food there was little information in their care plans describing how this was to be done.” from the report
Medicines trolley temperature
needs fixingThe temperature where the medicines trolley was kept was not monitored. Inspectors therefore could not be sure that all medicines were stored at the correct temperature.
“But the temperature was not being monitored where the drug trolley was kept so we couldn't be sure that all medicines were being stored at the right temperature.” from the report
Window safety
needs fixingInspectors found no window restrictors during the visit. The registered manager said they would be fitted immediately and later confirmed that this had been done.
“We found that there were no window restrictors in place.” from the report
- 01How are medicines prescribed for use when needed now explained in each person's care plan and given consistently?
- 02How are medicines hidden in food authorised, recorded and explained to staff?
- 03How often is the medicines trolley temperature checked, and what happens if it is outside the safe range?
- 04Have window restrictors now been fitted throughout the home, and how are they checked?
- 05What changes were made after the previous inspection's medicines breach, and how are these changes audited?
This was an unannounced inspection covering all five key questions, with the report giving the inspection date as 23 February 2018 in the main text but 21 February 2018 in the header. This explanation was written from the published report of 5 June 2018 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 Residential Care Home
4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- February 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Bank House Residential Care Home →
- June 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
Read what inspectors found at Bank House Residential Care Home →
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvement
- March 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2016
Registered with the Care Quality Commission on 19 April 2016.
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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9 live-in carers within about an hour of Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.