CQC report explained · a nursing home
What the CQC found at Banksfield Nursing 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
- Inspectors found medicines were not always recorded, stored or managed safely. Risk assessments, safeguarding, recruitment and infection control were otherwise described positively, although some feedback suggested people sometimes waited too long for the call bell to be answered.
- Effective?
- Good
- Staff supported people's health needs, made referrals to other professionals and had completed relevant training. People received support with eating and drinking, and improvements had been made to oral care.
- Caring?
- Good
- People and relatives said staff were kind, caring and respectful. Inspectors saw people being offered choices and involved in decisions about their care.
- Responsive?
- Good
- Care was personalised and communication needs were assessed. People had access to activities, including one-to-one activities for those at risk of social isolation, and complaints were managed.
- Well-led?
- Requires improvement
- The home had made improvements and gathered feedback, but medicines audits and action plans were not robust enough. The provider remained in breach because oversight had not reliably identified or fixed the medicines problems.
What inspectors found, December 2022
Banksfield Nursing Home is rated Requires Improvement; inspectors found unsafe medicines systems that could put people at risk of harm.
This was an unannounced follow-up inspection on 2 November 2022. Inspectors spoke with people living at the home, relatives and staff. They reviewed medicines, care records, incidents, recruitment, training and quality checks.
The main problem was medicines management. Records about thickened drinks, medicine quantities, prescribed medicines and skin treatments were not always correct or complete. Some medicines were not stored safely. The inspectors said this could put people at risk of choking, missed medicines or other harm.
Care was rated Good in the Effective, Caring and Responsive areas. People were treated kindly, their health needs were supported, and activities and complaints processes were in place. Safe and Well-led were rated Requires Improvement because medicines systems and the checks on them were still not reliable.
The home had improved oral care and its current call bell system was working, although a new system was still being considered. The provider remained in breach of Regulations 12 and 17 from the previous inspection.
Kind and respectful staff
People and relatives were very positive about the staff. Inspectors found that people's privacy, dignity, independence and different needs were respected.
“Staff treated people with respect and were kind and caring towards them.” from the report
Health support
Staff made appropriate referrals and worked with health professionals. People and relatives told inspectors that health had improved while at the home.
“Staff worked effectively with healthcare professionals to ensure people's healthcare needs were met.” from the report
Personalised activities
The home supported people to take part in activities and included people who stayed in their rooms or were at risk of social isolation.
“People who were at risk of becoming socially isolated told us they had been fully included in the activities available on a one to one in their own rooms.” from the report
Improved oral care
The provider had acted on the previous recommendation about oral hygiene assessments and equipment for oral care.
“At this inspection we found the provider had acted on improving oral care assessments and providing the necessary equipment to complete oral care.” from the report
Unsafe medicines management
seriousMedicine records were incomplete or inaccurate in several areas. Thickened drinks were not always prepared correctly, medicine quantities did not always match records, and some medicines were not stored safely.
“Systems had not been established sufficiently to ensure using medicines in the home was done safely. This placed people at risk of harm.” from the report
Weak medicines oversight
seriousAudits did not identify the problems found by inspectors. Action plans did not always show whether improvements had been completed.
“However, we found those related to the management of medicines were not robust.” from the report
Possible staffing pressure
needs fixingAlthough staffing was assessed against people's needs, some people and relatives said staff appeared under pressure and call bells were sometimes not answered quickly.
“Sometimes I have to wait a long time for my buzzer to be answered” from the report
Call bell replacement not complete
minorThe existing call bell system was working, but the provider was still identifying the most suitable new system.
“The provider was also in the process of identifying the most appropriate new system to install.” from the report
- 01What has changed since the inspection to make sure all medicines are recorded, stored and administered safely?
- 02How do you now check that thickened drinks are prepared correctly for people who have difficulty swallowing?
- 03How are topical treatments and 'when required' medicines recorded and checked?
- 04What conditions has the CQC placed on the location registration, and how are you meeting them?
- 05Have staffing levels and response times to call bells improved, and how do you monitor this?
This was an unannounced follow-up inspection covering all five key questions, with infection prevention and control also reviewed under Safe. This explanation was written from the published report of 14 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.
What inspectors found, December 2022
Rated Requires Improvement; inspectors found kind and responsive care, but medicines safety and management oversight still put people at risk.
This was an unannounced follow-up inspection on 27 July 2022. Inspectors spoke with people, relatives and staff, reviewed care and medicines records, and checked accident, recruitment, training and quality records.
The home had improved since its previous inspection, which was rated Inadequate. Caring and responsive care were rated Good. People were treated with kindness and dignity, and their care was generally personalised. Food, drinks, healthcare support, staffing and infection control had also improved.
Important problems remained. Medicines were not always given or recorded safely. Some audits and action plans did not show that risks had been dealt with. Inspectors also had concerns about call bells and consistent oral care.
The home was still in breach of Regulations 12 and 17. It had improved enough to no longer be rated Inadequate or be in special measures, but further improvement was required.
Kind and respectful staff
People and relatives gave mostly positive feedback about staff. Inspectors saw kind interactions and found that privacy and dignity were respected.
“People and their relatives told us staff were caring and respectful.” from the report
Improved personalised care
Care records generally guided staff on people's needs, and actions were taken when needs changed. Communication about people's needs had improved.
“People's care appeared to be more personalised.” from the report
Better nutrition support
People were supported with meals, drinks and snacks. Staff worked with healthcare professionals to record and meet nutritional needs.
“We observed people being supported with their meals, the atmosphere was pleasant, unrushed and food was presented in an appetising manner.” from the report
Improved staffing and culture
Staffing arrangements had improved, agency use had fallen and care was more consistent. Staff morale and confidence in the new management had also improved.
“There was an ongoing drive to recruit more permanent staff and the use of agency staff had significantly been reduced.” from the report
Improved infection control
Inspectors were assured that the home had suitable systems for preventing and managing infections, including the safe use of protective equipment.
“At this inspection enough improvement had been made to the infection prevention and control systems and the environment and the provider was no longer in breach.” from the report
Medicines were not always safe
seriousThere were gaps in medicines administration records, creams and patches were not always recorded or used safely, and one person went six days without a medicine because it was unavailable.
“Three out of the seven people had some gaps on their Medicines Administration Records so we could not be certain that their medicines had been given safely.” from the report
Quality checks did not identify or resolve all risks
seriousSome audits were incomplete or not robust. Action plans did not always show that problems had been dealt with, particularly in medicines management.
“The monitoring of the quality and safety of the service provided failed to mitigate all the risks relating to the safety and welfare of people who lived at the home.” from the report
Call bell reliability
needs fixingSome call bells were not easy to reach and records suggested a possible risk of system failure. Two people were reported to have waited a while for their call bells to be answered.
“The call bell system service record showed some potential risk of failure and not all call bells were easily accessible.” from the report
Oral care was inconsistent
needs fixingOral hygiene needs were not consistently assessed, so inspectors could not be sure everyone received the right level of support.
“People's oral hygiene needs were not consistently assessed, and we could not be fully assured people were always receiving the right level of support with their oral health needs.” from the report
Activities did not meet every need
minorThe home offered activities, but the range needed further development. One person who was cared for in bed rarely received one-to-one activity time.
“Further work was needed to develop the range of activities for people's differing needs.” from the report
- 01What has changed since the inspection to prevent gaps in medicines administration records and missed doses?
- 02How do you now check medicine fridge temperatures, medicine patches and topical creams?
- 03How do you test the call bell system and make sure every call bell is within reach?
- 04How do you record and check that each person's oral hygiene assessment and daily oral care are completed?
- 05How are incomplete audits and action plans reviewed to make sure identified risks have been dealt with?
This was an unannounced follow-up inspection after the previous Inadequate rating, covering all five key questions and infection prevention and control. This explanation was written from the published report of 9 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 Banksfield Nursing Home
7 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- December 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2022Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2022Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- March 2021Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- June 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 8 February 2011.
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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Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
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