Archived: Bunkers Hill Care Home

Updated 5 June 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise included residential and dementia care.

Notice of inspection: The unannounced inspection was undertaken by three inspectors on 17 April 2019. On 18 April 2019 one inspector and an Expert by Experience concluded the inspection.

Service and service type: Bunkers Hill is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

What we did: Before the inspection we checked information, we held about the service. This included notifications the provider had sent us about events or incidents that occurred and which affected their service or the people who used it. We contacted the local authority’s adult safeguarding, commissioning and quality monitoring team to gain their views. And contacted Healthwatch England, the national consumer champion for health and social care, to ask if they had any information to share about the service. We used this information to help plan our inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

Some people who used the service were unable to tell us about their experiences. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

During the inspection, we spoke with 12 people living at the service and with seven relatives to ask about their experiences of the service. We spoke with the registered manager, residential manager, regional director, two nurses, a senior carer, chef, one activities co-ordinator, nine care staff, one housekeeping assistant and the maintenance person. We also gained the views of one visiting health care professional.

We reviewed a range of documentation including eight people’s care records, medicine administration records (MARs), quality monitoring checks and audits, policies and procedures and three staff recruitment, training, supervision and appraisal records. We also looked at the compliments and complaints received.

Updated 5 June 2019

About the service: Bunkers Hill Care Home is in the heart of the city of Lincoln. It provides personal and nursing care for up to 78 people. The home is divided into four separate units to enable more focused and personalised care for people. It provides services to people who have needs relating to dementia, mental health issues, older age, and physical disabilities.

People’s experience of using this service: People received safe care. Safeguarding policies and procedures were in place to protect people from harm and abuse. Management of people’s medicine was robust. Staff followed infection prevention and control practices. Staffing levels were monitored and there were enough skilled and experienced staff to meet people’s needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Staff received appropriate induction, training, and support and applied learning effectively in line with best practice. This led to good outcomes for people and supported a good quality of life.

Where risks to people’s wellbeing had been found detailed person-centred care plans and risk assessments were in place to inform the staff about the care people needed to receive.

People had their capacity assessed and were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were caring and kind. People we spoke with and their relatives confirmed this. Staff provided comfort and support if people became anxious or upset. Information was provided to people in a format that met their needs in line with the Accessible Information Standards.

Staff supported people to meet their health and nutritional needs. People were supported and encouraged to maintain their independence. Staff worked with health care professionals to maintain people’s wellbeing.

People felt able to raise concerns and were confident they would

be addressed. There was a good programme of activities in place. Dignified end of life care was provided at the service.

The service was well-led. The registered manager supported the staff team and they all worked well together. A range of quality checks and audits were undertaken to monitor the service provided. Action plans were created when shortfalls were found and corrective action was undertaken to improve the service

Continuous improvement, learning and innovation had been implemented at the service. Community links were promoted. People and relatives had the opportunity to provide feedback about the service. Data security was maintained.

Rating at last inspection: At the last inspection the service was rated requires improvement with two breaches of regulation (report published on 18/04/18). Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor this service and inspect in line with our re-inspection schedule or sooner if we receive information of concern.