This was an unannounced inspection which took place on 20 April 2016. The service was last inspected in April 2014 when it was found to be meeting all the regulations we reviewed.Higher Bank provides accommodation for up to 22 older people who require support with personal care. Accommodation is provided in 18 single bedrooms and two double rooms on two floors. The home is located in a residential area close to Blackburn town centre. There were 22 people living at the service at the time of our inspection.
The service had two registered managers in place. The position was shared between two members of the partnership which was also the provider of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
During this inspection we found a breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because not all people who worked in the service had received the training they required to be able to deliver safe and effective care. You can see what action we have told the provider to take at the back of the full version of the report.
People who used the service told us they felt safe in Higher Bank and that staff were always kind and caring. We found there were sufficient numbers of staff available to meet people’s needs. There was a stable staff team in the service with no new staff having been employed since 2012. However we found the recruitment policy needed to be more robust to help ensure people who used the service were protected from the risk of unsuitable staff being appointed in the future.
We saw that suitable arrangements were in place to help safeguard people from abuse. Guidance and training was provided for staff on identifying and responding to the signs and allegations of abuse.
All areas of the home were clean and we saw that procedures were in place to prevent and control the spread of infection. Risk assessments were in place for the safety of the premises and systems were in place to deal with any emergency that could affect the provision of care.
We saw that the equipment and services within the home were serviced and maintained in accordance with the manufacturers' instructions. This helped to ensure the safety and wellbeing of everybody living, working and visiting the home.
The staff we spoke with had a good understanding of the care and support that people required. We saw people looked well cared for and there was enough equipment available to promote people's safety, comfort and independence. Interactions between staff and the people who used the service were warm, friendly and relaxed.
Although there were systems in place to assess whether people had the capacity to consent to their care and treatment in Higher Bank, we found some of the records contained conflicting information. The registered managers told us that in their opinion all the people who used the service had the capacity to consent to their care in the home and there were no restrictions in place. However we found improvements needed to be made to the arrangements to assess whether DoLS applications needed to be made in order to protect the rights of people who used the service.
People's care records contained enough information to guide staff on the care and support required. Care records showed that risks to people's health and well-being had been identified and regularly reviewed.
People told us they enjoyed the meals provided in Higher Bank. Our observations during the inspection showed the food was of high quality and well presented. Systems were in place to help ensure people’s nutritional needs were monitored and referrals made to specialist services when any concerns were identified.
To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided. There were systems in place for receiving, handling and responding appropriately to complaints. The registered managers demonstrated a commitment to continuing to drive forward improvements in the service.