Bunkers Hill Care Home

Updated 24 June 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors 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.

Service and service type

Bunkers Hill Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Bunkers Hill Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent to us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvement they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with six people who use the service and seven relatives to ask about their experience of the care provided. We observed staff interaction with people who use the service, this included a 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.

We also spoke with the registered manager, the operations manager, the training coordinator, the head housekeeper, two domestics, two senior care workers, a nursing assistant, four care workers, the cook, an activities coordinator and two visiting professionals. We looked at eight care files along with a range of medication administration records. We looked at other records relating to the management of the service including staff recruitment and audits.

After the inspection

We continued to seek clarification from the provider to validate evidence found. This included training data, quality assurance records and policies. We also contacted further external professionals and received feedback from the GP.

Updated 24 June 2022

About the service

Bunkers Hill care Home, is a nursing home providing accommodation and personal care for up to 78 older people, including people living with dementia and people with nursing care needs. At the time of our inspection, there were 69 people living at the service.

People's experience of using this service and what we found

Staff deployment did not consistently meet people’s individual needs. People told us they often had to wait for assistance and one unit did not have sufficient staff. The provider was in the process of completing a new dependency tool, but increased staffing levels and reviewed staff deployment immediately.

We found some equipment used by three people were not fully working. These items were replaced by the provider with immediate effect. We found medicines management expected best practice guidance was not consistently followed. This had not impacted on people’s safety and the provider had a monthly medicines audit that showed shortfalls and actions were taken when required.

Staff were aware of their role and responsibilities to protect people from abuse and avoidable harm. However, they had not always followed the provider’s safeguarding policies. Action by the management team was taken to address this.

Risks associated with people’s needs had on the whole been assessed and action had been taken to mitigate risks. The provider’s audits and checks had identified care plans and risk assessments needed reviewing to ensure they were sufficiently detailed, and action was being taken to address this.

Infection prevention and control measures were in place to reduce risks and the service was found to be clean and hygienic.

Staff had been safely recruited and received ongoing training and support. Training needs were regularly reviewed, and gaps were discussed with staff and additional training planned. People felt staff were competent and understood their individual needs.

The providers policies and procedures reflected best practice guidance and recognised assessment tools were used. People confirmed they were supported effectively with their health conditions and accessed external health care services. Recommendations made by external health care professionals were implemented.

People were happy with the quality and choice of meals. Staff knew people’s dietary needs and preferences.

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

People were positive about the approach of staff and found them to be caring and kind, and independence was promoted, and overall dignity respected. People and or their relatives and advocates were involved in discussions about how care was provided. People’s end of life care wishes had been discussed and planned with them.

People and visitors had access to the provider’s complaint procedure and complaints had been fully investigated and action taken to make improvements where required.

People’s social history, cultural and spiritual needs, interests, hobbies, and pastimes had been discussed and recorded. People received opportunities to share their experience of the service.

A new governance framework had recently been introduced. The provider and registered manager understood and met their registration regulatory requirements.

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

Rating at last inspection

The last rating for the service was good (published 5 June 2019). Since then the provider has changed its legal entity.

Why we inspected

This inspection was completed due to the provider’s registration history.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bunkers Hill Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.