This was an announced inspection, which took place on 18 and 19 October 2016. The service was previously inspected in April 2013 when it was found to be meeting all the regulations we reviewed at that time except medicines management. We carried out a follow up visit to check that the service had made improvements to the medicines systems in January 2014 and found the service to be compliant.

Bankfield is a care home registered to provide accommodation and personal care for up to 47 elderly people. It is a large purpose built detached home situated in a residential area of Bury. It is close to public transport and is approximately three miles away from the centre of Bury. Forty two people were using the service at the time of our visit.

There was a registered manager in place at the time of the inspection. 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.

The registered manager was present during our inspection. The registered manager was said to be approachable, supportive and a visible leader who had over 30 years experience of working in health and social care. They had clear expectations of the standards that the service was to achieve in relation to individual personal care.

People we spoke with told us they felt safe at the service. There were systems in place to help ensure staff were supported to report any abuse they witnessed or suspected.

The provider carried out the required recruitment checks to ensure that staff were safe to work with vulnerable people. There were sufficient staff on duty to meet people’s needs.

There were procedures in place to ensure people received the appropriate support to manage their medicines. People were cared for in a safe and clean environment.

Care records we reviewed contained risk assessments and information for staff to follow in order to manage the identified risks.

Staff had an understanding of how to keep people safe and protect their rights should they be unable to consent to the care and support they required.

Staff spoke positively about working at the service. Staff told us that they worked well as a team which helped ensure people were not overlooked and individual needs were met.

People were supported to access the health services they needed. Staff monitored people’s nutritional needs and encouraged them to maintain a healthy diet.

We saw that six health and social care professionals had recently completed a quality monitoring review for professional visitors. They had rated the home as excellent and good. Comments included, “ A wonderful home lead by an excellent manager which then cascades through the care home to staff members. Well done to all” and “Staff are professional at all times and are approachable.”

The atmosphere at the service was friendly, calm and relaxed and people appeared well dressed and cared for. People we spoke with spoke positively about the service and the staff. They said, “I’m glad to be here, in the company, I suffered awfully at home,” “They’ve been very nice, like an ordinary home,” “They’re very kind” and “They’re fantastic here everything is good.”

The involvement of family and friends in the service was actively encouraged. Where people lacked capacity and had no family or friends an independent mental capacity advocate was involved in overseeing their best interests.

We saw that the service had been involved in the NHS National Institute for Health Research Enabling Research In Care Homes (ENRICH) programme. This is a way to help find better ways of looking after people who use the service and improve their health care and quality of life.

The service had won an award for the development of an oral care pictorial recording tool, to hel

The purpose of this inspection was to investigate concerns that had been brought to our attention anonymously. The person made allegations that the night staff were required to get 15 or 16 people using the service up from their beds between the hours of 05:30 and 07:30. It was alleged that the people using the service had to be washed, dressed and sat at the dining table for breakfast, which was served at 08:00 hours. It was alleged that staff were also expected to make the beds of the 15 or 16 people and clean their commodes. The person who made the allegations sent us a copy of a list they were given that instructed them to get the 15 or 16 people out of bed.

We arrived at the home at 06:55 to undertake our inspection. We identified that the allegations did have some substance to them, in that the night staff were required to ensure some people were up and dressed before the day staff came on duty at 07:00 hours. We found however, that the provider was meeting the essential standards of quality and safety in relation to the care and welfare of people using the service.

During the last inspection visit of April 2013 we found that people were not fully protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to safely manage medicines within the home. We carried out this visit to see whether improvements had been made. During this visit we found that improvements had been made and the medication system was safe.

We spoke with two people using the service about their medicines. Neither were aware of what medicines they were prescribed, which meant that they were unable to talk to us about their medicines in a meaningful way. Neither person expressed any concerns about how their medicines were handled, however we did find that medicines, particularly creams and ointments were not always administered correctly.

People's care records contained enough information to show how they were to be supported and cared for and showed how their dignity and privacy were to be respected.

The handling of medicines was not as safe as it should have been. This could place people's safety, health and well being at risk.

People were cared for by a sufficient number of staff who were suitably trained. This helps ensure the safety and welfare of the people using the service.

The complaints procedure in place ensured people were given clear guidance on how to make a complaint.

The residents that we spoke to were very complimentary about the care they received. Residents told us that they felt the staff respected their privacy, their dignity and their right to make choices about how they spent their day.

Some of the comments were:

“I like it here”.

“They are so good”.

Relatives expressed their satisfaction with the care provided in the home.