Benoni Nursing Home Limited

Updated 15 October 2019

The inspection:

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

Inspection team:

This inspection was carried out by one inspector, a specialist advisor 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:

Benoni is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: This inspection was unannounced.

What we did before the inspection:

We reviewed information we had received about the service since the last 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. We reviewed the monthly reports sent to us under the requirement of the condition placed upon the registration of Benoni following the last inspection. We also reviewed the last inspection report, information we had received from other agencies and feedback we had received from other interested parties. We used all of this information to plan our inspection.

During the inspection:

We spoke with six people who used the service, four relatives, six staff members, the administrator, the registered manager and the provider. We reviewed the care records for three people and medication records for all the people who used the service. We reviewed records of accidents, incidents, staff recruitment, training and support as well as audits and quality assurance reports. Some people were not able to tell us verbally about their experience of living at Benoni. Therefore, we observed the interactions between people and the staff supporting them. 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.

After the inspection we looked at staff training data and spoke with two relatives.

Updated 15 October 2019

About the service:

Benoni provides accommodation with nursing and personal care for up 25 people. There were 22 predominantly older people using the service at the time of our inspection.

People’s experience of using this service and what we found:

Medicine systems and processes were in place. People received their medicines safely and as prescribed.

People were provided with the equipment they had been assessed as needing to meet their needs. For example, pressure relieving mattresses. These were correctly set for the person using them.

Staff were recruited safely in sufficient numbers to ensure people’s needs were met. Two nurses were on duty each day supported by six care workers. One nurse and two care workers were on duty at night.

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. Any restrictive practices were regularly reviewed to ensure they remained the least restrictive option and were proportionate and necessary.

There were systems and processes in place to monitor the Mental Capacity Act, and associated Deprivation of Liberty Safeguards assessments and records.

People told us, “Staff are good at what they do, they encourage you to get well and are proactive on your behalf with health care professionals,” “There is nowhere better. I feel comfortable and peaceful and that’s what I want” and “The staff are very caring”.

Relatives told us, “I can’t fault the place. They provide good care for [Person’s name] and they do a good job. I visit most weeks and they are always very chatty and offer me tea and even a meal if I want it,” and “I give the home ‘full marks’. The staff are very good, I visit twice a week and as a family we are very pleased Mum is getting the care she needs”.

Staff had received appropriate training and support to enable them to carry out their roles safely.

The food provided by the service was enjoyed by people. However, meals were not a social event. People were provided with their drinks and food at the seat in which they sat for most of the day. We have made a recommendation about this in the Effective section of this report.

There were activities provided for people. People’s views on activities were mixed. Activities were not always relevant and meaningful to all the people living at the service. We have made a recommendation about this in the Responsive section of this report.

People received care and support that was individual to their needs and wishes. Care plans were regularly reviewed and updated and were an accurate reflection of people’s needs and wishes.

Risk assessments provided staff with sufficient guidance and direction to provide person-centred care and support.

Audits were carried out regularly to monitor the service provided. Actions from these audits were being acted upon to further improve the service.

We observed many kind and caring interactions between staff and people. Staff spent time chatting with people as they moved around the service.

A complaints process and procedure was available to people. The manager told us there were no on-going complaints at the time of this inspection.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.

Rating at last inspection and update:

At the last inspection the service was rated as requires improvement (report published 3 October 2018) and we issued requirement notices and imposed a condition on the providers registration of the service which required the service to report to CQC each month on areas of concern identified at that inspection. The provider completed an action plan after the last inspection 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 regulation. Conditions applied after the previous inspection in October 2018 were met.

Why we inspected: This inspection was carried out to ensure improvements required at the last inspection had been made.

Follow up: We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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