Archived: Benedict House Nursing Home

Updated 29 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 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 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. The inspection was also undertaken to check on concerns we had received in relation to safety.

This unannounced inspection was carried out on 20, 22 and 23 June 2016. The inspection team on the first day consisted of 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 service. One inspector returned to the home on the second and third day.

Before the inspection we looked at all the information we had about the service. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events which the service is required by law to send us. We spent time observing the care and support being delivered. We spoke with twelve people using the service, five visiting relatives, a visiting health care professional, five members of staff, the chef, the maintenance person, the homes administrator, the home manager and the registered provider. We looked at records relating to the management of the service including quality monitoring records, the care records of six people using the service, medicine’s records, staff training and supervision records and six staff members’ recruitment records.

We also contacted the local authority responsible for monitoring the quality of the service to seek their views. We used this information to help inform our inspection.

Updated 29 July 2016

Benedict House Nursing Home provides accommodation and nursing care for up to 41 older people. At the time of this inspection the home was providing care and support to 27 people.

This unannounced inspection was carried out on 20, 22 and 23 June 2016. At this inspection we found several breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities), Regulations 2014 in relation to safe care and treatment and person centred care and good governance. We found that action had not always been taken to support people where risks to them had been identified and that the provider's systems for monitoring the quality of the service were not operating effectively as we found some issues with care plans and risk assessments that the provider had not identified. We took action to impose urgent conditions on the provider. These required the provider to carry out a thorough and comprehensive review of all people using the services care plans and risk assessments to ensure they fully reflected people’s current needs and to undertake monthly audits of care plans and risk assessments and send the Care Quality Commission a report of any actions taken as a result of these audits each month.

We also found that staff were not always aware of people's care needs. Staff were not always following the guidance as recorded in some people's care files. Staff did not assess risks to people using the service in a timely way following falls. Some staff had not received the appropriate training to enable them to carry out their duties. Leadership within the home was inconsistent. There was a high turnover of managers and nursing staff at the home. You can see what action we told the provider to take at the back of the full version of the report.

The home did not have a registered manager in post. 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. A new home manager started work at the home in April 2016. They had begun the process of applying to the CQC to become the registered manager for the home.

At our last inspection of the service we found breaches of legal requirements relating to regulations 9 and 18 of the Health and Social care Act 2008 (Regulated Activities) Regulation 2014. These related to staff supervision and appraisals and a lack of activities for people using the service. At this inspection we found that the provider had addressed these breaches.

There were safeguarding adult’s procedures in place and staff had a clear understanding of these procedures. There was a whistle-blowing procedure available and staff said they would use it if they needed to. People’s medicines were managed appropriately and people received their medicines as prescribed by health care professionals. There were arrangements in place to deal with foreseeable emergencies. People had individual emergency evacuation plans which highlighted the level of support they would need to evacuate the building safely. Appropriate recruitment checks took place before staff started work.

Recruitment for nursing staff was on-going. The provider had yet to establish a full complement of qualified nursing staff to support people using the service with their health care needs. The provider had limited the numbers of people they would support at the home until the home had established a fully functional nursing team that would meet people’s health care needs.

Staff had completed an induction when they started work. The manager and staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation. People were receiving the food and fluids as recorded in their care plans. People had access to a GP and health and social care professionals when they needed them.

Staff spoke to and treated people in a respectful and dignified manner and people’s privacy was respected. People using the service and their relatives, where appropriate, had been consulted about their care and support needs. There was a range of activities available for people to enjoy. People and their relatives knew about the home’s complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

Staff said they enjoyed working at the home and received good support from the new manager. The provider took into account the views of people using the service and their relatives about the quality of care provided through relatives meetings and surveys. The manager used the feedback from the meetings to make improvements at the home. The manager carried out unannounced visits to the home to make sure people were receiving appropriate care and support.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we may take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.