Benjamin Lodge

We found the following examples of good practice.

Risks in relation to COVID-19 were assessed for staff and people. The service had a robust continuity plan for the event of a COVID-19 outbreak at the home.

Staff were vaccinated and took part in regular testing. They wore personal protective equipment in line with current guidance to minimise risk of infections potentially spreading.

Staff were confident and knowledgeable regarding infection prevention and control practices and staff competency checks had routinely been completed.

The provider took prompt action to address a small number of minor areas where aspects of policy or best practice were not being followed consistently, or where cleaning records were not completed fully.

The home is registered to provide care to a maximum of 17 people who require support with mental health needs. It is situated in a residential area of Cottingham, in the East Riding of Yorkshire, and is within walking distance of local amenities. 16 people were living at the home during this inspection.

The inspection took place on the 13 August 2018 and was unannounced. At our last comprehensive rated inspection in January and February 2016 we rated the service good. We then conducted a focussed inspection in April 2017, looking at the key questions 'Is the service safe?' and 'Is the service responsive?' only. This was because we had received concerns in relation to staffing levels and recruitment, and how the service was meeting the needs of people who use the service. We did not change the rating for the service at that inspection.

At this comprehensive inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a manager in post as required by the Care Quality Commission (CQC) as a condition of their registration. A registered manager is a person who has registered with the CQC 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 the inspection we found the registered manager to be open, transparent and receptive to the feedback provided.

Notifications relating to potential safeguarding incidents had not always been made to the CQC as required by law.

Systems were in place to safeguard people from abuse as staff were trained to understand the signs of abuse and take action if they had concerns. Care plans and risk assessments were in place. People's medicines were managed safely, and staff were safely recruited and in sufficient numbers to provide people with the level of care and support they required. The premises were maintained safely and provided sufficient space for people to occupy themselves alone, or in the company of others.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems supported this practice. People's health and well-being needs were reflected in their care plans. Staff supported people to attend routine and follow up appointments and liaised with external healthcare professionals as required. People were supported to ensure that they had enough to eat and drink. There was a choice of food available and people spoke positively to us about the food.

People told us staff were caring and treated them with dignity and respect. We saw staff supported people both emotionally and practically, in a kind and compassionate manner. People were involved in how their care and support was received.

Staff took account of people's preferences and offered choices. Staff knew people well, including their background and history. Activities were supported and people were encouraged to maintain contact with their friends and relatives. People said staff listened to them and they felt confident to raise any issues if they felt they needed to.

Leadership was visible within the service and the registered manager received support from the provider and a director of the organisation. Governance systems were in place to gather feedback and check the quality of the service.

Further information is in the detailed findings below.

The service is situated in the village of Cottingham, which is a large village in the East Riding of Yorkshire. It is within walking distance of local shops and other amenities. Accommodation is provided over two floors and there is a selection of bedrooms for single occupancy and communal areas which include a lounge, dining room and garden. There is a car park to the rear of the property.

The service had a manager in post as required by a condition of registration with the Care Quality Commission (CQC). A registered manager is a person who has registered with CQC 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.

We carried out an unannounced comprehensive inspection of Benjamin Lodge on 14 January and 5 February 2016. After this inspection we received concerns in relation to staffing levels and recruitment, and how the service was meeting the needs of people who use the service. Because of the concerns raised we completed a focused inspection. This report covers our findings in relation to the concerns we received. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Benjamin Lodge on our website at www.cqc.org.uk.

We undertook this unannounced focused inspection on the 19 April 2017. At the last inspection the service was rated as 'Good' in all five domains of Safe, Effective, Caring, Responsive and Well-led. As we have not completed a full inspection, we have not changed the overall rating for the service.

At the time of the inspection, 16 people lived and received a service at Benjamin Lodge.

We found that people's individual needs were assessed and the registered provider put risk assessments in place to manage and reduce the risk of avoidable harm. The registered provider and manager were aware of their obligations in relation to managing and reporting any safeguarding concerns.

The staff we spoke with understood the risks to people's wellbeing and knew what action they must take to help minimise risks. General maintenance was carried out at the home. Service contracts were in place to ensure equipment remained safe to use.

We found that the management of medication was safely carried out and staffing levels provided on the day of our inspection were adequate to meet people's holistic needs.

Recruitment policies, procedures and practices were followed to ensure staff were of suitable character to care for and support people living at Benjamin Lodge.

People we spoke with told us they felt safe living at Benjamin Lodge. We observed warm and positive interactions between people, the staff and managers. We observed people were relaxed and at ease in their home environment.

We saw that people were supported according to their person-centred care plans, which reflected their needs well and which were regularly reviewed. People had the opportunity and, were supported to engage in employment, pastimes and activities if they wished to do so.

We found that there was an effective complaint procedure in place and people were able to have any complaints investigated.

Benjamin Lodge is situated in the village of Cottingham and is within walking distance of local shops, churches and other amenities. The home is registered to provide care to a maximum of 17 people who require support with mental health needs. Each room is single occupancy and there are sufficient communal areas. There is a car park to the rear of the building. The home is owned by Benjamin Lodge Limited.

The registered provider is required to have a registered manager in post and there was a registered manager at this 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.

People told us that they felt safe living at the home. We found that staff had a good knowledge of how to keep people safe from harm and there were enough staff to meet people’s needs. Staff had been employed following appropriate recruitment and selection processes and we found that the recording and administration of medicines was being managed appropriately in the service.

We found assessments of risk had been completed for each person and plans had been put in place. Incidents and accidents in the home were accurately recorded and monitored monthly.

The home was mostly clean, tidy and free from odour and cleaning schedules were in place. However, we found that the downstairs shower room and WC required improvements. We saw plans were in place to address this.

We saw that staff completed an induction process and they had received a wide range of training, which covered courses the home deemed essential, such as safeguarding, moving and handling and infection control and also home specific training such as mental health awareness.

The registered provider’s management team understood the Deprivation of Liberty Safeguards (DoLS) and we found that Mental Capacity Act (MCA) (2005) guidelines had been fully followed. The home did not use restraint but the registered manager understood the process to ensure that any restraint was lawful.

People’s nutritional needs were met. People enjoyed a good choice of food and drink and were provided with regular snacks and refreshments throughout the day. People told us they enjoyed the food and that they had enough to eat and drink. People were supported to maintain good health and had access to healthcare professionals and specialist Mental Health services.

We found that staff were knowledgeable about the people they supported and saw they interacted positively with people living in the home. People were able to make choices and staff actively encouraged them to maintain their independence.

People had their health and social care needs assessed and care and support was planned and delivered in line with their individual care needs. Care plans were individualised to include preferences, likes and dislikes and contained detailed information about how each person should be supported on day to day basis and also during a ‘Crisis’.

People’s comments and complaints were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided. We saw that any comments, suggestions or complaints were appropriately actioned. We found the provider had audits in place to check that the systems at the home were being followed and people were receiving appropriate care and support.

We found people were being looked after by friendly, supportive staff within a warm and homely environment. Care was personalised and reflected people's choices and decisions. People said "We are well looked after here. The food is good and the staff are really nice all the time' and 'You cannot fault the staff at all. We get plenty of food, drinks when we want them and we can go out into town when we like.'

People told us they felt safe in the home and the care was good. People said they were aware of their rights and choices and were confident in the systems set up by the service to enable them to voice any concerns.

People received their medicines on time and when they needed them. We saw there were safe and effective working practices for the management of medicines used within the service.

The provider had an effective quality assurance system in place and people's views and opinions of the service were listened to and acted on where necessary. People told us 'We attend regular meetings where we can talk about any issues we might have about the service' and 'The manager and staff listen to what we have to say and will sort things out when necessary."

We saw that people were supported to live their lives and make decisions with people's choices being respected. People received support to attend medical appointments. Staff received training to help protect people from harm.

Systems were in place to help inform people about changes to the home and to gain their opinions. On the whole records were well maintained.