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Benoni Nursing Home Limited, St Just, Penzance.

Benoni Nursing Home Limited in St Just, Penzance is a Nursing home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs, dementia, physical disabilities and treatment of disease, disorder or injury. The last inspection date here was 15th October 2019

Benoni Nursing Home Limited is managed by Benoni Nursing Home Limited.

Contact Details:

    Address:
      Benoni Nursing Home Limited
      12 Carrallack Terrace
      St Just
      Penzance
      TR19 7LW
      United Kingdom
    Telephone:
      01736788433
    Website:

Ratings:

For a guide to the ratings, click here.

Safe: Good
Effective: Requires Improvement
Caring: Good
Responsive: Good
Well-Led: Requires Improvement
Overall:

Further Details:

Important Dates:

    Last Inspection 2019-10-15
    Last Published 2018-10-03

Local Authority:

    Cornwall

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

11th September 2018 - During a routine inspection pdf icon

Benoni is a care home which offers nursing care and support for up to 25 predominantly older people. At the time of the inspection there were 20 people living at the service. Some of these people were living with dementia. The service occupies a detached house over three floors with a passenger lift and a stair lift for access.

This unannounced comprehensive inspection took place on 11 September 2018. The last inspection took place on 11 July 2017 and was focused on reviewing the warning notice issued due to the concerns found at the April/May 2017 inspection. Those concerns were about the auditing of medicines, fire risk management, the provision of hot water and infection control issues. At the July 2017 Inspection we found the provider had taken appropriate action to address the issues raised in the warning notice. However, the rating remained as Requires Improvement as we needed to see the changes sustained over time and would review the outstanding breaches at this comprehensive inspection.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

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 and associated Regulations about how the service is run. The service is required to have a registered manager and at the time of the inspection there was no registered manager in post. There was an acting manager at the service who had not applied to become the registered manager at the time of this inspection. The acting managers position was under review by the provider.

People received their medicines as prescribed. Systems and processes relating to the administration and storage of medicines helped ensure medicines were managed safely. Medicine audits were carried out monthly. The service had increased the areas that were covered by this audit since the last inspection and it was now more robust. Any issues that arose from the regular audits were being addressed by the nurses.

The premises were regularly maintained. There were no unpleasant odours at the service. The service was registered for dementia care, and we had raised concerns with the provider, at previous inspections, that there was no pictorial signage to support people who were living with dementia and who may require additional support with recognising their surroundings. At the last inspection we were given assurances that the provider had ordered new signage for people’s bedroom doors which would help people to recognise their own rooms. At this inspection new signage had still not arrived despite the providers repeated assurances it would be arriving soon.

We had previously identified concerns with the supply of hot water to some rooms. Some rooms did not have any hot water, one room had no water. We also identified that the provider was not carrying out regular Legionella tests. At this inspection we found the hot water supply was regularly checked to ensure the temperature was safe for people to use. All rooms had a working water supply. Legionella checks were recorded regularly.

Equipment and services used at Benoni were regularly checked by competent people to ensure they were safe to use. The service carried out regular health and safety audits. The service was due to have a fire risk assessment carried out by an external agency, we were assured this had been booked to take place in the coming weeks following this inspection. The provider had taken advice from a fire assessment and was planning to have a sprinkler system installed. Emergency fire evacuation equipment was evident on all landings and in people’s rooms. All people had personal emerg

24th April 2018 - During a routine inspection pdf icon

Benoni is a nursing home which offers care and support for up to 25 predominantly older people. At the time of the inspection there were 23 people living at the service. Some of these people were living with dementia. The service occupies a detached house over three floors with a passenger lift to assist people to the upper floors.

This unannounced comprehensive inspection took place on 24 April 2018. The last comprehensive inspection took place on 28 April and 3 May 2017when the service was not meeting the legal requirements. There were four breaches of the regulations. The service was rated as Requires Improvement that time. A warning notice was issued regarding the management of medicines, fire risk management, the provision of hot water and infection control issues. Statutory requirements were issued for the other breaches of the regulations related to staffing levels, the management of risk, lack of effective quality assurance processes and the poor condition of the premises. We carried out a focused inspection on 11 July 2017 to review the actions taken by the provider to address the issues in the warning notice. At that time the provider was found to have addressed the conditions of the warning notice, however the rating remained as Requires Improvement as we needed to see the changes sustained over time and review the outstanding breaches at the next comprehensive inspection.

At this inspection we found the service had taken action to address the breaches of the regulations and improvements were noted. However, some concerns remained and the service has continued to be rated as Requires Improvement.

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 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. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. There was a registered manager in post, however they told us and the provider confirmed, that they were stepping down from their post. The provider had begun to put plans in place for the on-going management of the service.

We spent time in the communal areas of the service. Staff were kind and respectful in their approach. They knew people well and had an understanding of their needs and preferences. People were treated with kindness, compassion and respect. The service was comfortable and appeared clean with no odours. People’s bedrooms were personalised to reflect their individual tastes. People told us, “Its the little things the staff do that makes a difference," "The staff are always dropping in to see if I'm alright” and "The staff are very nice people and very caring."

Staffing levels had been increased since the last inspection. People’s needs were being met and call bells were answered quickly. There were no staffing vacancies at the time of this inspection.

People received their medicines as prescribed. Systems and processes relating to the administration and storage of medicines helped ensure medicines were managed safely. However, the audit currently carried out was not detailed enough to capture all aspects of medicines management. The provider told us they were in the process of addressing this and templates were shown to inspectors of the new audit to be used in the future.

People and relatives told us, “The safety of the home is very good. There are always plenty of staff about,” “The staff made sure we are safe” and “I always get my tablets when I should and that makes me feel safe.”

The premises had been improved since the last inspection. The condition of floor covering was improved and

11th July 2017 - During an inspection to make sure that the improvements required had been made pdf icon

Benoni is a nursing home which offers care and support for up to 25 predominantly older people. At the time of the inspection there were 19 people living at the service. Some of these people were living with dementia. Bedrooms were arranged over three floors with a passenger lift and stair lift providing access for people to the upper floors.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

This unannounced focused inspection took place on 11 July 2017. The last comprehensive inspection took place on 28 April and 3 May 2017. We identified four breaches of the regulations at that inspection. The breaches related to staffing levels, the management of risk, lack of effective quality assurance processes and the poor condition of the premises. A warning notice was issued regarding the management of medicines, fire risk management, the provision of hot water and infection control issues. Statutory requirements were issued for the other breaches of the regulations. The provider sent the Care Quality Commission an action plan detailing how the service would meet the requirements of the regulations. We carried out this focused inspection to check on the action taken by the service to meet the requirements of the warning notice. The action taken to address the requirements will be reviewed at a comprehensive inspection at a later date.

This report only covers our finding in relation to “Is the service Safe”. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Benoni Nursing Home on our website at www.cqc.org.uk.

During this inspection we checked the services medicines systems. The management of prescribed medicines at Benoni had improved. Handwritten entries on the medicine management record were always signed by two staff to help ensure the risk of errors was reduced. Where people were prescribed pain relieving patches records were being kept consistently of where the patch was sited to help ensure it was always a different position on the person’s body.

However, we still found some errors. Staff were required to count medicines at each medicine round to ensure all were accounted for. The records for one medicine did not tally with the stock held. One person was on a prescribed medicine, which was monitored by a regular blood test. The result of this blood test led to frequent changes in the dose of the medicine. The records relating to this medicine did not show the person had received the correct dose of this medicine, according to advice from the GP. Prescribed creams continued to not be dated when opened. Regular medicine audits were now being carried out and showed some improvement in errors. However, the audits were not being entirely effective in identifying issues found at this inspection.

Although action had been taken to address the concerns in the warning notice about the safe management of medicines further improvements are required and the service remained in breach of the requirements of the regulations.

The service had now followed their own recommendation from the last infection control audit in 2016 which stated ‘liquid soap must not be topped up’ and that sealed cartridges of liquid soap should be used. We found new sealed cartridge soap dispensers were in place.

The maintenance person had been replaced at the service since the last inspection. Work had been carried out to ensure that hot water was available in all outlets at a safe temperature. Further work was planned to provide constant hot water to a staff toilet where it was found to be cold on the day of this inspection.

A large fan, without a guard, that was found in regular use at the top of the stairs at the last inspection

28th April 2017 - During a routine inspection pdf icon

This unannounced comprehensive inspection took place on 28 April and 3 May 2017. The last inspection took place on 20 August 2015 when we found one breach of the regulations regarding the management of medicines.

Benoni is a nursing home which offers care and support for up to 25 predominantly older people with physical health needs, some of whom have a form of dementia. At the time of the inspection there were 25 people living at the service. Bedrooms were arranged over three floors. There was a communal lounge and a dining area on the ground floor. A lift assisted people to access the upper floors.

The service did not have a registered manager in post; however, the current manager had made an application to become registered with CQC. 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.

There were not sufficient staff available to meet people’s needs. We heard call bells ringing frequently throughout the day and observed lengthy periods when staff were unable to attend to people who had called them. For example, one person told us, ““I’ve asked for the commode over half an hour ago and I’m still waiting.”

People who used the service and staff who worked at Benoni all commented there were not enough staff to meet people’s needs. Comments included, “The staff are all very nice. But I do think they are understaffed. They are running around covering what they have to do but you won’t find many have time to stand and chat with you”, “The staff are very nice but very very busy” and “They are always short staffed it appears. Call bells are ringing all morning on and off.”

We had concerns with the way medicines were managed by the service. We found incidents when medicines had been signed as being given which were not in stock. For example, a person was prescribed one dose of a medicine which had been signed as being administered twice. Management told us this had taken place because the staff member had not referred to the medicine administration records while administering medicines. This meant the MARs records were not an accurate reflection of the medicines people had received.

Handwritten entries had not been signed by a member of staff or witnessed by a second member of staff. The strength of one medicine for a person had been crossed out and a handwritten amendment had been added. There was no authorisation or explanation for this change and the amendment was not double signed as a checking mechanism. This meant there was a potential risk of errors and people might not receive their medicines safely.

Where people were prescribed pain relieving patches we saw body maps were included with prescribing information. However, these were not consistently being used to indicate where patches had been placed. This meant there was a risk that concurrent patches could be placed on the same site which is not medically recommended.

Carpets in communal areas throughout the ground floor were badly stained and in need of replacement. We saw there were maintenance issues throughout the service. For example, there was damage to wood work around the walls in one person’s room, in another room a double electric plug socket was broken but still being used. We saw a rusty wall mounted corner unit in a bathroom and brown water stains on the ceiling in the lounge and two people’s bedrooms.

Care plans were personalised to the individual but did not consistently give clear details about each person’s specific needs For example, there was a lack of clear guidance about diabetes management recorded in care plans.

Details recorded in care plans about how people liked to be supported were not always consistent with what people told us. For example, one person said

20th August 2015 - During a routine inspection pdf icon

Benoni provides care for primarily older people, some of whom have a form of dementia. The home can accommodate up to a maximum of 25 people. On the day of the inspection 17 people were living at the service. Some of the people at the time of our inspection had physical health needs and some mental frailty due to a diagnosis of dementia.

We carried out this unannounced inspection of Benoni on the 20 August 2015. Our findings were that people were being cared for by competent and experienced staff, people had choices in their daily lives and that their mobility was supported appropriately.

The service is required to have a registered manager and at the time of our inspection there was a registered manager in post. 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 and associated Regulations about how the service is run.

People told us they received their medicines on time. Medicines were stored in people’s rooms in a locked cabinet. The cabinets had no means of identification on them. In shared bedrooms this could particularly pose a risk of potential medication errors. We noted that the medicines fridge which was labelled ‘to be locked at all times’ was open. This did not adhere to the storage of medicine guidance. The Medicines Administration Records (MAR), showed that medicines had been administered as per the dispensing instructions. However medicines which were handwritten on the MAR sheets were not recorded as per medicine guidance. If this process is not followed it could pose a risk of medication errors.

Due to the design of the building it does bring challenges in how people’s needs could be met. For example some corridors leading into bedroom doors were not wide enough for a hoist to go through. We noted that bedroom doors were numbered but there was no signage for people to recognise their rooms or orientate themselves around the home. A visiting social worker asked “how do I get out of here?” as there was no signage to show the way out. This could lead to difficulties for example in case of emergency evacuation.

People told us staff were; “marvellous” and ““I feel safe here as I’m looked after so well.” They told us they were completely satisfied with the care provided and the manner in which it was given. Relatives were complimentary about the care provided

People felt safe living in the home, commenting “I feel safe here, very safe.” One person commented “This is my home now and I’m happy here.” Relatives told us they felt their family member was cared for safely. Staff were aware of how to report any suspicions of abuse and had confidence that appropriate action would be taken.

People’s care and health needs were assessed prior to admission to the service. Staff ensured they found out as much information about the person as possible so that they could get to know the persons wishes and preferences. Relatives felt this gave staff a very good understanding of their family member and how they could care for them.

People chose how to spend their day and a wide range of activities were provided. Activities were provided by the service individually and in a group format, such as for arts and crafts and through outside entertainers coming into the service. Visitors told us they were always made welcome and were able to visit at any time.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. Where people did not have the capacity to make certain decisions the home involved family and relevant professionals to ensure decisions were made in the person’s best interests.

People’s care plans identified the person’s care and health needs in depth and how the person wished to be supported by the service. They were written in a manner that informed, guided and directed staff in how to approach and care for a person’s physical and emotional needs. Records showed staff had made referrals to relevant healthcare services quickly when changes to people’s health or wellbeing had been identified. Staff felt the care plans allowed a consistent approach when providing care so the person received effective care from all the staff. People that used the service and their relatives told us they were invited and attended care plan review meetings and found these meetings really helpful.

People told us staff were very caring and looked after them well. Visitors told us; ““Staff are marvellous, you have to have a laugh and I pull staffs leg and they like it”, “It will never be as good as being in your own home but I’m happy here” “The staff are very kind and very understanding, they treat me with respect and they do listen to me and act on what I say.” We saw staff providing care to people in a calm and sensitive manner and at the person’s pace. When staff talked with us about individuals in the service they spoke about them in a caring and compassionate manner. Staff demonstrated a really good knowledge of the people they supported. Peoples' privacy, dignity and independence were respected by staff. At this visit we undertook direct observations using the SOFI tool to see how people were cared for by staff. We saw many examples of kindness, patience and empathy from staff to people who lived at the service.

There were sufficient numbers of suitably qualified staff on duty to keep people safe and meet their needs. People said that staff respond to the call bell promptly, which we observed. Relatives echoed this view commenting staff were always available if they had any queries at any time. Staff felt there were sufficient staff on duty.

Staff attended regular training to ensure that their skills remained up to date with recent guidance. People and relatives felt staff were skilled and competent to undertake their job.

Staff told us they were supported by managers. They attended regular meetings (called supervision) with their line managers. This allowed staff the opportunity to discuss how they provided support to people, to ensure they met people’s needs, and gave time to review their aims, objectives and any professional development plans. Staff also had an annual appraisal to review their work performance over the year.

We saw the service’s complaints procedure which provided people with information on how to make a complaint. People and relatives told us they had no concerns at the time of the inspection and if they had any issues they felt able to address them with the management team.

The registered manager promoted a culture that was well led and centred on people’s needs. People told us how they were involved in decisions about their care and how the service was run. The management and running of the service was ‘person centred’ with people being consulted and involved in decision making. People were empowered by being actively involved in decision making so the service was run to reflect their needs and preferences.

The service was keen to gain the views of people’s relatives and health and social care professionals. Some of this was completed via a questionnaire and the results of these were compiled in a report which identified areas for improvement and any actions the provider needed to make. For example some areas of the service had recently been redecorated to make the service more comfortable.

There was a management structure in the service which provided clear lines of responsibility and accountability. There was a clear ethos at the home which was understood by all the staff. It was very important to all the staff and management at the service that people who lived there were supported to be as independent as possible and to live their life as they chose. The provider had an effective system to regularly assess and monitor the quality of service that people received and was continuously trying to further improve the quality of the service.

We found a Breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we have told the provider to take at the end of the full version of the report.

2nd May 2013 - During a routine inspection pdf icon

On the day of the inspection we spoke with people to seek their views of the service provided. We were able to speak with some people’s relatives and also to some staff members. Everyone we spoke with was very positive about the care and support people who lived in the home received. For example one person who used the service said “it is a wonderful place…I cannot find fault with anything”. Another person said “the carers are wonderful, I have no complaints at all…they have been marvellous here.” Subsequently we judged care and health standards were good, we concluded people were treated with respect and dignity and staff worked with people professionally.

Accommodation was decorated, furnished and maintained to a satisfactory standard, although some areas were in need of upgrading. When we inspected the home was clean and odour free. A satisfactory system was generally in place regarding staff recruitment checks. Staffing levels and staff training standards were satisfactory. Quality assurance systems were satisfactory.

17th September 2012 - During a routine inspection pdf icon

We spoke to five people who lived at Benoni Nursing Home, two visitors, and the staff and manager. The comments we received were mostly positive. The people praised the way they were treated by the staff and said they “felt at home”. They all agreed that they were treated with respect. One person was quick to inform us that they were at home, not in a nursing home and they were able to do what they wanted. One person thought more could be done for their relative by way of referral to other health professionals.

We saw people’s privacy and dignity being respected and staff being helpful. We saw that residents were spoken with in an adult, attentive, respectful, and caring way. We saw and heard staff greeting people in passing, “hello Mr *” or “hello sir”.

Staff confirmed the training they had done and also confirmed that they were supervised. Staff said that they enjoyed working at Benoni Nursing Home.

27th March 2012 - During an inspection in response to concerns pdf icon

We spoke with five people who used the service during our inspection visit to seek their views of the service they received.

People told us that they were generally satisfied with the care provided to them and that the staff were kind, caring and polite. We spoke with two relatives who were visiting the home and they confirmed this. We were told by some people who used the service that when they required assistance, they sometimes had to wait as the staff were always very busy.

We saw people’s privacy and dignity being respected as staff knocked on bedroom, bathroom and toilet doors before entering.

 

 

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