Bennfield House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home offers accommodation for up to 27 older people living with dementia, mental health or nursing needs. Bennfield House is situated on a main road and has easy access to local transport, shops and other community facilities. There were 22 people living at the home at the time of the inspection.

At our last inspection we rated the service ‘good’. At this 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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Bennfield House’ on our website at www.cqc.org.uk’

There was a registered manager who had been in post since 2007. 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 they were very happy with the quality of the care they received, and said staff treated them with respect and dignity, and cared for them in a way which met their needs and preferences. This was also confirmed by the relatives and healthcare professionals we spoke with.

There were arrangements in place to keep people safe and to help safeguard people from the risk of abuse. Staff understood their responsibilities for safeguarding people from harm. Systems were in place to identify potential risks associated with people, the environment and equipment.

Medicines were stored and administered safely and medication records were legible and accurate.

Recruitment procedures continued to be robust, but we noted the application form did not request a full employment history, which would allow the registered provider to check people’s employment history more thoroughly. The registered provider said they would address this immediately. There was sufficient staff available to meet people's needs safely. Staff received the training and support they needed to meet people's needs and develop their skills and knowledge.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's needs and choices continued to be assessed when they moved into the home and periodically after that. People were involved in planning their care. Care plans were personalised and overall they clearly reflected people’s current needs and preferences. People had access to a varied programme of social activities and events.

The service had an open and positive culture that encouraged involvement of people using the service, their families, staff and other professional organisations. Leadership was visible and promoted teamwork. People were encouraged to raise concerns or complaints and were asked for feedback about the service they received. Staff spoke positively about the service and had a clear understanding of their roles and responsibilities.

Checks were carried out to identify areas where the service needed improving. The general environment needed some attention in places, for instance some areas needing redecoration or repair. However, these had been identified by the registered provider and action was being taken to address them.

The service understood their legal responsibilities for reporting and sharing information with other services.

Further information is in the detailed findings below.

The inspection was unannounced, which meant the provider did not know we were coming. It took place on 29 October 2015. The home was previously inspected in August 2014, and at the time was meeting all regulations assessed during the inspection.

Bennfield House provides care for up to 27 older people with dementia, mental health needs and nursing. It is located in Thorne and is situated on a main road and has easy access to local transport, shops and other community facilities. There were 26 people living at the home when we visited.

A registered manager was 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.’

The registered provider worked in the home as the matron, alongside the registered manager, and a general manager who oversaw all of the ancillary aspects of the service.

The feedback we received from everyone was overwhelmingly positive. For instance, we explained to one person’s relatives that at our inspection we were asking if the service was safe, effective, caring, responsive and well led. They responded, “We would say a resounding yes on all five counts.”

There was a strong person centred and caring culture in the home. (Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual.) The vision of the service was very positive and very much about showing love and care to people. This had resulted in some very positive experiences for people living in the home. This vision was shared by the managers, the nurses and the care team. For instance, one external professional told us that the matron was determined that the people who used the service should know that they were valued, and should be told that they were loved every day.

When we asked one professional what they felt was good about the service they replied, “Everything. I absolutely love this home. They really care. The matron absolutely cares about the people who live here. She also cares about her staff, and makes sure they do things to the right standard.”

Staff told us they worked as part of a team that was particularly nice to work in, and very committed to providing care that was centred on people’s individual needs. Staff received the training they needed to deliver a high standard of care. They told us that they received a lot of training and their achievements were celebrated.

Everyone we spoke with, including people who used the service, their relatives and external professionals said people received exceptional and individualised care. They said the service provided specialist care for people living with dementia, particularly well. Especially for those who presented behaviour that may challenge others. We found that the management team and staff were continually looking for innovative ideas to help improve the experience for people who used the service.

The service provided end of life care and there was a strong commitment to supporting people and their relatives, before and after death. People had end of life care plans in place, which clearly stated how they wanted to be supported during the end stages of their life. People told us that the staff provided this care with true compassion, and this extended to the support they provided to members of people’s families and their friends. Professionals commented that it was very rare that people were hospitalised, as they always found ways to meet people’s needs in the home.

There were systems in place to manage risks, safeguarding matters and medication and this ensured people’s safety. Where people displayed behaviour that was challenging the training and guidance given to staff helped them to manage situations in a consistent and positive way. This protected people’s dignity and rights.

We saw that staff recruited had the right values, and skills to work with people who used the service. Where any issues regarding safety were identified in the recruitment process appropriate safeguards had been put in place. Staff rotas showed that there were consistently high levels of staff, and this helped to keep people safe.

We found that the care planning process very much centred on individuals and their views and preferences. This also involved people who were important to them, such as their close relatives and in some cases, their neighbours and friends. People were supported to maintain their important relationships through visitors being made so welcome in the home and we were told that staff were particularly caring towards people’s relatives.

People had contact with their GP and other health professionals, as needed. People were protected from the risks associated with poor nutrition and hydration and spoke positively about the choice and quality of the food. Where people were at risk of malnutrition, referrals had been made to the dietician for specialist advice.

Staff engaged with people and supported them to be involved in a broad range of activities to enhance their wellbeing and there was a very warm, positive and homely atmosphere in the service.

CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The members of the management team and nurses we spoke with had a full and up to date understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. We found that appropriate DoLS applications had been made, and staff were acting in accordance with DoLS authorisations.

Systems were in place which continuously assessed and monitored the quality of the service, including obtaining feedback from people who used the service and their relatives. Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were managed well and that management took steps to learn from such events and put measures in place which meant they were less likely to happen again.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

People experienced care, treatment and support that met their needs and protected their rights. During the inspection we spent time observing how staff members interacted with people who used the service. The staff were good at communicating with and engaging people. They were respectful of people’s wishes and feelings. One person’s relative said, “This is an excellent service." Another person’s relative told us their relative was much happier and sang a lot since moving to the home.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

There was an effective complaints system available.

People who used the service told us they were treated with respect and were happy with the care they received. We spoke with four visiting relatives. The words they used to describe the service included; “Brilliant” “Excellent” “Wonderful” “Caring” and “Patient and kind.”

One relative said “I can’t fault them. The standard of care is very good.”

Another said the home “Always smelled lovely” and was “Spotlessly clean.”