The inspection took place on 14 March 2017. The inspection was unannounced.

Benton House is a 'care home'. People in care homes receive accommodation and nursing and 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.

Benton House provides accommodation and support for up to 34 older people. There were 26 people living at the service at the time of our inspection. People had varying care needs. Some people were living with dementia, some people had diabetes, some people required support with their mobility around the home and others were able to walk independently.

The service was in a detached building in a residential area. A private garden was available for people to sit out in when the weather was fine. Bedrooms were on the ground and first floors. A passenger lift was available between floors so people could access any part of the building if they wished.

At the last inspection in December 2015 the service was rated Good. At this inspection, we found the service remained Good.

There was a registered manager who had been in post approximately four months. 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 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 and followed the registered provider's policy and procedure. Systems were in place to identify potential risks associated with people, the environment and equipment. Medicines were stored appropriately and kept at a suitable temperature, including controlled drugs needing additional security. Medicine records (MARs) were well kept and legible. Recruitment procedures were thorough and ensured there was sufficient evidence of the applicant's suitability before staff were confirmed in post. There was sufficient staff available to meet people's needs safely.

People's needs and choices continued to be assessed when they started using the service. People received care that was personalised to their needs. People were encouraged to raise concerns or complaints and were asked for feedback about the service they received.

People were supported to make their own choices and decisions whenever possible. The registered manager and staff continued to have a good understanding of the basic principles of the Mental Capacity Act 2005 (MCA) and promoted people's rights.

People were involved in their care. Care plans were personalised and reflected people’s current needs and preferences. They contained the information staff needed to provide people with the care and support they wanted and required. There continued to be clear evidence of the caring approach of staff. People and their relatives were positive about the staff who supported them, describing them as caring and saying they were confident in the care they received. Staff knew people well and were able to respond to their needs on an individual basis whilst treating people with respect and upholding people’s dignity.

The service had an open and positive culture that encouraged involvement of people, their families, staff and other professional organisations. Leadership was visible and promoted teamwork. Staff spoke positively about the service and had a clear understanding of their roles and responsibilities. Audits and quality assurance processes were in place to identify areas of service improvement. The service understood their legal responsibilities for reporting and sharing information with other services.

Further information is in the detailed findings below.

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We observed people were treated with respect and staff maintained people’s dignity.

Staff supervisions, appraisals and training had been recommenced. Staff told us they were supported and worked well as a team.

Is the service effective?

Identified shortfalls in the training audit had been addressed; staff had received updates for mandatory training. Staff had also been able to attend other training to be able to meet people’s needs. For example, Mental Capacity Act, challenging behaviour and Deprivation of Liberty Safeguards.

We observed activities on-going during our visit. People were engaging in the activity and enjoying it. People were laughing and joking together during the activities.

Is the service caring?

We observed care workers interacted positively with people who used the service. Staff showed patience and gave encouragement when supporting people.

Is the service responsive?

At our last visit the provider had implemented a redecoration programme. This had been completed; an extension had also been provided which gave additional communal space. There was direct access onto the gardens, which had been landscaped. Many people were using the garden at the time of our visit. One person told us, “I like sitting here, it is a nice garden.”

Is the service well-led?

Staff we spoke with told us the service had much improved over the last three months. They said they worked well as a team and the new manager had made positive changes. The new manager had also completed the registration process with The Care Quality Commission.

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found adequate quality monitoring systems were in place. This ensured the risks to people were identified and reduced, to be able to continually improve.

Appropriate arrangements for the recording, safe keeping and safe administration of medicines were in place.

Is the service effective?

People’s health and care needs were reviewed, and if people were able they were involved in the reviews.

We observed activities ongoing during our visit, people were engaging in the activity and enjoying it. People were laughing and joking together during the activities. In the afternoon entertainment had been arranged two singers were performing, the people joined in and danced during this activity. Relatives told us “The activities are very good.”

Is the service caring?

We observed care workers interacted positively with people who used the service. Staff showed patience and gave encouragement when supporting people. One person we spoke with told us, “They look after me.” Relative’s we spoke with praised the staff and said they worked very hard to ensure people had a good quality of life.

We spent time in the dining room observing lunch. We saw the experience was inclusive, calm, supportive and enjoyed by people who used the service. There were two sittings; this had been implemented to ensure the experience was calm. People were not rushed and their choices and preferences were respected. We observed staff giving appropriate sensitive support when required.

People were treated with respect and staff maintained people’s dignity.

Is the service responsive?

The new manager had already identified a number of improvements required and was in the process of implementing what was required to ensure the improvements were carried out.

Is the service well-led?

The acting manager had been in post for three weeks at the time of our visit. They told us the previous registered manager had given a hand over and worked with them for a week to ensure they had the information they required. The new manager had submitted an application to CQC to become the registered manager and this was being processed.

Audits and reviews had taken place; the audits were thorough and detailed. However, shortfalls that had been identified in the training audit dated February 2104 had not been addressed

The provider had implemented a redecoration programme which was ongoing at the time of our inspection. The provider had also ensured a new manager was in post prior to the registered manager leaving.

Staff supervisions, appraisals and training had not been kept up to date since September 2013. This included clinical supervision for qualified staff. The new manager had identified this and was implementing a schedule to address this.

This inspection took place on 1 and 10 December 2015 and was unannounced on the first day. The home was previously inspected in August 2014 and the service was meeting the regulations we looked at.

Benton House is situated in the village of Rossington near Doncaster. The service is registered to provide both nursing and personal care for up to 34 people. At the time of our inspection there were 34 people living at the service.

The home had 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 2008 and associated Regulations about how the service is run.

People who used the service and their relatives we spoke with told us the service provided good care and support. They told us they felt safe, the staff were caring, kind and respected their choices and decisions.

Medicines were stored safely and procedures were in place to ensure medicines were administered safely. However we identified some areas that required improvement, these had been identified in an audit and were being addressed.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this and the registered manager had assessed people who used the service to determine if an application for a DoLS was required.

People were supported with their dietary requirements. We found a varied, nutritious diet was provided. People we spoke with told us they enjoyed the food. From our observations we saw people enjoyed their meal.

We found staff approached people in a kind and caring way which encouraged people to express how and when they needed support. We saw staff respected people’s privacy and dignity and spoke to people with understanding, warmth and respect.

People’s needs had been identified, and from talking to people and observing staff supporting them, we found their needs were met by staff who knew them well. Care records we saw detailed people’s needs.

There were robust recruitment procedures in place, staff had received formal supervision. Qualified nursing staff had also received a monthly clinical supervision. Staff also received an annual appraisal of their work. These ensured development and training necessary to support staff to fulfil their roles and responsibilities was identified. Staff training was up to date which, ensured staff had the knowledge to meet people’s needs. We found that there were enough staff to keep people safe, although people told us there were times when staff were very busy. A new activities coordinator had been employed and had commenced in post the week of our inspection.

There were systems in place for monitoring quality, which were mostly effective. Although the registered manager had identified the medication audit required improvement. However, where improvements were needed, these were addressed and followed up to ensure continuous improvement.

We found some people who used the service were living well with dementia. However, we have made a recommendation that the provider consider best practice guidance in relation to the the use of contrasting colours on doors and walls and in particular table cloths and crockery. This will enable people to orientate themselves and improve visaually the meals for people living with dementia, when served on contrasting crockery.