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Inspection carried out on 11 March 2018

During a routine inspection

This unannounced comprehensive inspection took place on 11 March 2018 and was carried out by one adult social care inspector. We last inspected this home on 13 November 2015 when it was rated as ‘Good’ overall and in every key question.

Summon Bonum is a ‘care home’. 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. Summon Bonum is registered to accommodate up to nine people with learning disabilities and complex needs in one adapted building. Nursing care is not provided by staff at Summon Bonum. This is provided by the community nursing service. At the time of this inspection in March 2018 there were eight people living in the home.

Summon Bonum is owned by Mrs J Whitney. As the owner is not a company there is no requirement to register a manager of the service. Although Mrs Whitney is at the home on a regular basis, there is also a manager who takes day to day control of the home. We will refer to this person as ‘the manager’.

At our last inspection in November 2015 we rated the service good. At this inspection in March 2018 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.

At this inspection we found the service remained Good.

Although the care service had been developed and designed prior to Building the Right Support and Registering the Right Support guidance being published, it followed these values and principles. These values related to people with learning disabilities using the service could live as ordinary a life as any citizen. They achieved this by promoting enablement, independence, choice and inclusion. They demonstrated how they delivered person-centred care and how they ensured people had easy access and include to the local community.

At the time of our inspection in March 2018 people living in Summon Bonum were living with learning disabilities along with varying physical and mental health needs. People had varying levels of need, with some people being able to leave the home independently and others requiring support to do so.

People who lived in Summon Bonum were protected from risks relating to possible abuse, relating to their needs and their health conditions. Staff knew how to recognise possible signs of abuse which also helped protect people Staff had assessed individual risks to people and had taken action to minimise these. Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risks of reoccurrence. Staff supported people to take their medicines safely and staff competencies relating to the administration of medicines were regularly checked. Staff told us they felt comfortable raising concerns.

Recruitment procedures were in place to help ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work. Staffing numbers at the service were sufficient to meet people’s needs and provide them with two to one or one to one support where required. Staff had the competencies and information they required in order to meet people’s needs. Staff received sufficient training as well as regular supervision and appraisal.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put it into practice. Where people had been unable to make a particular decision at a particular time, their capacity had been assessed and best interests decisions had taken place and had been recorded. Where people were being deprived of their liberty for their own safety the registered manager had made Depri

Inspection carried out on 13 November 2015

During a routine inspection

Summon Bonum is a large detached property that is registered to provide care for up to nine people with learning disabilities and complex needs.

This inspection took place on 13 November 2015, when there were nine people living there. The home was last inspected in October 2013 when it was meeting all the requirements relevant at that time.

Summon Bonum is owned by Mrs J Whitney. As the owner is not a company there is no requirement to register a manager of the service. Although Mrs Whitney is at the home on a regular basis, there is also a manager who takes day to day control of the home.

At the time of this inspection in November 2015 people living at Summon Bonum had a learning disability as well as varying physical and mental health needs. Some people were confident to leave the home on their own, while others needed physical or emotional support to leave the building. Staff told us there were always enough staff available to ensure people who needed support could leave the home whenever they wished. Staff also told us extra staff could always be called on if needed.

There were robust recruitment procedures in place. This minimised the risks of staff being employed who may be unsuitable to work with vulnerable people. People were protected from the risks of abuse. Staff were aware of different types of abuse and how to recognise if someone was being abused. Staff knew how and to who they should raise any concerns if they suspected people were being abused.

Staff had a good understanding of the principles of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards (DoLS). They knew people should always be assumed to have the capacity to make decisions unless they had been assessed otherwise. Staff knew any decisions made on behalf of people who did not have capacity, should only be done in their best interests. People were asked for their consent before staff provided personal care.

There were safe systems in place to manage people's medicines. These systems ensured people received their medicines as prescribed. People were supported to receive the healthcare they needed. Records showed people had been supported to visit GPs, psychiatrists and chiropodists as and when needed.

People were supported to maintain a healthy balanced diet, while ensuring they always had a choice of food. There was a house meeting each morning so people could choose what they wanted to eat, and how they wanted to spend their day.

People were supported to maintain contact with people who were important to them. People told us staff often supported them to visit their relatives. One visitor was spending the afternoon at the home and having tea with the person they were visiting.

There was much care and affection shown between staff and the people they cared for. There was much fun and laughter in the lounge when people returned from their outings. Staff were responsive to people’s needs. They recognised and swiftly took action when one person became distressed. People were clean and well dressed and took a pride in their appearance. Staff respected people’s privacy and dignity and all personal care was provided in private.

People’s care plans were comprehensive and reviewed regularly. The plans contained good details of people’s preferences and how they liked to be supported. People took part in interviewing staff and their opinions were considered when appointments were made.

Staff told us they though the home was well managed and the managed was open and supportive. Staff said they received lots of training that helped them do their jobs.

There were effective quality assurance systems in place to monitor care and plan on-going improvements. A series of audits and spot checks ensured any issues were identified and dealt with. Any concerns or allegations were thoroughly investigated by the manager.

Inspection carried out on 4 October 2013

During a routine inspection

We last visited Summon Bonum in March 2013. We found that the home was meeting the essential standards that we looked at.

On the day of our visit in October 2013 there were nine people living at the home. All had some degree of learning disability.

We were told that everyone had the ability to consent to day to day care and treatment. We found that people�s consent had been obtained for care and treatment provided to them by the service.

We looked at three care plans and found that there were good risk assessments in place for mobility, personal care, nutrition and the environment. We found that care plans reflected the needs of the person as an individual because each plan had the needs of the person clearly set out. Care workers told about the types of activities each individual particularly liked. For example, shopping, going out for lunch or going to the betting shop.

The medication systems allowed for a full audit trail to be completed recording the receipt, administration or return and disposal of prescribed medication. We saw that medication quantities were audited each time a new batch was received.

Effective recruitment procedures were in place. For example, we saw evidence that Disclosure and Barring Service (DBS) (criminal records) checks had been performed.

We found that the home had a robust system in place which ensured that records were secure, accurate and up to date.

Inspection carried out on 19 March 2013

During a routine inspection

During our inspection there were nine people living at the home, most of whom had lived at the home for over twenty years. People had learning disabilities and had complex needs. Most were unable to tell us about their care. We therefore observed their behaviours, demeanour and interactions with staff to ascertain the quality of their care.

We saw that people were treated in a dignified manner. Staff gave their time freely and fairly to ensure that people were cared for and happy. One staff member told us that �the people are always lovely� and it was clear that staff understood the importance of providing individual care.

Treatment and care was planned and carried out in line with these plans. We saw evidence that there had been sensitive thought put into the care planning procedure and that the home had worked to enable people to understand and influence this process.

Staff looked after people with care and skill. We saw that, as both people and staff had been at the home for a long time, a family style relationship had formed within the home environment. A staff member described the home as �outstanding� and it was clear that all the staff members observed were dedicated to providing a high standard service.

There was a clear complaints procedure in place and any complaints were dealt with at the appropriate level. Staff told us that �[the manager�s] door is always open� and we observed the manager playing an active part in the day to day running of the home.