We carried out a review of the data available to us about Summon Bonum Support & Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Summon Bonum Support & Care, you can give feedback on this service.
Summon Bonum Support & Care, referred to in this report as ‘the service’, provided personal care support for adults who live in their own homes independently in the community. The service was based in Maidencombe Manor where eight self-contained flats were available for rent by people with support needs. These people could choose to have their support provided to them by the service or by another provider if they wished. People renting these flats held their own tenancies. The service provided support for adults with learning and physical disabilities. At the time of our inspection the services provided support to over 30 people but only 15 of those received help with personal care. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. We therefore focused our inspection on those 15 people. Five people receiving personal care lived in the Maidencombe Manor flats. Other people receiving personal care from the service lived in Torquay and the surrounding areas.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service 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.
The service was exceptional at placing people at the centre of their care experience. People who received support from the service had access to care which was focused on what was important to them and supported them to achieve the most out of their lives. The service was passionate about helping people build confidence, reach and surpass their goals. For example, one person had been encouraged and supported to deliver their own training to staff as they were keen for staff to understand their specific individual needs. Not only did this help the staff understand this person’s needs better, it gave this person the confidence to join the National Autistic Society and they now deliver speeches and training to a wide range of people, travelling across the country.
Each person had a small team of staff they knew well. The service worked hard to match support staff with the people they were supporting and their families. People were involved in selecting their staff based on personalities and interests. The service was highly flexible to ensure people could be supported in the ways they wanted, when they wanted. People could choose which staff supported them with specific activities if they wanted and the rota was very flexible in order to ensure people could attend activities or appointments or accommodate changes in their schedule.
Staff were passionate about helping people have the best quality of life possible. Staff worked extremely closely with other healthcare professionals in order to achieve the best possible outcome for people. Healthcare professionals made comments including; “I would like to make you aware of the positive influence and commitment staff at the above provision have afforded to my numerous service users. Their commitment, clear understanding of need, personalisation and professional care and support provided has improved the quality of life of numerous service users.” Staff had worked with people to reduce the number of hours of support they needed. People had become more independent, developed stronger links with the community, and had achieved huge personal goals that improved their health and wellbeing.
People were treated with the utmost respect. The management and staff cared deeply for the people they supported and their dignity. They promoted equality and diversity and supported people to feel confident and happy. For example, one person was being supported to explore their gender expression as this was an area of anxiety for them. Staff constantly thought about how people were perceived in order to avoid people feeling judged or looked down upon. The registered manager told us they wanted people being supported by staff to look as though they were out with a friend when out in the community. They had therefore decided not to issue staff with uniforms or name badges and ask people how they wanted their staff to refer to themselves if asked. Some people had asked for staff to introduce themselves to others as their PA and this was being respected. One member of staff said; “There is no one judged here. We don’t have name badges to separate us from the clients. We’re all the same. Just people who deserve respect. We’re a family.”
We received overwhelmingly positive feedback from external healthcare professionals. They made comments which included, “What they have, in my opinion is something special. The care of (the people receiving support) exceeds expectations and they genuinely treat them as family. I have only ever witnessed person centred care, tailored to each individual, the majority of which, I have had the pleasure of meeting. I have nothing but praise and admiration for the work that they do, and their hard work and commitment is evident in the happiness of (the people receiving support)”, “I cannot commend this service highly enough. I have no hesitation in recommending any client to Sunnom Bonum and would commend them for the great service they offer.”
Staff had access to thorough training which met their needs. The day to day manager worked hard to create training workbooks for staff by liaising with healthcare professionals and conducting research on best practice. This ensured each person was supported by staff who understood their healthcare needs and how to meet them. People were protected from risks relating to their health, medicines, nutrition and behaviours. People’s individual risks had been assessed and staff had taken action to seek guidance where required and minimise identified risks. Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risk of reoccurrence. Staff supported people to take their medicines safely where required and as prescribed by their doctor.
People and staff benefited from a leadership team which valued staff contributions, skills and achievements. This was demonstrated by staff ideas being implemented and good work being highlighted. Staff praised the leadership team and felt supported by them. One member of staff commented; “I don’t think Summon Bonum Support and Care get the praise they deserve. They go above and beyond for people and for staff. We’re all taken out for a Christmas party every year. Every member of staff gets a birthday present every year. They promote equality and diversity. Everyone can be themselves and feel respected. The manager is lovely, it’s a lovely place to work. We’re more than a team. We’re a family.”
Staff knew how to recognise possible signs of abuse which also helped protect people. Staff knew what signs to look out for and the procedures to follow should they need to report concerns. Safeguarding information and contact numbers for the relevant bodies were accessible. 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. Staff had the competencies and information they required in order to meet people’s needs.
There was open and effective management at the service led by the registered manager and the provider. Staff felt supported and valued. An audit system was in place to monitor the quality of the service people received. Records were clear, well organised and up-to-date. Unannounced checks to observe staff’s competency were carried out on a regular basis.
People, their relatives and staff felt able to raise concerns or make a complaint. They were confident their concerns would be taken seriously. People told us they didn't have any complaints. Where complaints had been received they had been managed in line with the company policy.
Further information is in the detailed findings below
This inspection took place on 14 April 2016 and was announced. We gave the service 36 hours’ notice, to ensure that the registered manager and appropriate staff were available to support the inspection.
Summon Bonum Support and Care office is situated at Maidencombe Manor, where there are also 8 flats available for rent by people with support needs. These people can choose to have any support they need provided by Summon Bonum Support and Care, or by another provider if they wished. People hold their own tenancies on their flats, which are rented privately to them. Other people were being supported in the wider community or at day services. Some services were commissioned through the local authority and other people made their contract arrangements privately or through direct payments.
The last inspection of the service had taken place on the 13 and 14 August 2014, when the service was not meeting standards in relation to reporting incidents of concern and problems with the recording of the administration of medicines. The provider sent us an action plan telling us what they had done to put this right. On this inspection we looked and saw that changes had been made and sustained.
The service 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. The registered manager had not changed since the last inspection of the service.
Risks to people had been assessed and actions recorded on how the service was reducing the risks. This included assessments of people’s vulnerabilities, health conditions or day to day activities. Risk assessments were also carried out for people’s homes to help ensure staff safety. There were safe working practices risk assessments for staff, including lone working policies and staff were clear about actions to take if they could not gain access to a person’s home at the expected time.
Staff understood their responsibilities with regard to safeguarding people, and knew what to do if they had concerns about people’s well-being. Policies and procedures were in place to help staff identify and report abuse. Staff carried identity badges and were always introduced to new people before they started caring for them. Where the service had an involvement in supporting people with their finances and budgeting there were systems that ensured staff did not have access to people’s monies without the person being present.
Staff were employed following a full recruitment process, and there were enough staff to fulfil the contracts in place. The registerd manager told us the service did not take on people whose needs they could not meet. We saw evidence of good relationships having been built up between people being supported and the staff supporting them. People told us they liked the staff and were happy with the service they received. A visiting professional told us the staff were “attentive” and that they had no concerns.
Staff received the training they needed for their job role and were knowledgeable about people’s care needs. Staff were supported by the service management and received regular supervision and appraisal, including spot checks on their performance. Staff were encouraged to reflect on the work they did with people and their working practice, and comments from people being supported were included in the appraisal process.
The service was supporting people in line with the Mental Capacity Act 2005 (MCA), and protecting their rights. Assessments of people’s best interests were being carried out where they lacked the capacity to make a specific decision for themselves. Decisions were made in line with the MCA, involving other supporters or advocates where needed.
Medicine practices were safe. People were supported to manage their own medicines if they wished. Medicines were kept safely in people’s homes and staff completed medicine administration charts to show when medicines had been given. People were supported to attend healthcare services if that was a part of their care plan. Staff were aware of people’s healthcare needs and of signs that a person’s physical or mental health was deteriorating. They understood how to escalate these concerns to support the person. Staff understood protocols, for example for supporting a person with epilepsy. These detailed when to administer medicines and when to call for emergency medical support.
People were supported to live their lives as independently as they wished. People were able to discuss with the service’s manager any changes they wanted to make to their care plans which were regularly reviewed. This helped ensure people’s goals were clear and attainable. People were supported to make choices about meals and help prepare food with support if they wished and this was a part of their care plan. Staff supported people with budgeting and healthy living choices. People were supported follow activities of their choice if that was a part of their care plan.
Staff took time to understand people’s communication where this was not verbal, and clear information was available in people’s care plans to support this. Some information was available for people in easy read formats, and the registered manager was looking at developing this further with greater use of tablet computers and the internet. Staff demonstrated respect for people’s dignity and individuality. Staff spoke fondly of people, recognising their skills and qualities when describing the work they were doing with them.
People were confident that any complaints or concerns would be managed well. Complaints and feedback was seen by the service as a positive tool, and were used by the service as a way of learning and improving the quality of the service. People were encouraged to be open about anything they wanted done differently.
The registered manager of the service was well liked and respected by staff and people using the service. They were able to manage the service well, and communicated a clear ethos and philosophy through the staff team. The staff team learned and reflected on what was going well for people and where improvements could be made as a group. This included the discussion of ethical dilemmas in the support they were delivering. This helped to achieve a consistent approach and clear understanding of how to work with people.
People were involved in having a say about the service they received through questionnaires, spot checks and regular meetings with the registered manager. Quality assurance and quality management systems were in place to ensure people received a consistent high quality experience of their care. There was a calendar of regular audits carried out, which led to action plans where improvements were identified as being needed.
Records were well maintained. Policies and procedures were reviewed regularly, and stored securely. There were systems for the safe disposal of records when no longer needed.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
The inspection was announced 48 hours before. There were no concerns to follow up from our last inspection of the 21 March 2013.
Summon Bonum Support & Care (also referred to as ‘the service’) provides enabling services and personal care to people with a learning disability. The Care Quality Commission (CQC) only regulates personal care in relation to this service. Although they provided services for 24 people, only six people were currently receiving personal care.
There was a registered manager 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 and associated Regulations about how the service is run.
We found some issues in respect of the completion of Medicine Administration Records (MARs) and ensuring they were accurate and in line with current guidelines. The registered manager was not auditing these and ensuring practice was safe. Archiving of records held in people’s homes was not taking place to ensure these were available for future scrutiny if required.
There were sufficient staff with the right skill mix to meet people’s needs and staff were recruited safely. People told us they felt safe in the care of the staff. Staff received training to enable them to meet people’s needs and keep them safe. Further training was provided as required. Care plans were regularly reviewed and reflected people’s current needs.
People and staff told us they were well looked after by the management and felt important to the service. People were supported by staff who were caring and compassionate. They had control of their care planning and who they wanted to deliver their care. People were asked their view of their care and their view was listened to.
People were supported by care plans that reflected their current need. People showed us how they had been supported to ensure the care was how they wanted it to be. Care plans were reviewed and changed to meet changing needs.
The service was well led and the registered manager was identified as the most important person by people and staff. Ensuring the values and quality of the service was stated as important to the service and registered manager. Continual improvement was central and people and staff were involved in this process.
We found a number breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.
The service provided care and support for 22 people, supported by approximately 14 support staff.
Care and support was personalised and took into account individual preferences and choice. We looked at three care records and saw that they contained clear, detailed plans which held all the information required and were up to date. Regular reviews of care were carried out.
People were very complimentary of the service provided and the support staff. Comments included "they look after me - I like all of them" and "I feel safe". When people were asked if they were happy they all said "yes!"
Staff were knowledgeable in their understanding of hygiene requirements.
All staff told us they felt supported by the manager, felt part of a team and were listened to. Comments included "I love it here - we are all friends", "everyone gets on" and "we are on the same wavelength". People were involved in choosing the support staff they would like to look after them.
All the necessary checks were carried out before staff began work and staff were chosen to fit in with people who use the service.
The service had systems in place to monitor the quality of service provided. There was a complaints procedure in place should people need to use it.
We saw four case files which contained clear case plans and support logs and staff and management were able to talk about the practical uses of the files. This means that the people's care is thoughtful and productive.
People spoke highly of the staff and the care they provided. One family member told us that staff were 'helpful' and 'obliging'. The staff explained that they focused on individual care and that the happiness and safety of people who use the service is the focus of their care.
The manager took a proactive approach and one person told us that they were 'the best person in the world'. There was clear complaint procedure in place and the manager was able to show how they were constantly evaluating the service to ensure high quality.