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Inspection carried out on 31 January 2018

During a routine inspection

This inspection was carried out on 31 January and 1 February 2017 and was unannounced.

At the last inspection, the service was rated ‘Good.’ At this inspection we found the service remained Good.

Bon Secours 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. The service provides accommodation and personal care to up to three people who might need support with the mental health or may be living with a learning disability.

The 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 using the service can live as ordinary a life as any citizen.

The service continued to be well managed by the long standing registered manager and staff team. Staff continued to be supported and had a yearly appraisal and the training they needed to meet people’s specific needs. There were enough staff on duty and they were recruited safely.

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 continued to lead the lives they wanted to, people were supported to meet friends, follow their hobbies and interests and to get a job if this is what they wanted.

People said they felt safe and said they had the support they needed to achieve their goals and hopes for the future. Risk taking was encouraged so that people were not restricted.

There was a feeling of trust and mutual respect, there was laughter and joking and people seemed at ease with the staff and each other. Everyone was involved in the cooking and cleaning and achievement however small was celebrated. People were supported to eat well and healthy life styles were promoted, people told us about their swimming sessions and recent gym membership. People attended college and had work placements and were leading fulfilling lives.

Staff were caring and kind and respectful. People said they had the privacy they needed. People were supported to be as independent as they wanted to be and were fully involved in making decisions about things that affected them.

People felt safe, they were protected from abuse and knew about personal safety. People had control over what went on at the service including taking more control of their medicines and taking more responsibility to travel independently with the right amount of support. Staff responded well to people’s needs especially when they became anxious and we saw this during the inspection.

The service was clean, hygienic and well maintained. People told us about plans for redecoration and about a plan to develop the garden as they wanted to grow more vegetables. Staff worked with other organisations including care managers and health professionals to make sure people had the support they needed.

Incidents and complaints were reviewed so that lessons could be learned. The registered manager continued to learn from when things went wrong and from when things went right and continued to have the oversight they needed to make sure staff continued to provide good support.

People’s needs were thoroughly assessed with their involvement and the senior staff was reviewing and developing support plans. People received person centred care and they had a say about their care and support. Any complaints and concerns were acted on and everyone had a say about what might be improved.

The provider’s philosophy was based on maximising people’s ability to make choices, respecting basic human rights, fostering inclusion in wider society, and encouraging people to gain the maximum level of independence they were able to. S

Inspection carried out on 25 September 2015

During a routine inspection

The inspection took place on 25 September 2015 and was unannounced.

Bon Secours provides accommodation and personal care to up to three adults. Each person has their own bedroom and some rooms have en suite facilities. There is a shared kitchen, dining area and lounge. There is a garden with patio area, seating and vegetable plot. There were three people living at Bon Secours when we inspected.

The registered manager was present during the inspection. 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 provided leadership and guidance to the staff and had oversight of all aspects of the service. Staff were motivated and said they felt supported by the manager. The staff team were aware of the aims of the service that was to ‘provide high quality support’. Staff told us that the manager was approachable and they were confident about raising any concerns they had with the manager. One person told us “The staff are superb.”

There were enough staff, who knew people well, to meet peoples’ needs at all times. Staffing was planned around peoples’ activities, hobbies and appointments. Staff had the time and skills to provide the support people needed. Staff were clear about their roles and responsibilities. Staff recruitment systems were in place and new employees had been checked to make sure they were suitable. People had been involved in recruiting staff in the past; although no new staff had been employed for some time. The staff team were established and had worked at the service for some time, people told us they liked and trusted the staff.

Staff were supported to provide good quality care and support. A training manager was employed who had a training plan in place to keep staff skills up to date. New staff completed a thorough induction before they were assessed as competent and could work on their own. Staff met regularly with the manager to discuss their work and any concerns they had.

Staff knew the possible signs of abuse and knew how to alert the manager or external agencies. Staff knew how to keep people safe in an emergency. Risks were managed so that people were not restricted but empowered to try new things. People were supported to participate in hobbies and activities they enjoyed and were supported to have paid work and to continue their education.

People’s needs had been assessed and support was planned with people to support them to be as independent as possible. Each person had a support plan that was personal to them with pictures and photographs. As well as this each person had a health action plan detailing their health needs and a ‘hospital passport’ which had information about the person that hospital staff may need to know. People received their medicines safely and were supported to take as much control of their medicines as they could.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant supervisory body in line with guidance.

People were involved in planning and preparing the meals and were supported to have a balanced diet and regular exercise. Everyone was involved in the housework and gardening and everyone had a say about how the service was run. People were treated with respect and their privacy and dignity was protected. Staff were kind, caring and compassionate and knew people well.

People were confident about raising concerns and complaints about the service. These were investigated and people had received a satisfactory response. The manager and staff completed regular checks of the quality of the service provided. When shortfalls were found action was taken quickly to address these. People, their relatives, staff and visiting professionals were asked about their views of the service. People’s views were used to improve and develop the service. The environment was safe, clean and homely. A representative from the local authority told us that the service was clean, homely and well managed.

Accurate records were kept about the care and support people received and about the day to day running of the service. Staff had the information they needed to provide safe and consistent care and support to people.

Inspection carried out on 22 June 2013

During a routine inspection

We spoke with the three people who lived at the service and they were all positive about it. One person told us the service was �Nice and friendly� and �Relaxed.� Another said �It�s a nice place to live, I feel safe here.�

The interactions we saw between staff and people using the service were friendly and respectful. The people we spoke with said they found the staff supportive. One person told us �The people who work here treat me good.� Another said �I love it here.� The people we spoke with told us what they liked to do, and they said they were able to make choices about their lives and pursue their interests. People told us that they were satisfied with the care and support that they received. One person said "The food is good, there is a good choice or I can ask for something different". Another person commented when asked, I like the food, we get treats and the staff makes cake for us.

The home was clean and tidy throughout.

There were effective recruitment and selection procedures in place. The service had processes in place for the recruitment and management of staff, and the staff working at the service had had the necessary recruitment checks.

The provider had an effective system to regularly monitor the quality of the service that people receive. There was an effective system in place to identify, assess and manage risks to health, safety and welfare of the people who used the service and others.

Inspection carried out on 21 September 2012

During an inspection to make sure that the improvements required had been made

We spoke with all three people living in the home. People told us that they liked the home and they had a good lifestyle. One person said, "I'm very happy." Another person talked about their plans to go on holiday and said they were going out later that day. People talked about what they had been doing and recent outings. People said the staff helped them and listened to them. People told us how the staff were encouraging them to live a healthy lifestyle by taking more exercise and promoting healthy eating. One person said, "I go out walking, I eat healthy food and have some treats and I do exercises to music." People were supported to maintain relationships that were important to them with their families and friends. We found that there were enough staff to support each person so that they were able to develop their independence and choose how they wanted to spend their time. Staff were able to attend training and said they were well supported by the manager.

Reports under our old system of regulation (including those from before CQC was created)