Archived: Bonhomie Sarisbury Green

Bonhomie Sarisbury Green is a care home which provides care and support to people living with a wide range of complex healthcare needs. These include acquired brain injuries, neurological conditions, physical disabilities and mental health issues. At the time of our inspection there were nine people living at the service. The accommodation is made up of 16 small studios which have a living area with a small kitchen area where people can make drinks and prepare snacks. There are en-suite bathrooms to each bedroom area. People could access some of the facilities at a nearby service run by the same provider. For example, swimming pool and Jacuzzi which is used for therapeutic and leisure activities.

Bonhomie House 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 been on long term sick, so the deputy manager was acting up into this role in their absence.

Processes and procedures to monitor the use of controlled medicines were not always being managed safely. These need to improve to ensure medicines are administered safely.

People that we spoke with told us that they felt safe. Staff had received training in safeguarding and were able to explain what they would do if they suspected that someone was being abused.

Recruitment and selection procedures were in place and appropriate checks were carried out before staff started work.

People living at the home had detailed care plans which included an assessment of risk. These were subject to regular review and contained sufficient detail to inform staff of risk factors and appropriate responses.

Staffing numbers were adequate to meet the needs of people living at the home. This was reviewed following incidents where new behaviours were observed which might increase or change people's dependency level.

Staff were suitably trained and skilled to meet the needs of people living at the home. The staff we spoke with confirmed that they felt equipped for their role. The training matrix and staff certificates showed that the majority of training was in date.

Staff had a good knowledge of people's individual needs and wishes and their likes and dislikes. This enabled staff to support people appropriately while promoting their independence. People were supported to take part in a range of activities both within and outside of the home.

Quality audits were routinely carried out. The provider was not routinely notifying the Care Quality Commission about incidents and accidents that had happened in the home.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We found action had been taken to improve people's day to day decisions about their care, and staff had received training and support to enhance promotion of people's dignity. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Care plans had been revised and extended and staff were aware of the individual support needed for people who used the service.

Risk assessments had been carried out to ensure that any restrictions in the home had been assessed and support planned to meet people's needs. Staff refresher training and support in the Deprivation of Liberty Safeguards (DoLs) and The Mental Capacity Act (MCA) 2005 had taken place and was ongoing.

The provider had taken action to improve the monitoring of the quality of service and identify, assess and manage risks to the health, safety and welfare of people using the service.

Staff had received safeguarding vulnerable adults training and showed an awareness of their understanding of the principles involved. The staff we spoke with had limited knowledge of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DOLS). This meant they were not aware of how these should influence their care practices. We also found some restrictions of movement in the home and these were not based on individual people's assessed needs.

We found systems to monitor and assess the quality of the service had not identified all areas requiring improvement. This had not led to necessary changes or minimised the risks to people who used the service. We found further areas of concern including staffing, the prevention and control of infection and the premises.

Medicine administration was well managed but details about 'as required' medicines were not sufficiently documented. Staffing levels had been reviewed and recruitment was taking place to increase permanent staff. The deployment of staff throughout the day did not always ensure staff were available when needed. Quality assurance systems were in place although these were not comprehensive.