Background to this inspection
Updated
7 September 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Boniville House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This first day of the inspection was unannounced. The second day was announced.
What we did before the inspection
Before the inspection we looked at information we held about the service. This information included the last inspection report, feedback we had received about the service and any statutory notifications that the provider had sent to the CQC. Statutory notifications include information about important events which the provider is required to send us by law. We also received feedback about the care home from two social care professionals. This information helps support our inspections.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with the five people using the service, the registered manager, deputy manager and three care staff. We reviewed a range of records which related to people's individual care and the running of the service. These records included people's care files, staff records, policies, medicine administration records and a range of records relating to the management and quality monitoring of the service. We also spent time observing staff engagement with people using the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. The registered manager provided us with staff training and recruitment information and other documentation to do with the management and running of the care home. We spoke with three people’s relatives and one social care professional by telephone and received written feedback from one healthcare professional.
Updated
7 September 2021
About the service
Boniville House is a care home providing personal care to up to five people who live with mental health conditions. At the time of our inspection five people were living in the home.
People’s experience of using this service and what we found
Quality assurance systems were not always effective. Audits of routine checks and other areas of the service to assess, monitor and improve the service were not completed by management staff.
It was not clear how the provider determined that staffing during weekends was suitable and effective in meeting people’s individual needs and ensuring that people and staff were safe.
We saw positive engagement between staff and people. Systems were in place to ensure people were protected from abuse and treated with respect and dignity. Policies and procedures were in place to protect people from abuse and staff were confident that allegations of abuse would be dealt with appropriately
Suitable infection prevention and control measures and practices were in place to keep people safe and prevent people, staff and visitors catching and spreading infection.
Care staff told us that management were approachable and provided the training, guidance and support they needed to carry out their role and responsibilities effectively.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 8 June 2018).
Why we inspected
The inspection was prompted in part due to us having received anonymous information about concerns in relation to the management of the care home, medicines, confidentiality, and staffing. A decision was made for us to undertake a focused inspection to examine those risks by reviewing the key questions of Safe, Effective, and Well-led.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect these. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, and Well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified one breach in relation to quality assurance monitoring. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.