Bonhomie House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The provider was previously in breach of the legal regulation in relation to dignity and respect. Not enough improvement was found at this assessment, and the provider remained in breach of this regulation. ​

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not consistently ensure people were treated with kindness, empathy, and compassion or that their privacy and dignity were always respected.

People and relatives told us care was not always personalised and varied depending on the staff member. Some people told us they did not always feel respected, for example when staff did not handle their personal belongings as they wished.

We saw mixed interactions between staff and people. Some staff were respectful and discreet, but others did not explain what they were doing, missed chances to support comfort and emotional wellbeing, or interacted in ways that did not promote dignity. This meant people were not always fully involved or receiving kind, compassionate care.

The provider told us they had identified staff culture as an area for improvement and were taking action, including prioritising staff training, upskilling, and measures to support cultural change.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Some care records lacked personalised information and did not show how people were involved in planning their care. One person told us, “I am not involved in any care plans … they will update the care plans without you.”

People’s daily notes appeared task-focused and lacked meaningful detail about how people were supported to maintain or develop independence. This limited the provider’s ability to understand and reflect peoples lived experiences and meant care reviews were less effective. As a result, people’s support did not always fully meet their individual needs or promote independence.

However, some relatives gave positive feedback, telling us, “They do try to encourage him,” and “She can generally cook for herself. Her confidence is growing every day.” We also saw bedrooms personalised with items important to people, such as photos and belongings.

The provider told us they were reviewing care planning processes to improve personalisation.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

People’s choices and preferences were not consistently documented within care plans, meaning there was limited information about personal likes and dislikes. This meant staff did not always have clear guidance to deliver care that reflected individual preferences, increasing the risk that support was task-focused rather than person-centred. Although staff shared examples of promoting independence in practice, the lack of detailed care plans created a risk of inconsistent approaches.

We observed and heard examples of how people were supported to maintain independence. For instance, people using equipment such as motorised wheelchairs told us these were available and kept charged so they could use them when needed. Staff were able to describe how they supported people to make choices and promote independence, which was also reflected in feedback from some people.

People were supported to maintain relationships with friends and family, and relatives confirmed there were no restrictions on visits.

The provider told us they were working with people to identify personal goals and record these in care plans, with actions to support people to achieve them.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond promptly to minimise discomfort, concern or distress.

Some people told us staff were less available at certain times, such as when more than one staff member was on a break, and others said staff providing 1:1 support were sometimes unable to help when asked. Staff also told us they found it difficult to respond promptly when managing competing priorities or when breaks overlapped, which sometimes affected their ability to meet people’s immediate needs.

Some relatives told us they worried people’s health needs were not always monitored effectively, which could delay early intervention for conditions such as seizures or infections. Care plans varied in detail; for example, some included clear instructions for catheter care, while others, such as those for epilepsy, were less detailed. This indicated information about health monitoring was not always applied consistently across the team.

During our visit, we saw mixed responses from staff. At times, staff acted quickly and offered reassurance, but we also saw occasions where staff did not respond promptly or with empathy. This meant we could not be assured people’s emotional and psychological needs were always met promptly.

The provider did not always promote the wellbeing of their staff or fully support and enable them to deliver person-centred care.

People, relatives and staff told us frequent changes in management had affected morale and continuity of care. Staff told us communication could be improved, and some felt unsupported by leadership. However, most spoke positively about the new manager, describing them as approachable and accessible.

Leaders had introduced measures to support wellbeing, such as rotating staff allocations and monitoring shift patterns to reduce burnout and ensure fair rest periods. Staff gave mixed feedback about these changes: some welcomed the changes, while others felt they reduced familiarity for people and were not always applied fairly. Leaders told us these changes were intended to promote staff wellbeing and support effective deployment so more staff were suitably skilled to support people across the service.

Leaders told us they were taking steps to improve staff wellbeing and support, including more regular supervisions, team meetings, and an open-door policy.