Bonhomie Sarisbury Green

Bonhomie Sarisbury Green is a residential care home providing personal care to 14 people aged 18 to 65 at the time of the inspection. The service can support up to 19 people living with substance misuse or mental health conditions in an adapted building. Each person’s room had a kitchenette with snack and drink making facilities as well as a lounge and sleeping area.

People’s experience of using this service and what we found

We were not assured that medicines were safely managed. We found some medicines recording to be incomplete and some completed in error. There was not always sufficient information to support staff in administering PRN medicines.

The premises were not well maintained and as a result did not appear to be well cleaned. Scuffed paintwork prevented effective sanitising and there were unsealed edges to flooring in toilets. The registered manager has been responsive in addressing concerns we had about the premises and maintenance is underway.

People were supported by staff who understood the types of abuse that may occur and who were confident the registered manager would address any concerns they had. Safety checks ensured the premises were safe and equipment had regular services. Records of completed works were not always available. We were concerned about risks associated with alcohol gel however the registered manager addressed this during our inspection.

Care plans were very long, and we were not confident staff could support people after reading them as information was not always clearly stated. Assessments had been completed by both the provider and health and social care professionals and used to form care plans.

Staff were safely recruited, and staff told us there were usually sufficient staff deployed. Staff accessed training online and were mostly happy with the training they completed. We were not assured that all staff had sufficient first aid skills as they were not able to demonstrate their knowledge and skills, however all staff had received updates in this area. There was no specific training in the medical conditions people using the service lived with and there had been no mental health training since 2018.

Meals were appetising and generous however we were concerned that a person’s SaLT assessment around swallowing was not being followed. Snacks were available in the communal areas of the service.

We were not assured that oral health assessments and care plans were in use however the registered manager agreed to assess a person at our request. We have made a recommendation about this.

People were mostly supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We have made a recommendation about MCA records in the report.

Advocates were available to support people and there were signed consent forms for aspects of care and support in people’s care records.

Staff were kind to people and knew them well. They were aware of preferences and family and other information that enabled positive interactions. We were not assured that people were always treated with respect or that there was therapeutic value to interactions used during crises.

Care plans detailed how people wanted to receive care and there was some information about how best to communicate with people.

There was no overall activities programme, people had individual plans according to their interests and needs. The provider had supported people to stay in contact with friends and relatives during the pandemic through phone and video calls and visits in the garden.

Audits were completed of the service however these did not always identify areas that needed improvement. The provider issued regular quality assurance questionnaires to peoples, relatives and staff and devised action plans to address any improvements needed.

Health and social care professionals told us the provider worked well in partnership with them.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, Right Care, Right Culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service is not currently registered to provide a service to people who have learning disabilities or autism however people with both conditions use the service. We have asked them to add learning disability and autism to their service user bands. It is also important for the provider to consider the principles of Right Support, Right Care, Right Culture when delivering care to people with learning disabilities or autism.

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 the service under the previous provider or legal entity was good, published on 13 February 2018.

Why we inspected

This was a planned inspection based on the previous rating and the change to provider.

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.

We have found evidence that the provider needs to make improvements. Please see the safe and effective sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bonhomie Sarisbury Green on our website at www.cqc.org.uk.

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 monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to medicines recording. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.

Bonhomie Sarisbury Green is a care home providing accommodation for up to 19 people who may be living with mental health needs. At the time of the inspection there were 14 people living at the home.

People’s experience of using this service

We found recommendations from the Food Standards Agency (FSA) had been implemented and sustained.

Appropriate plans were in place to mitigate risk and regular communication with healthcare professionals was evident.

Prior to the inspection we received information concern from the general public.

Rating at last inspection

The location has not been rated.

Why we inspected

We undertook this targeted inspection to follow up on specific concerns received about the service. The inspection was prompted in response to concerns received about the safe handling of food, maintenance and behaviours that others found challenging. We found no evidence during this inspection that people were at risk of harm from these concerns.

Please see the safe section of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.