We carried out a review of the data available to us about Bonhomie House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Bonhomie House, you can give feedback on this service.
Bonhomie House is a residential care home providing personal and nursing care to up to 78 people. The service provides support to people with physical disabilities, brain injury, mental health needs, complex needs and for people who experience periods of anxiety or distress . At the time of our inspection there were 62 people using the service.
People’s experience of using this service and what we found
Improvements had been made in respect of the safe management of medicines, the environment and governance and the provider was no longer in breach of regulation. People were safeguarded from abuse by staff trained to protect them. People felt safe at the service and regular servicing and maintenance ensured the premises were safe. Recruitment was safely completed, and agency staff were used to maintain safe staffing levels. Medicines were safely managed, and improvements had been made since we last inspected. We were assured the provider maintained good infection prevention and control standards and government guidance was followed both in IPC and around visiting the service.
Peoples care records contained extensive plans to ensure they received the care they needed in a way they were happy with. Staff completed an induction on commencing in post and completed additional and refresher training to ensure they were familiar with current good practice. Kitchen staff were responsive to people’s needs and wishes and prepared meals people enjoyed. The premises was currently undergoing a full refurbishment. People were supported to remain active and as independent as possible. People were 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.
There were a wide range of plans addressing aspects of people’s health and well-being and daily activities. People were supported to access the local community and where possible and safe to do so they were encouraged to engage independently. The service was managed in a positive way and staff could access the management team when needed as they had an open-door policy. The provider understood their responsibilities under the duty of candour and informed CQC of significant events in the service. Regular meetings and surveys ensured the provider maintained good communications with staff, people and relatives. Meetings were held with staff and the senior management team and relatives were involved in the newly implemented key working system.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 11 February 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
The inspection was prompted in part due to concerns received about leadership, care provision and culture within the service. A decision was made for us to inspect and examine those risks.
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.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Bonhomie House provides nursing and personal care for up to 78 people who may be living with dementia, have complex mental health needs or a disability.
People’s experience of using this service
The provider did not have effective oversight to consistently drive improvement. Systems and processes were not always effective to assess, monitor and improve the quality and safety of the service.
The provider failed to ensure the decision to use CCTV had been appropriately assessed and documented in line with the code of practice set out by the Surveillance Camera Commissioner (SCC). We recommend the provider seek guidance from the Surveillance Camera Commissioner to ensure people's human rights were respected and protected.
The maintenance and cleanliness of the building required improvement to ensure good infection control procedures were being followed.
Medicines were not always being managed safely.
Records relating to end of life care did not consistently document people's wishes and preferences.
Staff had received safeguarding training and had their competency in this subject checked. They were aware of the types of abuse that could happen to people, what signs to look out for and their responsibilities for reporting any concerns.
The registered manager had a good understanding of their responsibilities to notify the CQC of important events that happened within the service. People and their families had been given information so that they knew what to expect from the service.
Staff received an appropriate induction into their role and learning opportunities were made available.
Most staff said they felt supported in their role. They told us they received regular supervision and appraisal.
Staffing levels met the needs of the people using the service. Staff had been recruited safely.
People were supported to have choice and control of their lives.
People had good access to healthcare services.
People, their families and other professionals had been involved in an assessment before the service provided any support. The assessment had been used to create care and support plans that addressed people’s individual identified needs. Staff demonstrated a good understanding of the actions they needed to take to support people.
A complaints procedure was in place and people told us they were confident that concerns would be dealt with appropriately by management.
Staff were supported and encouraged to share ideas about how the service could be improved and had been pro-active in supporting changes. Most staff spoke enthusiastically about the positive teamwork and support they received.
Why we inspected
This service was registered with us on 11 January 2019 and this is the first comprehensive inspection.
Enforcement and Recommendations
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 and will take further action if needed.
We have identified a breach of Regulation 17 (Good governance) at this inspection. The provider failed to ensure governance systems consistently drove improvement.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Bonhomie House is a care home with nursing registered for up to 78 people. People using the service may have a disability, a mental health condition or they may require care and support for substance misuse.
Bonhomie House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided.
People’s experience of using this service and what we found
People who displayed behaviours that challenged others were supported effectively and plans were in place to mitigate risk.
Suitable recruitment processes were in place to keep people safe.
Appropriate infection prevention and control procedures were in place to reduce the risk of infection and to keep people safe.
The provider and management team carried out audits to monitor the quality of the service and ensure they delivered a high standard of care. The registered manager and staff worked in partnership with other health and social care professionals to achieve positive outcomes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was previously inspected on 30 May 2018 and rated requires Improvement.
Why we inspected
We undertook this targeted inspection to check on specific concerns we had about risk management and recruitment. This visit did not find any concerns in the areas inspected.
CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question. 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 coronavirus and other infection outbreaks effectively.
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.