Bonhomie House

Updated 5 January 2023

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.

Inspection team

The inspection team consisted of 2 inspectors, a specialist nurse advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Bonhomie House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. 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 Care Quality Commission. 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 inspection was unannounced.

What we did before the inspection

We used information the provider sent us in the Provider Information Return (PIR). Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We looked at information we held about the service including notifications they had made to us about important events.

Why we inspected

We received information of concern relating to the management and the culture of the home and the quality of care provided. During our last inspection we identified a breach of regulation. During this inspection we used this information of concern to assist our inspection and to check the provider was no longer in breach.

During the inspection

We spoke with 7 people and 8 relatives about their experience of the care provided. We spoke with 12 members of staff including the registered manager, the training manager, the chief operating officer and the clinical lead. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 8 people’s care records and 10 people’s medication records. We looked at 6 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, clinical and care audits and feedback questionnaires.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 5 January 2023

About the 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.