Bonhomie Sarisbury Green

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

There were shortfalls in how the systems and processes within the service supported people to have maximum possible choice and control over their own care. The culture of the service did not reflect the principles of the guidance Right Support, Right Care, Right Culture. Care plans lacked information about how people communicated and expressed their choices. Whilst activities did take place both within the home and within the community, the systems and processes of the service did not ensure there was sufficient planning and consideration of people’s longer-term aspirations and how these could be achieved. This has resulted in a breach of regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

There were some evidence people were supported to direct their care and support. For example, people had chosen how to decorate their own apartment. One person told us “I order my own prescriptions independently and then hand them over to staff they administer them at the right time.” This person also explained how they attended their own appointments independently. They were also able to self-identify when they felt they needed PRN medicines and requested these from staff saying, “If I ask for PRN this is given to me when required.” Key worker meetings took place and 1 person spoke positively about these saying, “Yes, I have a key worker, it is always the same person, they discuss the care I want with me… I am always involved in my care planning and discuss this with my own keyworker if a change needed, I have always been involved in my care planning from the beginning …. I ask for female carers and this is respected.” We received mixed feedback from relatives as to how involved they had been in planning their relatives care and in reviews of the placement. One relative was positive saying, “I have received phone calls regarding care planning in the past year… I feel they respect choices, preferences, likes and dislikes…I feel they can choose the activities they would like to be involved in” but another told us this was an area that could be improved saying, “There have never been any progress reports….I have never seen any care plans or been involved regarding this, I have never been invited to meetings that have taken place.” We also received mixed feedback from relatives about how effectively the service supported their family member to access activities, promote independence, health and wellbeing. For example,1 relative said, “My [Family member] is there for rehabilitation, but there is no sense that there is anything in place to move forward… there appears to be no progress and no structure within the facility.”

Whilst people felt their choices were respected, we identified shortfalls in how the systems and processes within the service supported people to have maximum possible choice and control over their own care. The culture of the service did not reflect the principles of the guidance Right Support, Right Care, Right Culture and the systems and processes in the service did not always support staff to provide person-centred care and support which maximised people’s choice, independence, and inclusion. For example, care plans lacked information about people’s preferences and skills. This increased the risk of people being disempowered. Care plans lacked information about how people communicated and expressed their choices and decisions. This increased the risk of people not being listened to, and not being supported to communicate their needs or direct their care. Written records used language and terminology which was not always respectful or person centred. For example, some care plans interchanged between genders when describing the person’s needs or had another person’s name in it. Staff were guided to be ‘strict and firm’ or to use an ‘assertive manner’. There was no detail about what was meant by these statements. There was a risk staff might interpret this in different ways placing the person at an increased risk of being supported inappropriately, or not in line with their assessed needs and preferences. Key worker review meetings took place but the records relating to these were basic and it was not clear actions resulting from these were addressed and resolved. Whilst activities did take place both within the home and within the community, the systems and processes of the service did not ensure there was sufficient planning and consideration of people’s longer-term aspirations and how these could be achieved. A relative expressed a frustration that their family member was not getting a suitable level of rehabilitation.

Staff were able to talk about how they supported people and did appear to overall know people well, but their responses were not always consistent with one another which increased the risk of people not being supported in a manner that met their individual needs. The registered manager described how people were supported to develop their independence and to make choices. They had introduced a yoga class and transformed a room in the service into a yoga studio. Cooking classes had been introduced. People were supported to access local community services and activities.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.