CQC report explained · a nursing home
What the CQC found at Bonhomie House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2023
Bonhomie House was rated Good; inspectors found safe, respectful care and clear improvements, but some concerns remained about activities and support with alcohol misuse.
Inspectors visited without notice on 21 and 22 November 2022. They spoke with people, relatives and staff, observed care, and checked care plans, medicines records, recruitment files and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People were described as safe, treated with respect, supported to make choices and helped to access healthcare and the community.
The home had improved since the previous inspection, which was rated Requires Improvement. Medicines management, the environment and management oversight had improved, and the previous breach of Regulation 17 no longer applied.
Some work was still continuing. The home was being refurbished, one weight record had been entered incorrectly, relatives raised concerns about activities, and extra training was being provided about supporting people with substance misuse.
Safer medicines systems
Previous problems with controlled drugs and as-required medicines had been corrected. Records of medicines received, given and disposed of were accurate.
“At this inspection we found improvements had been made and previous issues had been rectified.” from the report
Personalised care
Care records gave staff detailed guidance about people's needs, preferences and how to support them. Records were reviewed with people and their families.
“Care records were detailed and accurately reflected people's needs.” from the report
Respectful staff
Inspectors saw staff engaging positively with people and visitors. Staff knew people's likes, dislikes and life stories.
“Staff were observed to engage very positively with residents and visitors.” from the report
Stronger management oversight
New management arrangements and regular audits helped the home track actions and drive improvements. The previous governance breach had been resolved.
“Governance systems were significantly more organised and more effective at driving improvement.” from the report
Alcohol and medicines risk
seriousA relative reported that other people brought alcohol into a person's room and gave them more than usual. The home provided evidence of extra training for staff about substance misuse, but this is an important issue to discuss.
“This amount of alcohol mixed with his medicines and health conditions and his lack of mental capacity made this a volatile situation.” from the report
Refurbishment was unfinished
needs fixingThe home was improving its flooring and decoration during the inspection. Some bedroom carpets still needed updating, although the provider had an action plan.
“Whilst there were a number of bedroom carpets that required updating, the provider was actively making the changes during our inspection.” from the report
One incorrect weight record
needs fixingOne person's weight had been entered incorrectly, so the clinical lead had not been alerted. The report does not say that harm resulted.
“However, one residents' weight had been incorrectly entered and therefore clinical lead had not been alerted.” from the report
Activities could be better
minorPeople were supported to access the community and activities were provided, but some relatives felt the range or quality of activities inside the home could improve.
“However, a number of relatives felt the activities in the service could be improved.” from the report
Mixed safeguarding communication
needs fixingSome relatives said they felt people were safe, but one relative said they found out about incidents only after noticing something themselves. Inspectors were satisfied with the home's investigation and reporting arrangements.
“We find out about incidents after they have happened and then only when we spot something ourselves relating to our relative.” from the report
- 01What safeguards are now in place to prevent alcohol being given to people when it could interact with their medicines or health conditions?
- 02How will you keep families informed promptly when accidents, incidents or safeguarding concerns affect their relative?
- 03Which bedroom carpets and other refurbishment work are still outstanding, and when will they be completed?
- 04How do you check that people's weights are recorded correctly and that possible weight loss is acted on?
- 05What activities are currently available, and how have you responded to relatives who wanted activities improved?
This was an unannounced inspection covering all five key questions, prompted partly by concerns about leadership, culture and care quality. This explanation was written from the published report of 5 January 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2022
Rated Requires Improvement; inspectors found kind and personalised care, but safety checks, medicines, the building and management oversight needed improvement.
This was the home's first comprehensive inspection. It was unannounced and took place on 22 and 25 November 2021. Inspectors spoke with people, relatives, staff and healthcare professionals. They also observed care and checked care plans, medicines, staff records and management records.
The home was caring and responsive. People were treated with dignity, had choices about their daily lives and received personalised support. People had access to healthcare, activities and visits, and staff understood their needs.
However, inspectors found risks with medicines, the cleanliness and maintenance of the building, end of life records and the use of CCTV. The provider's checks had not consistently led to improvements. This resulted in a breach of Regulation 17, Good governance.
The overall rating was Requires Improvement. Safe, effective and well-led were also rated Requires Improvement. Caring and responsive were rated Good. The CQC said it would continue to monitor the home and check that improvements were made.
Kind and respectful care
People told inspectors they felt listened to and were not rushed. Observations showed staff treated people with dignity and respect.
“When they are helping me to the toilet they take their time with me and I don't feel rushed” from the report
Personalised support
Care plans reflected people's individual needs and preferences. Staff could explain how they supported people in line with those plans.
“People received personalised care and support specific to their needs and preferences.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs and safe recruitment checks were in place.
“Sufficient staff were deployed to meet people's needs.” from the report
Medicines
seriousSome medicines were not managed safely. Controlled drugs were not always stored according to regulations, and information about medicines taken when needed was limited.
“Controlled drugs (medicines that have additional controls due their potential for misuse) were not always stored in accordance with current regulations.” from the report
Building cleanliness and maintenance
needs fixingThe building needed improvement to support infection control. Inspectors found stained and worn carpets and other concerns about cleanliness and maintenance.
“The maintenance, decoration and cleanliness of the building required improvement.” from the report
CCTV and people's rights
seriousThe provider had not shown that the CCTV decision had considered the least restrictive option or completed the required data protection assessment. Inspectors recommended seeking specialist guidance.
“We could not be confident the person's human rights were always respected.” from the report
End of life records
needs fixingCare plans did not consistently record people's wishes and preferences for end of life care. This meant inspectors could not be assured that care would always reflect those wishes.
“Care plans failed to consistently document people's end of life wishes and preferences.” from the report
Management oversight
seriousThe provider's quality checks had not consistently led to improvements in medicines, records, the environment and CCTV arrangements. This was a legal breach.
“The provider failed to ensure governance systems consistently drove improvement.” from the report
- 01How have you improved the storage and checking of controlled medicines since this inspection?
- 02What work has been completed to improve the cleanliness, carpets, decoration and maintenance of the building?
- 03What assessment and data protection review now support the CCTV, and how are people's rights protected?
- 04How do you now record and review each person's end of life wishes and preferences?
- 05How do your quality checks show that problems are found, acted on and checked again?
This was the home's first unannounced comprehensive inspection and covered all five CQC questions, including infection prevention and control measures. This explanation was written from the published report of 12 February 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Bonhomie House
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- January 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2022Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- January 2019
Registered with the Care Quality Commission on 10 January 2019.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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