Summon Bonum Support & Care

Updated 19 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 30 September and was announced. We gave the service 48 hours’ notice of the inspection visit to ensure we were able to speak with the registered manager and conduct home visits with people.

This inspection included home visits to people who used the service and their relatives. We visited the office location to see the registered manager and the day to day manager, speak with staff and review care records, policies and procedures.

One adult social care inspector carried out this inspection. Before the inspection we reviewed the information, we held about the service. This included previous contact about the service and notifications we had received. A notification is information about important events which the service is required to send us by law. The provider also completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We used a range of different methods to help us understand people’s experience of the service. We spoke with four people who used the service and two relatives in total. We spoke with two care staff, the day to day manager and the registered manager. We received written feedback from two relatives and seven external healthcare professionals.

We saw a range of records relating to people’s care and support and looked at three people’s care records in detail. We also looked at staff recruitment, training, supervision and appraisal records for three members of care staff and looked at records relating to the management of the service, including quality audits. We also reviewed how the service supported people with their medicines.

Updated 19 December 2018

This announced comprehensive inspection took place on 30 September 2018. The provider was given 48 hours’ notice because they provide a domiciliary care service and we needed to be sure key people were available. The service was previously inspected on 14 April 2016 and was rated ‘good’ in every key question and overall.

Summon Bonum Support & Care, referred to in this report as ‘the service’, provided personal care support for adults who live in their own homes independently in the community. The service was based in Maidencombe Manor where eight self-contained flats were available for rent by people with support needs. These people could choose to have their support provided to them by the service or by another provider if they wished. People renting these flats held their own tenancies. The service provided support for adults with learning and physical disabilities. At the time of our inspection the services provided support to over 30 people but only 15 of those received help with personal care. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. We therefore focused our inspection on those 15 people. Five people receiving personal care lived in the Maidencombe Manor flats. Other people receiving personal care from the service lived in Torquay and the surrounding areas.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was exceptional at placing people at the centre of their care experience. People who received support from the service had access to care which was focused on what was important to them and supported them to achieve the most out of their lives. The service was passionate about helping people build confidence, reach and surpass their goals. For example, one person had been encouraged and supported to deliver their own training to staff as they were keen for staff to understand their specific individual needs. Not only did this help the staff understand this person’s needs better, it gave this person the confidence to join the National Autistic Society and they now deliver speeches and training to a wide range of people, travelling across the country.

Each person had a small team of staff they knew well. The service worked hard to match support staff with the people they were supporting and their families. People were involved in selecting their staff based on personalities and interests. The service was highly flexible to ensure people could be supported in the ways they wanted, when they wanted. People could choose which staff supported them with specific activities if they wanted and the rota was very flexible in order to ensure people could attend activities or appointments or accommodate changes in their schedule.

Staff were passionate about helping people have the best quality of life possible. Staff worked extremely closely with other healthcare professionals in order to achieve the best possible outcome for people. Healthcare professionals made comments including; “I would like to make you aware of the positive influence and commitment staff at the above provision have afforded to my numerous service users. Their commitment, clear understanding of need, personalisation and professional care and support provided has improved the quality of life of numerous service users.” Staff had worked with people to reduce the number of hours of support they needed. People had become more independent, developed stronger links with the community, and had achieved huge personal goals that improved their health and wellbeing.

People were treated with the utmost respect. The management and staff cared deeply for the people they supported and their dignity. They promoted equality and diversity and supported people to feel confident and happy. For example, one person was being supported to explore their gender expression as this was an area of anxiety for them. Staff constantly thought about how people were perceived in order to avoid people feeling judged or looked down upon. The registered manager told us they wanted people being supported by staff to look as though they were out with a friend when out in the community. They had therefore decided not to issue staff with uniforms or name badges and ask people how they wanted their staff to refer to themselves if asked. Some people had asked for staff to introduce themselves to others as their PA and this was being respected. One member of staff said; “There is no one judged here. We don’t have name badges to separate us from the clients. We’re all the same. Just people who deserve respect. We’re a family.”

We received overwhelmingly positive feedback from external healthcare professionals. They made comments which included, “What they have, in my opinion is something special. The care of (the people receiving support) exceeds expectations and they genuinely treat them as family. I have only ever witnessed person centred care, tailored to each individual, the majority of which, I have had the pleasure of meeting. I have nothing but praise and admiration for the work that they do, and their hard work and commitment is evident in the happiness of (the people receiving support)”, “I cannot commend this service highly enough. I have no hesitation in recommending any client to Sunnom Bonum and would commend them for the great service they offer.”

Staff had access to thorough training which met their needs. The day to day manager worked hard to create training workbooks for staff by liaising with healthcare professionals and conducting research on best practice. This ensured each person was supported by staff who understood their healthcare needs and how to meet them. People were protected from risks relating to their health, medicines, nutrition and behaviours. People’s individual risks had been assessed and staff had taken action to seek guidance where required and minimise identified risks. Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risk of reoccurrence. Staff supported people to take their medicines safely where required and as prescribed by their doctor.

People and staff benefited from a leadership team which valued staff contributions, skills and achievements. This was demonstrated by staff ideas being implemented and good work being highlighted. Staff praised the leadership team and felt supported by them. One member of staff commented; “I don’t think Summon Bonum Support and Care get the praise they deserve. They go above and beyond for people and for staff. We’re all taken out for a Christmas party every year. Every member of staff gets a birthday present every year. They promote equality and diversity. Everyone can be themselves and feel respected. The manager is lovely, it’s a lovely place to work. We’re more than a team. We’re a family.”

Staff knew how to recognise possible signs of abuse which also helped protect people. Staff knew what signs to look out for and the procedures to follow should they need to report concerns. Safeguarding information and contact numbers for the relevant bodies were accessible. Staff told us they felt comfortable raising concerns.

Recruitment procedures were in place to help ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work. Staff had the competencies and information they required in order to meet people’s needs.

There was open and effective management at the service led by the registered manager and the provider. Staff felt supported and valued. An audit system was in place to monitor the quality of the service people received. Records were clear, well organised and up-to-date. Unannounced checks to observe staff’s competency were carried out on a regular basis.

People, their relatives and staff felt able to raise concerns or make a complaint. They were confident their concerns would be taken seriously. People told us they didn't have any complaints. Where complaints had been received they had been managed in line with the company policy.

Further information is in the detailed findings below