Bonhomie Sarisbury Green

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The provider’s governance systems were not always effective, did not drive improvement and did not identify all of the shortfalls we found during this assessment. Concerns were found with regards to medicines and risk management, oversight of accidents and incidents, person-centred care, consent and quality assurance. This has resulted in a continuing breach of Regulation 17 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. There was also a failure to notify the Care Quality Commission, without delay, of allegations of abuse. This has resulted in a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

This service scored 46 (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 Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider's governance processes had not been effective at identifying the areas where the safety and quality of care had fallen below the required standards and action had not been taken to make improvements. Effective systems had not been established to ensure accurate and complete records were maintained. There were significant shortfalls in many of the records viewed including those relating to the premises, but also to people’s care and support needs. The systems in place to ensure risks relating to people’s care and support were assessed and mitigated were not robust. The systems in place to ensure environmental concerns were addressed in a timely manner were not effective. The culture of the service did not always reflect the principles of the guidance Right Support, Right Care, Right Culture and the systems in place did not maximise opportunities to provide person-centred care that achieved good outcomes for people. The systems and processes in place had failed to ensure the Care Quality Commission (CQC) were always notified without delay of incidents which affected the health, safety, and welfare of service users. We received mixed feedback from healthcare professionals about the effectiveness of the governance systems in place. For example, 1 HCP praised the registered managers commitment to the service and the consistency this brought to the service, however raised concerns about their lack of insight into the Mental Health Act, risk management and need for escalation of concern. This professional told us that despite considerable support and guidance being provided to the home and leadership team, this had not always been implemented or embedded within the service. The provider told us they had already identified some concerns with their governance and record keeping and had taken some action to address the shortfalls. Such as, additional auditing by the senior management team with actions plans which were reviewed regularly.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.