Boniville House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission [CQC] regulates both the premises and the care provided, and both were looked at during this inspection. Boniville House provides care and support for up to five people who live with mental health conditions. At the time of our inspection three people were using the service. Public transport and a range of shops are located close to the home.

We carried out an unannounced inspection of Boniville House on the 17 April 2018. At our previous inspection on the 4 April 2017 we rated the service 'requires improvement' and identified three breaches of legal requirements relating to safe care and treatment, staffing and good governance. At this inspection we found the provider had taken sufficient action to address the breaches of regulation identified at our previous inspection and we rated the service as good overall and for the key questions safe, effective caring, responsive and well-led.

The service has a registered manager. A registered manager is a person who has registered with the CQC 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.

All the people using the service told us that they were happy living in the home and satisfied with the care and support that they received from staff.

People told us that they felt safe at the service. Risk assessment and management processes had been improved and staff knew about the risks to people’s safety and how these were minimised by the service. Action had been taken to address the deficiencies in fire safety, and an emergency plan had been put in place.

Staff training and supervision arrangements had been improved. The provider had introduced a new training programme to ensure staff had the knowledge and skills to undertake their roles in providing people with individualised care. Staff now received effective supervision that supported them to carry out their roles.

The provider had improved and developed the arrangements in place to regularly monitor health and safety and the quality of the care and support provided for people who used the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff gained people's consent before providing them with assistance with personal care.

People's care plans included details about people’s individual preferences and information staff required to provide people with the care and support they needed in the way that they wanted. Care plans were reviewed regularly with people using the service and were updated when people's needs changed.

People told us that staff were kind to them. Staff knew people well and had a caring approach to their work and understood the importance of treating people with dignity, protecting people's privacy and respecting their differences.

People had the opportunity to take part in a range of activities of their choice. Appropriate recruitment procedures were in place so that only suitable staff were employed to provide people with the care and support that they needed. Staffing levels and skill mix provided people with the assistance and care that they needed.

People knew how to make a complaint and/or raise concerns about the service. They were confident that they would be listened to and their concerns addressed appropriately by management.

People’s healthcare needs were assessed and met by the service. Management liaised with healthcare and social care agencies to ensure people’s needs and preferences were met.

People enjoyed the meals provided by the service and confirm

This unannounced inspection of Boniville House took place on 4 April 2017. At our last inspection on 18 November 2014 the service met the regulations inspected.

Boniville House is registered to provide accommodation and personal care for five people. The home provides care and support for people who live with mental health needs. Some people had plans to move into more independent living and were being supported to do so. On the day of our visit there were four people living in the home. Public transport and a range of shops are located within walking distance.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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.

People said that they felt safe and were treated with respect. Staff engaged with people in a friendly and courteous manner. Throughout our visit we observed caring and supportive relationships between staff and people using the service. People told us staff were kind to them and respected their privacy and dignity.

There were procedures for safeguarding people. Staff knew how to safeguard the people they supported and cared for. Arrangements were in place to make sure sufficient numbers of skilled staff were deployed at all times. People’s individual needs and risks were identified and managed as part of their plan of care and support to minimise the likelihood of harm. However there were some other areas where risk to safety had not been identified.

Staff knew people well and understood people’s needs. However, although staff had received appropriate training, staff did not have an individual training plan, and refresher training in some areas to ensure they were skilled and competent to carry out their roles and responsibilities, had not been received by staff. Staff told us they received the support they needed to provide people with individualised care and support. However, records did not show staff were receiving organised and regular supervision and appraisal to receive support, guidance and to promote their personal and professional development in their role

There were systems in place to check certain aspects of the home however we found some deficiencies to do with assessment of people’s risks, staff training and supervision had not been identified and effectively addressed

Care plans reflected people’s current needs. They contained the information staff needed to provide people with the care and support they wanted and required. People were supported to choose and take part in activities of their choice. People’s dietary preferences and needs were understood by the service. People chose what they wanted to eat.

People were encouraged and supported to make decisions for themselves whenever possible and their independence was upheld and promoted. People were provided with the support they needed to maintain links with their family, friends and others important to them.

People were supported to maintain good health. They had access to appropriate healthcare services that monitored their health and provided people with appropriate support, treatment and specialist advice when needed. Systems were in place to make sure people received their medicines safely.

Staff understood the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). They knew about the systems in place for making decisions in people’s best interest when they were unable to make one or more decisions about their care and/or other aspects of their lives.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered manager to take at the back of the full version of this rep

This unannounced inspection took place on the 18 November 2014.

Boniville House is a care home that is registered to accommodate up to five people who have mental health needs. There were three people living in the service at the time of our inspection. The service is located in Willesden Green in the London borough of Brent and has access to public transport. A range of shops are within walking distance of the home.

There was a registered manager in post at the time of our visit. 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 atmosphere of the home was relaxed and welcoming. People told us they were happy living in the home and felt safe. Staff were aware of their responsibilities in supporting people to be safe and protecting them from risk of harm and knew the importance of respecting people’s individual choices and promoting their independence.

People knew who to speak with if they had a concern or a complaint, were confident they would be listened to and appropriate action would be taken in response to any issues they raised. Staff knew how to recognise abuse and understood their responsibility to report it.

Staff recruitment was robust so only suitable people were employed in the home. Staffing numbers and skill mix were arranged to make sure people received the care and supported they needed and to enable them to participate in activities of their choice. Recent staff changes had led to some reliance upon the use of regular agency staff. However, people spoke positively about the staff and told us they were provided with the assistance and care they needed. Staff knew people well and provided people with the care and assistance they required. People’s health was monitored and referrals made to health professionals when this was required.

We saw staff interact with people in a friendly and courteous manner. They promptly addressed questions and issues raised by people using the service during the inspection. People told us the staff were kind and treated them with respect.

We saw people took part in activities of their choice including going out to the local shops independently. People were supported to maintain the links they wanted with their family and friends.

People told us they were happy with the meals they received and were able to choose what they wanted to eat and drink. People received the medicines they were prescribed.

The registered manager knew about the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), so was aware of when a person can be deprived of their liberty in their best interests, such as for keeping them safe.

The registered manager was approachable and spent a significant amount of time in the home working with staff and people using the service The quality of the service was monitored and improvements made when needed.

During the inspection we spoke with the three people who used the service, a care worker and a senior member of staff.

Each person who used the service had a plan of care that had been regularly reviewed, and included information about the individual support and care that people who used the service needed.

People made choices about their lives. People told us that they were asked for their consent about matters to do with their care and treatment.

Staff knew about their roles and responsibilities in meeting the needs of the people they supported. There were enough skilled and experienced staff to meet people’s needs.

The home was clean. People’s health, safety and welfare were protected as they received the advice and treatment that they needed from a range of healthcare and social care professionals.

Records were accurate and up to date.

We carried out an unannounced inspection to check if the provider had complied with two compliance actions that we had made at the time of our previous inspection that took place on the 21st and 22nd March 2013.

During this follow-up inspection we spoke to two people who used the service, a care worker and the manager. We also checked the premises and looked at records. We did this to make a judgement as to whether the provider was meeting the compliance actions Regulation 15 (Health and Social Care Act 2008 Regulated Activities) Regulations 2010 (Outcome 10 -Safety and suitability of premises), and Regulation 22 (Health and Social Care Act 2008 Regulated Activities) Regulations 2010 (Outcome 13 -Staffing).

At this inspection we found that the provider had taken action to ensure that people who used the service,staff and visitors were protected against the risks associated with unsafe or unsuitable premises and there were sufficient qualified, skilled and experienced staff to meet people’s needs. The provider was compliant with the compliance actions that had been made during our previous inspection.

During our visit to Bonville House Limited we spent most of our the time talking to people using the service to gain their views about what it was like living in the home.

People told us they were happy, and they informed us they liked their bedrooms, and enjoyed the meals. They told us they made choices about their lives which included making decisions about when they went to bed, when they got up, and what they wanted to wear. People confirmed they had the opportunity to participate in activities of their choice. They told us they received the care and support they wanted and needed.

People told us that staff listened to them, were approachable and asked them for feedback about the service provided by the home. During our visit people showed signs of ‘well being’. They were seen to smile and laugh, move freely in and out of the home and were well dressed.

We saw people talking with each other and approaching staff without hesitation.

Comments from people using the service included, “I have lived here for a long time,” “I like it here,” “The staff are helpful,” “I can talk to staff,” “The staff are very nice, and kind,” “All the staff help me,” “I go on the bus,” “I like to go to a café and have a coffee and a cake,” “I go for walks,” “I buy things at the local shops,” “I buy food that I like,” and “I like the meals.”

Staff spoke of enjoying their job supporting and caring for people at Bonville House. They told us there was good staff communication and they felt supported by the manager and senior staff.

There were three people living in the home. We spoke with all of them. They indicated that they had been treated with respect and dignity and their care needs had been attended to. Their views can be summarised by the following comment made by a person who used the service, “It’s alright here. Yes, they take care of us. We can cook our own food.”

People informed us that care staff were attentive and responsive to their care needs. They had access to healthcare services and had their medication administered to them by care staff.

People’s needs had been fully assessed. Appropriate care plans had been prepared and they were reviewed regularly. Most of the staff had worked in the home for many years and were knowledgeable regarding the care needs of people.

People said they were happy with their accommodation. The premises were clean and tidy. Bedrooms of people appeared comfortable and had been personalised by them. Safety inspections had been carried out on the gas and portable electrical appliances. Fire safety arrangements were in place. Improvements are however, needed in the staffing levels and in the maintenance of the premises.