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 prof

Summon Bonum Support and Care is a small domiciliary care service providing support to people with a learning disability living in their own homes. At the time of the inspection the service was supporting over thirty people, but only ten of these were receiving support under the regulated activity of ‘personal care’. The Care Quality Commission (CQC) does not have a legal remit to look at the arrangements to support people who were not receiving ‘personal care’ as a part of their support package.

This inspection took place on 14 April 2016 and was announced. We gave the service 36 hours’ notice, to ensure that the registered manager and appropriate staff were available to support the inspection.

Summon Bonum Support and Care office is situated at Maidencombe Manor, where there are also 8 flats available for rent by people with support needs. These people can choose to have any support they need provided by Summon Bonum Support and Care, or by another provider if they wished. People hold their own tenancies on their flats, which are rented privately to them. Other people were being supported in the wider community or at day services. Some services were commissioned through the local authority and other people made their contract arrangements privately or through direct payments.

The last inspection of the service had taken place on the 13 and 14 August 2014, when the service was not meeting standards in relation to reporting incidents of concern and problems with the recording of the administration of medicines. The provider sent us an action plan telling us what they had done to put this right. On this inspection we looked and saw that changes had been made and sustained.

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 registered manager had not changed since the last inspection of the service.

Risks to people had been assessed and actions recorded on how the service was reducing the risks. This included assessments of people’s vulnerabilities, health conditions or day to day activities. Risk assessments were also carried out for people’s homes to help ensure staff safety. There were safe working practices risk assessments for staff, including lone working policies and staff were clear about actions to take if they could not gain access to a person’s home at the expected time.

Staff understood their responsibilities with regard to safeguarding people, and knew what to do if they had concerns about people’s well-being. Policies and procedures were in place to help staff identify and report abuse. Staff carried identity badges and were always introduced to new people before they started caring for them. Where the service had an involvement in supporting people with their finances and budgeting there were systems that ensured staff did not have access to people’s monies without the person being present.

Staff were employed following a full recruitment process, and there were enough staff to fulfil the contracts in place. The registerd manager told us the service did not take on people whose needs they could not meet. We saw evidence of good relationships having been built up between people being supported and the staff supporting them. People told us they liked the staff and were happy with the service they received. A visiting professional told us the staff were “attentive” and that they had no concerns.

Staff received the training they needed for their job role and were knowledgeable about people’s care needs. Staff were supported by the service management and received regular supervision and appraisal, including spot checks on their performance. Staff were encouraged to reflect on the work t

We inspected the service at short notice and spoke in person with four people who use the service. We spoke with a fifth person in their own home. We met with six members of staff, the administrator and the manager.

The service provided care and support for 22 people, supported by approximately 14 support staff.

Care and support was personalised and took into account individual preferences and choice. We looked at three care records and saw that they contained clear, detailed plans which held all the information required and were up to date. Regular reviews of care were carried out.

People were very complimentary of the service provided and the support staff. Comments included "they look after me - I like all of them" and "I feel safe". When people were asked if they were happy they all said "yes!"

Staff were knowledgeable in their understanding of hygiene requirements.

All staff told us they felt supported by the manager, felt part of a team and were listened to. Comments included "I love it here - we are all friends", "everyone gets on" and "we are on the same wavelength". People were involved in choosing the support staff they would like to look after them.

All the necessary checks were carried out before staff began work and staff were chosen to fit in with people who use the service.

The service had systems in place to monitor the quality of service provided. There was a complaints procedure in place should people need to use it.

During our inspection we spoke to two people who use the service, a family member, and three staff members and the manager. Everyone spoke positively about the service and one person told us it was “wonderful”.

We saw four case files which contained clear case plans and support logs and staff and management were able to talk about the practical uses of the files. This means that the people’s care is thoughtful and productive.

People spoke highly of the staff and the care they provided. One family member told us that staff were “helpful” and “obliging”. The staff explained that they focused on individual care and that the happiness and safety of people who use the service is the focus of their care.

The manager took a proactive approach and one person told us that they were “the best person in the world”. There was clear complaint procedure in place and the manager was able to show how they were constantly evaluating the service to ensure high quality.

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced 48 hours before. There were no concerns to follow up from our last inspection of the 21 March 2013.

Summon Bonum Support & Care (also referred to as ‘the service’) provides enabling services and personal care to people with a learning disability. The Care Quality Commission (CQC) only regulates personal care in relation to this service. Although they provided services for 24 people, only six people were currently receiving personal care.

There was a registered manager in post. 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 and associated Regulations about how the service is run.

We found some issues in respect of the completion of Medicine Administration Records (MARs) and ensuring they were accurate and in line with current guidelines. The registered manager was not auditing these and ensuring practice was safe. Archiving of records held in people’s homes was not taking place to ensure these were available for future scrutiny if required.

There were sufficient staff with the right skill mix to meet people’s needs and staff were recruited safely. People told us they felt safe in the care of the staff. Staff received training to enable them to meet people’s needs and keep them safe. Further training was provided as required. Care plans were regularly reviewed and reflected people’s current needs.

People and staff told us they were well looked after by the management and felt important to the service. People were supported by staff who were caring and compassionate. They had control of their care planning and who they wanted to deliver their care. People were asked their view of their care and their view was listened to.

People were supported by care plans that reflected their current need. People showed us how they had been supported to ensure the care was how they wanted it to be. Care plans were reviewed and changed to meet changing needs.

The service was well led and the registered manager was identified as the most important person by people and staff. Ensuring the values and quality of the service was stated as important to the service and registered manager. Continual improvement was central and people and staff were involved in this process.

We found a number breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.