Archived: Sunrise Care Home

Updated 26 October 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by two inspectors.

Service and service type

Sunrise Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service about their experience of the care provided. We spoke with one health professional who regularly visited the service. We spoke with five members of staff including the manager, chef and care staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 15 people’s care records and multiple medication records. We looked at two staff files and one agency staff file in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at health and safety data, accidents and incidents and infection prevention information.

Updated 26 October 2021

About the service

Sunrise Care Home is a residential care home registered to provide personal care for up to 20 older people, some of whom are living with dementia. At the time of the inspection 15 people were living in the home.

People’s experience of using this service and what we found

The provider continued to fail to have sufficient systems and oversight to assess, monitor and mitigate the risks relating to the health, safety and welfare of people. The provider had not made enough improvement since the last inspection to ensure people were protected from risks associated with the safety and management of fire, water, food, substances that could be hazardous to health (COSHH), medicines and environmental risks. People living with dementia were exposed to unnecessary risks.

The provider failed to ensure staff had access to and follow current government guidelines for the prevention and control of infection. This placed people and staff at continual risk of being exposed to and acquiring infections including COVID-19.

There were not enough staff employed to meet people’s needs. The manager and care staff carried out multiple roles; there were not enough staff to provide personal care. People did not always receive their personal care as planned or have staff available to them to administer their medicines as prescribed. The provider failed to ensure staff followed national guidance when administering medicines.

The provider failed to learn from safeguarding, complaints, accident or incidents to use these experiences to improve the service.

Most staff had received training; new staff required further training and checks on their competence to ensure they were following the provider’s policies and procedures.

People were supported to maintain a balanced diet. However, not all risks had been mitigated to prevent the risk of choking.

Improvements had been made to the decoration and maintenance of the home. Flooring had been replaced in the communal areas and bedrooms and bathrooms had been refurbished. More improvements were required to create an environment which was more dementia friendly.

People’s risk assessments and care plans had been recently updated. Staff had the information they needed to mitigate the known risks. Staff received a comprehensive handover about people’s current needs.

Staff knew how to recognise the signs of abuse and who to report their concerns to. Staff had raised their concerns with the manager who raised safeguarding alerts appropriately.

Staff were skilled in taking clinical observations and referring people to medical services when people’s conditions deteriorated.

The provider was not meeting the requirements of the Accessible Information Standard. People living with dementia did not have access to information in mediums they could access.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Inadequate (published 20 April 2021).

Why we inspected

The inspection was prompted in part due to concerns received about the staffing levels, safety and managerial oversight demonstrated in the monthly action plans to the commission. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

At the last three inspections the provider was in breach of regulations relating to safe care and treatment and managerial oversight. We imposed conditions on their registration which required them to provide monthly action plans to show what they were doing to implement and sustain improvements.

At this inspection enough improvement had not been made and the provider was still in breach of regulations. We have identified three breaches in relation to safe care and treatment, staffing and management oversight.

Please see the action we have told the provider to take at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sunrise Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

This service has been in Special Measures since 24 March 2021. During this inspection the provider did not demonstrate that improvements have been made. The service remains rated as inadequate overall. Therefore, this service remains in Special Measures. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.