Archived: Sunrise Operations Purley Limited

Updated 17 November 2016

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Prior to our visit we reviewed the information we held about the service. This included notifications we had received from the provider and other information we hold about the service including any safeguarding alerts and outcomes, complaints and inspection history. Notifications are information about important events which the service is required to tell us about by law. Before the inspection, the provider completed a Provider Information Return (PIR).The PIR 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.

The inspection took place on 13 and 14 September 2016 and was unannounced. The first day was unannounced and the inspection was carried out by two inspectors, a specialist advisor in nursing and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

We spoke with twenty people using the service and two visiting relatives. Due to their needs, some people were unable to share their direct views and experiences. We therefore spent time observing how care and support was provided to people. Along with general observation, we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We reviewed records about people’s care, including 16 files of people who used the service.

We spoke with five nurses, eight care staff, the activities co-ordinator, a chef, three domestic staff, the reminiscence coordinator, the new general manager, the deputy manager and a registered manager from one of the provider’s other homes who had been providing extra management support to this home. We also spoke with a visiting operations manager. We checked ten staff files and the records kept for staff allocation, training and supervision. We looked around the premises and at records for the management of the service including quality assurance systems, audits and health and safety records. We also reviewed how medicines were managed and the records relating to this.

Following our inspection, the manager also sent us information we had requested about quality assurance findings and planned improvements.

Updated 17 November 2016

This inspection took place on 13 and 14 September 2016, the first day was unannounced. At our last inspection in July 2014 the provider met the regulations we inspected.

Sunrise Operations Purley Limited provides residential and nursing care for up to 119 older people. Accommodation is spread over four floors with passenger lift access. A separate specialised reminiscence neighbourhood is situated on the second floor for people living with dementia. Some people use the service for respite care breaks. There were 112 people using the service at the time of our inspection.

When we inspected, there was no registered manager at the service. A new manager had been appointed in August 2016 and was in the process of applying to register. 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.

People told us they felt safe and well cared for. There were robust systems and processes in place to protect people from the risk of harm. Staff knew how to recognise and report any concerns they had about the care and welfare of people and how to protect them from abuse. People's safety was promoted because risks that may cause them harm had been identified. Suitable risk assessments were in place to keep people safe.

People lived in a safe, clean and comfortable environment that was designed and equipped to meet their needs. The reminiscence neighbourhood promoted engagement and wellbeing for people living with dementia, using decoration, signage and other adaptations. Appropriate checks of the building and equipment were undertaken to ensure health and safety for people and staff was maintained.

The provider’s recruitment and employment processes were robust and protected people from unsafe care. When we inspected, there was enough staff to meet people’s needs although continuity of care was affected by staff turnover and the use of agency staff at times. The provider was taking action to improve this.

Staff received a structured induction and essential training at the beginning of their employment. This was followed by ongoing refresher training to update and develop their knowledge and skills. Staff also undertook training specific to the needs of people they cared for and to keep up to date with best practice. Staff were supported in their roles and the standard and quality of their work was kept under review through ongoing supervision and performance appraisal.

People’s rights were protected because the provider acted in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This legislation is intended to ensure people receive the support they need to make their own decisions wherever possible. The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them. Conditions on authorisations to deprive a person of their liberty were being met. Staff had completed training and understood their responsibilities where people lacked capacity to consent or make decisions.

People’s health needs were monitored and they had access to health care services when they needed them. Any advice from external professionals was included in their care and acted on accordingly. Medicines were managed safely and people had their medicines at the times they needed them. New audit and monitoring systems had been introduced to further ensure that people received their medicines as prescribed.

People’s care needs had been fully assessed prior to moving to the home and these were regularly monitored and reviewed to make sure the care was current and relevant. Care records contained information about the care and support people required and were written in a way that recognised individual needs and preferences. Staff worked well with external health and social care professionals to ensure people received the care and support they needed.

People were treated with kindness and respect and made decisions about their care and support, with family members involved where appropriate. Staff were mindful of people's privacy and dignity and encouraged people to maintain their independence as much as possible. The service worked closely with families and relevant professionals so that people received dignified care at the end of their lives.

People were provided with a choice of food and drink that met their nutritional needs. Mealtimes were unrushed and people were encouraged and supported to eat a healthy diet that also recognised their choices. People received the assistance they needed to eat and drink well and staff involved other relevant professionals when people were at risk of poor nutrition or dehydration.

There was a varied range of activities and entertainment for people, which included group activities or one to one outings. Staff understood the importance of preventing social isolation and ensured that they offered companionship and interaction with people where necessary. People were supported to maintain relationships with family and friends who were important to them. Relatives and friends were welcome to visit when they wished and invited to participate in social events at the home.

Systems were in place that encouraged feedback from people who used the service, relatives, and staff and this was used to improve their experience at the service. People knew how to complain and told us they would do so if required. Procedures were in place to monitor, investigate and respond to complaints. There was monthly auditing to make sure that lessons could be learnt.

The registered provider had values for the service, which were known and followed by the staff team. Staff were clear about their roles and responsibilities and felt supported by management.

Consistent audits were undertaken to monitor the quality and health and safety of the service. Where improvements were needed or lessons learnt, action was taken. Records supported that audits were effective and supported the provision of safe and appropriate care. The provider worked in partnership with other agencies and professionals to support care provision and service development.