Archived: Sunningdale

Sunningdale is a care home providing nursing and personal care for up to 49 people some of whom may be living with dementia. At the time of the inspection there were 43 people living at the service.

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

People told us they felt at home and their views were valued and acted upon. One person told us, "I like living here."

People were protected from the risk of harm and abuse. Safeguarding procedures guided staff about the action they must take if they suspected abuse was occurring. People’s risk assessments identify hazards to their health or wellbeing. Action was taken to reduce risks but maintain people’s independence and choice. There were enough staff to meet people’s needs. Incidents and accidents were monitored, and corrective action was taken to prevent re-occurrence. Recruitment and medicine management was robust.

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.

Staff undertook training, supervision and appraisals to help maintain and develop their skills.

Staff were kind and caring. Staff provided encouragement and guidance to people. Information was provided to in a format that met people’s needs in line with the Accessible Information Standards.

People’s nutritional needs were known and met. People were encouraged to maintain their independence. Staff worked with relevant health care professionals to maintain people’s wellbeing.

People were provided with information about how to raise complaints, which were investigated and responded to by the management team. A programme of activities was provided in line with people’s hobbies, preferences and interests. End of life care was provided at the service.

People’s views were gained and acted upon about the service they received. The registered manager was available to receive feedback at any time. The ethos of the service was open and transparent. Data security was maintained.

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 good (published 02 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last comprehensive inspection on 7 and 8 October 2015 we found the registered provider was in breach of one of the regulations we assessed regarding the management of medicines. The service was rated ‘Requires Improvement overall.’ We undertook a focused inspection on 12 February 2016 to check the registered provider had made improvements and found they met legal requirements.

During this comprehensive inspection on the 24 April 2017, we found improvements had been made in three of the questions we ask about services and have changed the rating for the questions –Is the service ‘Safe’, ‘Effective’ and ‘Well-led?’ to Good. We have kept the rating for ‘Responsive’ and ‘Caring’ as Good. The overall rating for the service has improved and changed to ‘Good’. At the time of the inspection there were a total of 44 people living in Sunningdale.

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 2008 and associated Regulations about how the service is run.

People felt safe at the service. Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to protect people from harm. Accidents and incidents were managed appropriately by the service and reviewed regularly by the senior management team. The premises were well maintained. Checks of equipment had been completed.

Recruitment processes were thorough and helped the registered provider make safer recruitment decisions when employing new staff. The recruitment of more qualified staff had improved the consistency of care support and staff morale. Staff were deployed in suitable numbers to meet the assessed needs of the people who used the service.

Overall, we found the improvements in medicines management had been sustained. People’s medicines were stored safely and administered as prescribed. A recent shortfall in stock control had been addressed and ordering procedures had been reviewed and strengthened.

People were supported by staff who had been trained to carry out their roles effectively. Staff told us they felt supported by the registered manager and confirmed they had received formal supervision and appraisal from their line manager.

We found communication systems were more effective. Information was shared at regular staff, resident and managers meetings.

Consent was gained before care and support was delivered and the principles of the Mental Capacity Act were followed within the service.

Staff worked closely with health and social care professionals to ensure people were supported to maintain good health. People received a well-balanced diet that offered variety and choice. People liked the meals provided to them and their nutritional needs were met.

People told us they were supported by kind and caring staff who knew their preferences for how care and support should be delivered. During observations it was clear caring relationships had been developed between the people who used the service and staff. People’s privacy and dignity was respected by staff who encouraged them to be independent and make choices and decisions in their daily lives. Private and sensitive information was stored confidentially.

People were involved with the initial assessment and the reviews of their care and support. Their levels of independence and individual strengths and abilities were recorded. The majority of care plans we checked reflected individual’s needs clearly, some minor recording shortfalls were addressed during the inspection.

People were encouraged to maintain relationships with important people in their lives and to take part in a range of activities at the service. The registered provider had a complaints policy which was made available to people who used the service. When complaints were received they were responded to in line with the registered provider’s policy and used to develop the service whenever possible.

Staff told us the registered manager was approachable, supportive and listened to their views regarding developing the service. Their management style was open and inclusive. A comprehensive quality assurance system was in place to ensure shortfalls in care and support were identified and drive the continual improvement of the service.

People who used and visited the service were supported to share their opinion of the service provided to ensure their views were known and could be acted upon.

The findings from this inspection did not affect the overall rating of the service, which was ‘Requires Improvement’; it also did not affect the rating of the specific question ‘Is the service Safe’ which was also ‘Requires Improvement’ at the last inspection. This is because we want to make sure improvements are sustained over a period of time and we will check this out again at the next full comprehensive inspection. Just prior to the inspection we were notified by the local safeguarding team that they had received information of concern about pressure area care for three people who used the service and a bed rail issue for another person. A safeguarding officer accompanied us on the inspection to check this out.

Sunningdale is situated to the east of the city of Hull, near to public transport facilities and there are local shops within walking distance. The service is registered to provide accommodation and personal care for a maximum of 49 people some of whom may be living with dementia. All the rooms are for single occupancy. There are sufficient communal areas, bathrooms and toilets on both floors. There is an accessible garden and car parking at the front and rear of the building.

The service has 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.

We found there were improvements in the management of medicines. People who used the service received their medicines as prescribed. We found medicines were obtained in a timely way, they were stored securely and stock control was managed effectively. The recording of medicines had also improved. We observed medicines were signed for when they were received into the service and when they were administered to people.

The safeguarding officer found the records of one person who used the service did not indicate pressure relief had been carried out during the night. Staff had recorded the person was asleep and comfortable. However, the district nursing team had requested two hourly turns day and night for the person to help in the treatment of a sore area. The registered manager is to meet with the district nursing team to discuss options for the person. The safeguarding officer found there were no concerns with the three other people mentioned in the initial alert and appropriate action had been taken to meet their needs.

Suitable hand wash facilities, paper towels and pedal bins were available in all bathroom and toilet areas. All hand washing facilities had posters available for staff to follow on good hand washing techniques.

The administration manager told us, 'We have hand hygiene training booked for 16 October 2013 and as many staff as possible will be attending the training.'

A relative told us, 'The staff are nice and friendly and seemed to want to help and I do not have any complaints about the level of care my relative receives.'

A person who used the service told us that 'I can have a good laugh and rapport with the staff and I can say what I like to them' and 'I feel safe here and I don't want to go from here as I have been here from the beginning and staff always ask me if I am comfortable or need any personal care.'

We spoke to relatives of people who used the service who told us they were happy with the way the food was being served in terms of portions and that the staff preserved the dignity of people when assisting at mealtimes.

The overall building maintenance was kept to a high standard and the grounds outside were sufficiently well kept to offer outdoor activity to existing people who used the service and their relatives.

Records showed that there were annual checks on gas, fire and electrical fittings.

Staff commented that they feel that they have enough time to do their job. Another staff member commented, 'Everyday is different and we all work as a team and get the job done as it needs to.'

We looked at records to confirm that the home had systems in place to monitor staff, resident and relative comments and concerns.

People told us they felt safe in the home. They also said they liked their room and the home was clean and tidy. During our visit we also spoke with visiting relatives who confirmed the home offered excellent care and support for their relatives. A relative commented that, "The family feels that our mother is safe here" and "My mother is in a bigger room and it is personalised to her choice." Relatives also told us that, "Staff are always helpful and I visit my mother every day and when I couldn't visit due to me being ill, the staff called me to see if I was ok."

We saw from documentation that people had their needs assessed and were involved in the planning of their care. We looked at staff appraisal and training records which showed us that not all staff had undertaken an appraisal to ensure that staff training and development needs were assessed.