Background to this inspection
Updated
10 June 2022
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 Health and Social Care Act 2008.
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
We visited the home on the 12 and 16 May 2022. The first site visit was completed by two inspectors and a medicines inspector. The second site visit was completed by two inspectors. An Expert by Experience spoke with people over the telephone. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Sun Court Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Sun Court Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a manager employed however their application to register with CQC had not been completed.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 12 May 2022 and ended on 25 May 2022. We visited the service on the 12 and 16 May 2022.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We sought feedback from partner agencies, including the local authority, the associated clinical commissioning group and Healthwatch. Healthwatch is an independent consumer champion that gathers and represent the views of the public about health and social care services in England. We also used the on-going monitoring information received since the last inspection.
We used all this information to plan our inspection.
During the inspection
We spoke with 14 relatives and six people who used the service. We spoke with six staff including the director of residential care services, the manager, the deputy manager, the clinical lead, an agency nurse and a cook. We looked at the medicine’s records for 14 people who used the service and the care records for nine people. Governance records were also viewed and included quality monitoring audits, accidents and incident records, maintenance and servicing records and the personnel files for three staff members.
We continued to seek clarification regarding our findings following the inspection site visits. We spoke with a further four staff members including a nurse, care assistants and a senior care assistant. We also spoke with two health professionals and received written feedback from a third.
Updated
10 June 2022
About the service
Sun Court Nursing Home is a residential care home providing personal and nursing care to up to 29 people. The service provides support to younger adults and older people, some of whom may be living with dementia, have a mental health condition, a physical disability or a sensory impairment. At the time of our inspection there were 19 people using the service. The home is a converted period building over three floors accessed by a lift
People’s experience of using this service and what we found
The service had made improvements since our last inspection however further development was required. Some care records contained contradictory information and were not accurate; correct records were particularly important given the home was using a high number of agency staff.
Although staff demonstrated knowledge through discussion, not all had received the training the provider deemed necessary to meet people’s needs. For example, nurses were applying dressings without the correct training in place.
The provider had identified the shortfalls within the service and had a robust action plan in place. However, due to the volume of actions required, not all had been completed at the time of this inspection. Other stakeholders had visited the service prior to this inspection and made recommendations which the provider had been responsive to.
People told us they were well cared for, listened to and respected. Whilst care plans did not consistently cover all aspects of people’s lives, they told us these were mostly considered in practice. However, activities and entertainment had not resumed to the level they were prior to the pandemic and people told us they wanted more of this.
The home was running on a high number of agency staff due to nationally recognised shortages in social care staff although the provider had a recruitment drive in place. Agency staff were block booked meaning the same staff attended. People told us all staff, including agency staff, were kind and caring but they voiced the preference to receive care and support from permanent staff that were fully familiar with them and their needs.
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. Care plans were person-centred and had mostly been regularly reviewed. Although care plans did not consistently show people had been formally involved in them, they told us that in practice they were consulted, and their consent sought.
Systems in place helped protect people from the risk of abuse and they had access to a wide range of health professionals. People received their medicines as prescribed and were protected from the risks associated with infectious diseases. For example, we saw that the home was visibly clean, and that staff wore personal protective equipment (PPE).
People’s nutritional needs were met, and we saw they had choice in what they ate as well as support as required. Independence was encouraged and we saw that people’s dignity was maintained. The wishes people had for the end of their lives had been discussed and recorded and a health professional we spoke with told us the home was adept at providing this care.
Although the manager had only been in post for four weeks at the time of this inspection, people spoke positively about him and his plans for the home. Staff told us the culture within the home was positive and nurturing and that teamwork was good; staff told us they felt supported and involved in making the home the best it could be.
People acknowledged there were still improvements required at the home but told us the care was good and that people were happy living at Sun Court Nursing Home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (report published on 17 August 2021) and there were breaches of regulations. We imposed conditions on the provider’s registration meaning they were obliged to submit regular monthly updates showing what improvements they had made. At this inspection we found improvements had been made although the provider remained in breach of one regulation.
This service has been in Special Measures since 17 August 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
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.
We have found evidence that the provider needs to make further improvements. Please see the Safe, Effective, Responsive and Well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sun Court Nursing Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified a breach in relation to the provider’s governance systems at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request regular action plans from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.