Background to this inspection
Updated
28 August 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.
Inspection team
The inspection was carried out by one inspector, an Expert by Experience and a pharmacist specialist. 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
Sundial Cottage 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 had a manager registered with the Care Quality Commission. A registered manager, along with the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was unannounced on the first day. The second day was announced.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authority, clinical commissioning group and community healthcare providers. The provider had not been asked to complete a Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service. We spoke with three members of staff, the deputy manager, provider and registered manager. We carried out observations in communal areas to see how staff interacted with people and checked the premises to ensure they were clean, hygienic and a safe place for people to live.
We reviewed a range of records. This included four people’s care records and multiple medicines records, three staff files and a variety of records relating to the management of the service including policies and procedures.
After the inspection
We spoke with 12 relatives to gain feedback about the service. We continued to seek clarification from the provider to validate evidence found.
Updated
28 August 2021
About the service
Sundial Cottage is a care home, without nursing, accommodating up to 22 people. At the time of our inspection there were 21 people using the service. The accommodation is arranged over two floors with both a passenger lift and a stairlift available to access the upper floor. Some rooms are ensuite. There is an accessible, mature garden surrounding the home and a patio area with seating areas. Many of the people using the service were living with dementia.
At the time we started our inspection, Sundial Cottage was owned by a partnership, who, throughout this report, are referred to as the provider. Before our inspection report was published, the legal entity, or ownership, of the service changed to a limited company. However, there has not been any change to whom is responsible for the day to day management of the service. Mr N Sykes as the nominated individual remains accountable, along with the registered manager, for how the regulated activity, and care provision, is provided at the service.
People’s experience of using this service and what we found
Some environmental risks had not been adequately managed or mitigated. Records relating to people’s care and support were not being stored securely. These shortfalls had not been identified and addressed through the provider’s own checks, but they have now taken action to address these. The registered manager had good oversight of people’s care and feedback about their leadership was positive. There was a friendly, supportive atmosphere at the service and staff cared for people with patience and kindness. Investigations or ‘learning opportunities’ had been completed following safety related incidents. The service worked in partnership with other organisations to help improve the health and well-being of people.
We have made a recommendation about how often some of the training is refreshed. We have also recommended that any refurbishment of the environment considers best practice guidance on the importance of design for people living with dementia.
There were systems and processes in place to safeguard people from the risk of abuse and to learn from safety related events. Overall, suitable risk assessments were in place which described the actions staff should take to mitigate risks to people’s health and wellbeing. Overall, medicines were managed safely, but improvements were needed to ensure that medicines were being stored within recommended temperatures. Three medicines available for staff to administer were either past their expiry date or the ‘in-use’ expiry date. There were sufficient staff deployed to meet people’s needs.
We have made a recommendation about the safe and proper use of medicines.
As part of CQC's response to the coronavirus pandemic we conducted a review of infection prevention and control (IPC) measures in the home and were mostly assured by the systems in place.
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 Good (Published November 2019).
Why we inspected
The inspection was prompted in part due to concerns we had received about the safety of some aspects of the service, institutionalised care practices and medicines.
We did look 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 coronavirus and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
We reviewed all the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same. This is based on the findings at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sundial Cottage on our website at www.cqc.org.uk.
Please see the action we have told the provider to take at the end of this report
Follow up
We will continue to monitor information we receive about the service and we will continue to work with partner agencies. We will return to visit in line with our re-inspection programme. If we receive any concerning information we may inspect sooner.