Archived: Sunrise of Frognal

Sunrise of Frognal is a care home service for up to 131 older people living with dementia, sensory impairment or a physical disability. There were 114 people using the service at the time of our inspection.

We previously carried out an unannounced inspection of this service on 25 July 2014. At that inspection we found the service was meeting all the regulations that we assessed.

The service had 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.

At this inspection we found that staff knew how to keep people safe. The service had clear procedures to support staff to recognise and respond to abuse. The registered manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service which were up to date and included detailed guidance for staff to reduce risks. There was an effective system to manage accidents and incidents, and to prevent them happening again. The service had arrangements in place to deal with emergencies. The service carried out comprehensive background checks of staff before they started working and there were enough staff on duty to support to people when required. Staff supported people so that they took their medicines safely.

The provider had taken action to ensure the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were followed. Staff assessed people’s nutritional needs and supported them to have a balanced diet. Staff supported people to access the healthcare services they required and monitored their healthcare appointments.

People or their relatives where appropriate, were involved in the assessment, planning and review of their care. Staff considered people’s choices, health and social care needs, and their general wellbeing. Staff prepared, reviewed, and updated care plans for every person. The care plans were person centred and reflected people’s current needs.

Staff supported people in a way which was kind, caring, and respectful. Staff also protected people’s privacy, dignity, and human rights.

The service supported people to take part in a range of activities in support of their need for social interaction and stimulation. The service had a clear policy and procedure about managing complaints. People knew how to complain and told us they would do so if necessary.

There was a positive culture at the home where people felt included and consulted. People and their relatives commented positively about staff and the registered manager. Staff felt supported by the registered manager.

The service sought the views of people who used the services, their relatives, and staff to help drive improvements. The provider had effective systems in place to assess and monitor the quality of services people received, and to make improvements where required. Staff used the results of audits to identify how improvements could be made to the service.

We checked to see whether the provider had taken appropriate action following our inspection on 07 January 2014 where we identified some concerns with the way medicines were managed. At our inspection on 07 March 2014 we found the provider had taken appropriate action including making improvements to the storage of medicines, the information for staff and the availability of medicines.

We spoke to some people who used the service and observed how they were cared for. One visitor told us they felt the home was "quite good", the staff were "friendly and helpful" and that they felt the food was "alright". We found people were provided with appropriate choices and they were consulted in relation to the way their care was delivered. People were asked for their consent, for example if they wanted to take their medication, and they were engaged in activities provided by the home.

We found the provider had made improvements to seeking consent and where one person was deprived of their liberty this was done so lawfully. The provider had made some improvements in relation to record keeping, but further work was still required. However, we identified further concerns in relation to the management of medication and in particular there were inadequate arrangements in place for the storage and disposal of medicines.

People we spoke with told us they were satisfied with the care they received. One person we spoke with told us that staff were "very helpful" and that they were happy living in the home. We saw that people were engaged with staff and were enjoying activities in a relaxed atmosphere during our inspection.

We found that the provider had made improvements to the care and welfare of people living in the home and that most people's care plans had been reviewed and updated appropriately where required to ensure they reflected people's current needs.

People and relatives we spoke with told us that they were happy with the care they received in the home. One relative told us the staff were "excellent" and gave their loved one "plenty of attention". Another person told us "the food is very good and there is plenty of choice". Two people also told us they enjoyed the activities on offer in the home.

We found that people were offered a choice of nutritious food and were appropriately supported to ensure they ate and drank sufficient amounts to meet there needs.

At our inspection we found that people were involved in their care and treated with respect. The provider had suitable safeguarding arrangements, staff mostly received adequate support and the provider’s quality assurance system was being suitably implemented. However, we also found that people who used the service were not fully protected against the risk of receiving inappropriate care due to risk assessments not always including a clear description of the ways in which risks could be controlled.