Archived: Sunbridge

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

We found there had been improvements in the environment and quality of care following the last inspection. However, further work was required to improve the garden area.

Relatives praised the service for keeping their loved ones safe during the COVID-19 pandemic, however some relatives felt communication and updates could be improved. We have made a recommendation about this.

We observed people to be cared for by staff who were caring and compassionate. Relatives spoke positively of the caring and friendly staff team.

Safeguarding processes were in place to help safeguard people from abuse. Risks associated with people's care had been assessed and guidance was in place for staff to follow. Medicines were safely managed.

There were processes in place to prevent and control infection at the service, through regular COVID-19 testing, additional cleaning and safe visiting precautions.

There were enough staff to meet people's needs and ensure their safety. Appropriate recruitment procedures ensured prospective staff were suitable to work in the home.

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.

People living at Sunbridge had a care plan which detailed their needs and preferences. Staff knew people's care needs well. People were supported to engage in activities, although these were impacted by the pandemic.

The management team maintained oversight of complaints, accidents and incidents and safeguarding concerns. The management team engaged well with health and care professionals.

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 requires improvement (report published 19 March 2020) and there were two breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.

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.

Sunbridge is a residential care home providing personal and nursing care to 42 older adults at the time of the inspection, many of whom were living with dementia. Sunbridge accommodates 42 people in a purpose-built care home across three floors.

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

People and their families were overall positive around their experience of care at Sunbridge. Feedback praised the person-centred care, caring and committed staff team and approachable management team.

We identified concerns with cleanliness and maintenance at the home which impacted on people’s privacy and dignity. There was inadequate bathing and showering facilities available, odours and issues with heating. Aspects of the home were also unclean.

The provider had monitoring systems in place, but these had not been effective as they had failed to proactively identify and address the issues we found during our inspection.

We have made recommendations around supporting people to manage their oral health and improving the environment to become more dementia friendly.

People were supported to engage in a range of activities, however we found instances where people were left for lengthy periods of time without any staff engagement or conversation.

People told us they felt safe living at Sunbridge. Risks associated with people's health and care were assessed and staff knew how to keep people safe. Staffing levels were appropriate and staff were safely recruited. Systems were in place to ensure the safe management of medicines.

Staff had received training to enable them to provide effective care. Staff supervisions had been inconsistent, but this was improving. Staff told us they felt supported by the home management team.

The provider sought feedback from people. People and staff were confident they could raise any concerns they had with the registered manager and felt they would be listened to.

The registered manager and senior staff were responsive to and worked in partnership with other agencies to meet people's 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.

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 3 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to premises and equipment and good governance 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 an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Sunbridge is a service for older people who require assistance with personal care. Sunbridge is registered to provide accommodation to a maximum of 43 people some of who may have dementia. There were 41 people using the service on the day of our inspection.

The home had 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.

People and staff told us that there had recently been times when there were not enough staff available to meet people's needs as staff shortages had not been covered. We saw that staff were not always available to meet people's needs and were rushed when assisting people at lunch time. The staff rota showed that there had been occasions when there had been shortages of staff.

Systems were in place to ensure that people received their medicines safely, and as prescribed. However, we identified areas where the provider needed to make improvements to the recording of the administration of creams and how regularly controlled drugs were monitored.

People were confident that their concerns would be addressed as the provider had procedures for detecting and protecting people against the risks of abuse. People told the felt safe and they knew how to raise concerns about their care. Staff understood what abuse was and how they should respond to an allegation of abuse.

Risk assessments identified the risks to people associated with receiving care and appropriate actions had been identified to mitigate these risks. Staff had the training and support they needed to meet people's needs.

People were supported to engage in activities met their needs. Activities had been developed to support people living with dementia.

People were treated with dignity and respect. People and relatives told us that were kind and responded to their needs. People were able to spend time alone if they choose to, as staff respected their privacy.

Care plans were person centred and care was delivered so that people's preferences and needs were met. Care plans included life histories and information about people's interests. People were supported to practice their culture and religious beliefs.

People and relatives told us they knew how to make a complaint and were confident that the provider would respond appropriately to any concerns they raised. Complaints had been investigated and where necessary action had been taken to so that the issues in complaints had been addressed.

People told us that staff always sought their consent before providing care. Where people were not able to consent to their care and treatment the provider had carried out best interest assessments and when necessary applied for a DoLS. Staff could explain when best interest decisions were needed. Staff had training and understood the process for applying for DoLS.

People, relatives and staff told us that the registered manager was approachable. The provider had sought the views of people who used the service and their relatives and action had been taken to respond to any suggestions they had made. The registered manager carried out regular audits of the service. Action taken to address issues highlighted in these audits to make sure that quality of care was maintained.

Sunbridge is a service for older people who are in need of personal care. Sunbridge provides accommodation to a maximum of 43 people some of who may have dementia.

The home did not have a registered manager. However, an interim manager was in place and was present during our inspection. A new manager has been appointed and is in the process of registering with the Care Quality Commission as 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 a number of breaches of regulations at this inspection. Risk prevention plans had not been developed to address the risks that had been identified to people’s safety. The provider had not told us about some important changes to the care and support provided to people who used the service.

People were treated with dignity and respect. There was an accessible complaints policy which the interim manager followed when complaints were made to ensure they were investigated and responded to appropriately. People and their relatives felt confident to express any concerns, so these could be addressed.

People were kept safe from the risk of abuse. Staff understood people’s rights to make choices about their care and the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty safeguards.

There were systems in place to ensure that people consistently received their medicines safely, and as prescribed. Sufficient staff were available and they had the necessary training to meet people's needs. Staff responded to people’s needs promptly.

Care was planned and delivered in ways that enhanced people’s safety and welfare according to their needs and preferences. Staff understood people’s preferences, likes and dislikes regarding their care and support needs.

People using the service, relatives and staff said the interim manager was approachable and supportive.

At this inspection there were breaches of regulations in relation to the need for safe care and treatment, and notification of other incidents. You can see what action we told the provider to take at the back of the full version of the report.

There were effective recruitment and selection processes in place. Staff told us that they had been through a detailed recruitment process that included completing an application form, interviews and references being taken up from their former employers. People felt that staff knew how to meet their needs. We saw that staff understood people's needs.

People told us and we observed that they felt that staff listened to them. Staff responded to any suggestions they made about the service. Regular audits had been carried out covering a range of areas such as infection control, medications management and care planning. These showed that the quality of service provision was assessed and monitored. Where issues were identified improvements were made.