Sunnyside

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe- this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this question Good. At this assessment the rating has changed to Requires Improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to people’s safe care and treatment. People’s environment was not always safe including significant fire safety risks. People’s risks were not always appropriately assessed and reviewed.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always have a proactive and positive culture of safety, based on openness and complete honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

People and their families told us they could raise concerns about their care and knew who to speak to. One person told us, “The manager is nice. I have no complaints and nothing is bothering me.” One relative told us, “The manager is helpful and easy to talk to. I wouldn’t have a problem raising concerns.”

Staff told us they could raise concerns and felt comfortable to do so. One staff member told us,”I feel I can talk to the manager, and they would help.” There were processes and policies to support a learning culture. We saw evidence of some learning identified for example during home learning meetings. However, these had not always been utilised effectively and some opportunities for learning had been missed. For example, in identifying environmental risks to both people and staff.

People told us they felt listened to. One person told us, “I see the manager around and they have knocked and come in for a chat.” One relative told us,” The manager is easy to talk to. If you ask something, they will act on it.”

The provider generally had good understanding of people’s risks. However, this has not always been reflected in people’s care plans where risks assessments were not always comprehensive, and person centred. There was little evidence that people were involved in their care planning.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff protected people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse and discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe. One person said, “I am safe and happy here.” One relative told us, “I think my loved one is very safe here.”

Staff received safeguarding training and had a good understanding of how to keep people safe and protected from harm. One staff member told us,” I would observe if people had any bruises, skin tears or they were acting differently.” Another staff member said,” If somebody was

fearful of staff, stopped eating. I would report it immediately.”

There were policies and procedures in place to ensure that people were safe and protected from harm.

The provider did not work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People told us they felt safe. One person told us,” They[staff] pull together and make sure I’m safe and happy.”

Overall, staff had a good understanding of people’s risk and knew how to support them. Most people had risk assessments in place, but these were not always been detailed and person-centred. Some people did not have relevant risk assessments in place to ensure adequate support in mitigating risks to that person, other people and staff. For example, there was no risk assessment in place for a person who at times became distressed and highly agitated and their behaviour could pose potential risk to other people and staff. People were not always involved in their care planning.

The provider did not always detect and control potential risks in the care environment. They did not make sure equipment, facilities and technology supported the delivery of safe care.

There were arrangements in place to monitor the safety and upkeep of premises. However, this was not always effective. For example, fire safety concerns identified during this assessment were not identified by the registered manager or the provider.

During the assessment we observed a number of fire safety risks. For example, on day 1 of the assessment we saw that a fire exit was obstructed with moving and handling equipment. We told the provider about this and the equipment was removed. However, when we came back on day 2 the same fire exit was blocked again. Additionally, we found that some of the fire doors did not shut properly and there were fire hazards in people’s bedrooms. Some people’s bedrooms were cluttered and untidy which also contributed to fire risk. We also found that in some bathrooms pull cords used by people to call for help were very long and tangled which posed a ligature risk to them. We told the registered manger about our findings, and this was addressed at the time of the assessment.

During both of our visits we found the home to be very hot. There were cooling fans placed in communal lounges, however these were not always being used. Both people and visitors commented on the temperature of the rooms, and this was raised with the registered manager during theassessment who said that action to manage the temperature within the home was already being taken.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

There was not always enough staff to meet people’s needs. People told us they found staff very busy and felt the home was short staffed. One person told us,” I would say there are enough staff, but at busy times they could do with an extra pair of hands sometimes.” One relative told us, “They are mad busy most of the time so I would say they could do with more staff to take a bit pressure off, but I’m happy that Dad is safe and looked after here.”

Staff also told us they would benefit from additional staff. One staff member told us, “If there was one thing, I could change it would be to have more staff.”

Provider told us, they use dependency tool to ensure of adequate staffing throughout the home.

Staff records demonstrated suitable recruitment practices. References had been obtained prior to employment and gaps in employment were explored by the provider.

Staff completed induction training prior to supporting people and received training to ensure they had the right skills and knowledge to meet people’s needs. However, some staff told us they would benefit from additional training in supporting people with dementia or behaviours that may challenge. One staff member told us, “We don’t receive training in managing people’s behaviour, we discuss it during the handovers.” Following our feedback the registered manager was arranging this training for staff.

Staff did not always receive regular supervisions and appraisals. One staff member told us, “Can’t remember when I had last supervision, and nobody has spoken to me about appraisal just yet.” Staff meetings did not always take place periodically. However, a daily “flash” meeting took place each day held by the registered manager with all heads of the departments within the home to gather feedback and agree any actions.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.