Sunbury Nursing Homes

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 key question good. At this assessment the rating has remained good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a proactive and positive culture of safety, based on openness and honesty.

They had established systems and processes for reporting, investigating and learning from accidents, incidents, complaints and near misses. At the time of our assessment, there had been no notifiable accidents requiring submission to the Care Quality Commission.

Staff understood how to respond when there had been an incident or accident. Records showed leaders reviewed incidents and took action to reduce the risk of recurrence. Learning was shared with staff through daily handovers.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, and monitored safety effectively. They made sure there was continuity of care, including when people moved between different services.

Pre-admission assessments were completed. Leaders told us they ensured they were available to welcome people when they arrived. When people moved into the service, staff told us how they engaged with people to understand their wishes and preferences. They used this information to create person-centred care plans.

Risk assessments were updated to reflect changes in people’s needs following admission or discharge from hospital. When people’s needs changed, the provider made referrals to health professionals and ensured staff had clear, up to date guidance to support people safely.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the capacity to do so themselves. Staff demonstrated an understanding of the MCA and their responsibilities to support people to make decisions wherever possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The provider made DoLS applications where required to ensure appropriate legal authorisations were in place.

Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. Safeguarding concerns were recorded and reported to the local authority. Staff understood how to raise concerns. People told us they felt safe and knew who to speak with if they had concerns.

The provider worked with people to understand and manage risks while considering their individual needs, preferences and circumstances. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were regularly reviewed to reflect people’s changing needs. People and relatives were involved in discussions. One relative told us, “We are always informed of any changes and if [person] was not very well.”

Where people experienced periods of distress, support plans identified triggers that could cause distress and people’s communication needs. These included personalised de-escalation strategies to help prevent distress and support people during these times. When required, the provider ensured referrals were made to mental health teams to complete reviews of people’s medicines.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Premises were well maintained, and risks were identified and managed through audits and action plans. Where issues were identified, actions were recorded and leaders maintained oversight of ongoing works.

There were regular health and safety checks, audits and servicing of equipment carried out, including fire safety checks, water temperature monitoring and legionella controls. Fire risk assessments were completed and identified actions had been addressed.

There was a designated storage area for equipment. Equipment was stored in an organised manner to ensure it was accessible when needed and did not present a hazard to people or staff. Walkways were free from obstructions, helping ensure people could move around the home safely. This reduced the risk of trips and falls.

The environment had been adapted to support people living with dementia. Dementia friendly signage was displayed throughout the building to help people orientate themselves and navigate the service independently.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Systems were in place to ensure staff received training and development required to carry out their roles effectively. Staff completed mandatory training relevant to their roles, including for supporting people with a learning disability and autism. The provider monitored and reviewed training, scheduling refresher modules annually to ensure all staff maintained their knowledge and skills.

Staff told us they received regular supervision and annual appraisals, which meant staff had opportunities to discuss their performance and development needs.

There were enough staff deployed to meet people’s needs safely. Recruitment processes ensured staff were suitable to work within the service. The provider completed appropriate pre-employment checks before staff started work, including employment history and criminal record checks.

The provider assessed and managed the risk of infection. Policies and procedures were in place and staff received regular training, including hand hygiene and use of personal protective equipment (PPE). Leaders completed daily audits, identified any actions required and addressed them promptly.

The environment was clean and hygienic, with appropriate facilities to support infection control.

Staff followed best practice, including being bare below the elbow, and PPE was readily available. People told us, “Staff wear gloves and aprons for personal care. They’re very clean here” and “It is kept clean. I have seen them wearing gloves and aprons for personal care.”

The provider generally ensured medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning their care and treatment. However, we identified one area of improvement regarding the storage of thickening agents.

Thickening agents are added to liquids to make them thicker for people and reduce the risk of choking, or liquids entering the lungs. We found these were stored in people’s bedrooms on side tables, and not within a locked cupboard. This increased the risk of people, such as visitors, preparing fluids inconsistently with the provided recommendations. The provider had not completed risk assessments to determine whether this storage arrangement was safe and appropriate for people. We discussed this with the provider, who acknowledged the concern and agreed to review the storage of thickening agents. Although people received their medicines safely, this limited the provider's ability to demonstrate effective oversight and assurance that medicines were managed in line with best practice. Medicines were managed safely, with systems in place for ordering, storing, administering and recording medicines. Staff had received training and medicines records were completed.

People received their medicines as prescribed, and no concerns were identified in relation to administration or safety of medicines in practice. One person told us, “The nurses give me my medication in a little plastic thing. I take a lot - three times a day. It’s all done on time.”

People spoke positively about the support they received with their medicines. Some people told us their medicines had been reviewed and where appropriate, reduced or discontinued. This ensured treatment remained appropriate to their current needs.