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Archived: Sunnyside Care Home Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 21 August 2015

The inspection of Sunnyside Care Home took place on 3 and 11 June 2015 and was unannounced. We previously inspected the service on 19 November 2013. The service was not in breach of the Health and Social Care Act 2008 regulations at that time.

Sunnyside Care Home is a converted property which is registered to provide accommodation and personal care for up to 30 older people. On the day of our inspection there were 27 people who had been assessed as having nursing needs, many of who were living with dementia, who were resident at Sunnyside Care Home. The home provides accommodation on the ground and first floor, with a dining room and a number of communal lounges on the ground floor.

The service did not have a registered manager in place. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager had commenced employment at the home three days before our inspection but had not yet commenced their application to register with CQC.

People who lived at the home told us they felt safe, however, staff were not clear about different types of abuse. We saw evidence of a potential safeguarding incident which the team leader had not been made aware of and therefore the incident had not been reported to either the local authority safeguarding team and/or CQC.

We could not evidence that peoples care and support was planned and delivered with the consent of the relevant person. This evidenced a breach of regulations 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff lacked knowledge and understanding of the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005. We saw evidence that people’s freedom of movement within the home was restricted by the use of key coded locks. We were told that no applications had been made to the local authority in regard to the restrictions placed on people’s freedom. These examples evidenced a failure to comply with the requirements of the Mental Capacity Act 2005.

This evidence demonstrated a breach of regulations 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The home was poorly maintained and had not been adapted to support people who were living with dementia to live well. There was no signage to direct people where they were or the locations of the rooms, for example the dining room. There was a lack of sensory stimulation for people. These examples demonstrated a breach of regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We also noted a number of concerns relating to poor management of infection prevention and control procedures. Two toilets were contaminated with faeces and two commode pans were urine stained. We also saw two easy chairs in people’s bedrooms which were not clean. This demonstrated a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The staffing level at the home had recently been increased following a request by the local authority.

There was a system in place for the receipt, storage and administration of medicines. However,

Medication Administration Record (MAR) did not detail the time that time critical medicine was administered.

We were not able to evidence staff received induction, regular training or supervision to provide them with the skills to perform their roles safely and effectively. This demonstrated a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

People told us the food they received was good. The food served to people on the day of our inspection looked appealing.

People told us they were happy with the care they received and the staff treated them with dignity. During our inspection we saw staff supporting people in a kind, caring and dignified manner. However, we also saw a number of examples where staff did not demonstrate respect towards people’s preferences, needs or possessions. This was a breach of regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We saw minimal evidence that people who lived at the home were engaged in meaningful activities. Relatives told us there was little stimulation or activities for people and two people who lived at the home told us they would like to go out more. This was a breach of regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Many of the relatives we spoke with told us they thought the service was well led because the care was good and staff felt the management were supportive.

People’s records were not an accurate reflection of the care and support they required. There was no evidence that the registered provider had a system in place to monitor and assess the quality of the service provided to people. Peoples records were not always accurate and did not consistently provide enough detail to ensure peoples support needs were met. These examples demonstrated a breach of regulation 17of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The overall rating for this service is ‘Inadequate’ and the service is therefore in 'special measures'.

The service will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Inadequate

Updated 21 August 2015

The service was not safe.

People were not adequately protected from the risk of abuse or harm.

People were at risk of injury or harm due to a failure to ensure the premises and equipment were safe, clean, suitable and well maintained.

Staffing had very recently been increased as a result of the local authority expressing serious concerns to the registered provider about inadequate staffing levels at the home.

Medication administration records were difficult to decipher and were unclear as to the time of administration for time critical medicine.

Effective

Inadequate

Updated 21 August 2015

The service was not effective.

There was no evidence that staff received appropriate or adequate induction, training or supervision.

No DoLS application had been submitted to the local authority for people whose freedom was being restricted. We could not clearly evidence people’s care and support was delivered with relevant consent.

The home had not been adapted to provide appropriate support to people who were living with dementia.

Caring

Inadequate

Updated 21 August 2015

The service was not always caring.

People told us staff were kind and caring.

We saw a number of examples where people’s dignity was not respected by staff.

People and/or their relatives were not actively involved in the care planning process.

Responsive

Inadequate

Updated 21 August 2015

The service was not always responsive.

People were not engaged in meaningful activities.

People and their relatives told us they would raise any concerns they had with a member of staff.

Well-led

Inadequate

Updated 21 August 2015

The service was not well led.

There was no evidence that people who lived at the home or, where appropriate their relatives had been asked for feedback about the quality of the service provided.

Peoples care records were not accurate and fully reflective of their care and support needs.

There were no effective systems in place to monitor the quality of the service.