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Archived: Sunrise Operations Eastbourne Limited Good

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Reports


Inspection carried out on 1 December 2016

During a routine inspection

Sunrise Eastbourne is a purpose built location. It is registered to provide accommodation for up to 107 people. Providing care and support, nursing, dementia care and respite accommodation. Sunrise is described as a community which is divided into neighbourhoods. This includes the Assisted Living neighbourhood which provides care and nursing for people dependant on their level of need and the Reminiscence neighbourhood which provides care for people living with dementia.

This was an unannounced inspection which took place on 1 and 2 December 2016.

Sunrise was inspected in May 2015. Two breaches of regulation were identified. Regulation 9, Person- centred care and Regulation 12, Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider sent us an action plan stating they would have addressed all of these concerns by October 2015. At this inspection we found these breaches had been met.

Sunrise had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The manager was in day to day charge of the home, supported by the deputy manager. People told us that they felt supported by the management team and knew that there was always someone available to support them when needed. Staff told us that the manager and deputy had a good overview of the home and knew everyone well. Staff went the extra mile to provide person centred care for people and were highly motivated to improve people’s day to day lives and had an excellent understanding of their needs.

We received many positive comments from people, staff and relatives. People said that they were able to question, discuss and be involved in changes and felt part of ‘the team’. People had a varied and active daily programme of activities offered. Staff had identified specific areas of interest for people and had gone out of their way to arrange special trips, organised pets visiting the home, and taken people out to events that were important to them.

Staff told us training provided was effective and ensured they were able to provide the best care for people. Staff were encouraged to attend further training, with a number of competency checks taking place to ensure staff understanding after training completed. When errors had occurred in relation to medicines the registered manager had ensured that all staff responsible for medicines had received further training and assessment. This showed a proactive response to facilitate on going improvement. There were numerous audits and a rigorous system in place to assess the quality of the service.

All required maintenance and equipment and services maintenance had taken place. Fire evacuation plans and personal evacuation procedure information was available in event of an emergency evacuation.

Medicine documentation and policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing and checks were carried out to ensure high standards were maintained. People told us they received their medicines on time.

There was a programme of supervision for all staff. Staff told us they valued the regular supervision as it was their opportunity to discuss their development and talk about their role.

Staffing levels were reviewed regularly to ensure people’s needs were met. Robust recruitment checks were completed before staff began work. And all new staff completed a 12 week induction period, which included shadowing a buddy and receiving training and support before being deemed competent to work unsupervised.

Care plans and risk assessments had been completed to ensure people received appropriate care. Care plans

Inspection carried out on 6 8 and 15 May 2015

During a routine inspection

Sunrise Operations Eastbourne Limited provides facilities and services for up to 107 older people who require personal or nursing care over three floors. The home is known and referred to as Sunrise Senior Living Eastbourne. The ground and first floor provides accommodation for people described as requiring assisted living, this part of the home is called the Assisted Living Neighbourhood. The care provided includes a range of care and nursing needs that include minimal support for people up to full nursing care. Some people lead a mainly independent life and used the home’s facilities to support their lifestyle. Other people had various health care needs that included physical and medical conditions that included diabetes, strokes and end of life care. Some people had limited mobility and needed to be supported with moving equipment. A few people lived with mild dementia that required regular prompting and supervision. The second floor provided accommodation for people who were living with a dementia as their prime care need. This unit was called the Reminiscence Neighbourhood.

The Sunrise Senior Living Organisation has a number of homes across the country and was originally set up by an American couple. Sunrise Senior Living Eastbourne was purpose built and provided care to privately funded people. At the time of this inspection 54 people were living in the Assisted Living Neighbourhood and 35 people were living in the Reminiscence Neighbourhood. .

This inspection took place 6, 8 and 15 May 2015 and was unannounced.

The service had appointed a deputy manager who had applied for registration with the CQC to become the 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 visitors spoke positively of the home and people said they felt safe and well cared for. Our observations and records did not confirm that people’s safety was always promoted. People were being moved in an unsafe way and risk assessments did not always ensure that appropriate measures were in place to protect people from risks. This included the risks presented by bed rails and pressure to skin.

Medicines were stored, administered and disposed of safely by staff who were suitably trained. However, guidelines and records relating to PRN and topical creams were not always clear and could mean that medicines were not given in a consistent way.

Staff were not supported in providing a person centred approach to care. Some care plans and care documentation lacked accurate documentation to inform the planning, delivery and evaluation of care. They were not always up to date and did not always reflect people’s needs and preferences. Accident reports were not used appropriately to monitor and reduce risks within the service

The deputy manager understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Relevant guidelines were available within the service for all staff to reference. Staff at all levels had an understanding of consent and caring for people without imposing any restrictions. However there was little evidence that people who lacked capacity had suitable processes followed to ensure staff took account of their individual rights and best interest.

Staff knew people well and responded positively to their physical and emotional needs and there were systems in place for staff to share information on people’s changing needs. This included hand over sessions. People had access to health care professionals when needed.

Staff were provided with a full induction and training programme which supported them to meet the needs of people. Staffing arrangements ensured staff worked in such numbers, with the appropriate skills that people’s needs could be met in a timely and safe fashion. The registered nurses attended additional training to update and ensure their nursing competency.

Recruitment records showed there were systems in place to ensure staff were suitable to work at the home. Staff had a clear understanding of the procedures in place to safeguard people from abuse.

People were complementary about the food and the choices available. Mealtimes were unrushed and people were assisted according to their need. Staff monitored people’s nutritional needs and responded to them.

There was a variety of activity and opportunity for interaction taking place in the service. This took account of people’s physical and mental limitations. Visitors told us they were warmly welcomed and felt they could come to the nursing home at any reasonable time.

People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be. A complaints procedure was readily available for people to use.

Quality assurance systems were in place and were identifying shortfalls that needed to be addressed. The management of the service responded positively to feedback received from safeguarding investigations and information identified through the inspection process.

Feedback was regularly sought from people, relatives and staff. Staff meetings were being held on a regular basis and surveys were used to gain staff views. People were encouraged to share their views on a daily basis and satisfaction surveys were being used.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 2 September 2014

During a routine inspection

Two adult social care inspectors carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led.

At the time of our inspection the service provided care and support to 92 people.

We spoke with a number of people who used the service. People living at Sunrise Senior Living had a wide range of personal needs, varying from minimal support to complex needs which meant that some people were not able to tell us their experiences. We observed people for interaction and signs of wellbeing. The home was divided into two distinct Neighbourhoods. The Assisted Living Neighbourhood cared and supported older people and the Reminiscence Neighbourhood provided care and support for people with a dementia.

We spoke with three visiting relatives following the inspection and nine staff members during the inspection, this included the registered manager, general manager and reminiscence coordinator, three other registered nurses, care staff and two domestic staff.

Below is a summary of what we found. The summary describes what people who used the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

People had been cared for in an environment that was clean and well maintained.

Risk assessments were in place to provide information to staff to help minimise the risk of any harm to people.

Systems were in place to ensure the safe administration of prescribed medicines. The provider had established recruitment processes and these had been followed.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were able to describe when a DoLS had been put in place and why this had been used. Staff had been trained to understand when an application should be made, and the manager knew how to submit and review one.

Is the service effective?

We saw individual plans of care were in place. There was evidence to confirm that each person had their care plans reviewed on a monthly basis.

People and their relatives told us that the care provided was appropriate and met people�s needs. Discussion with staff confirmed that staff knew and understood people�s individual care and social support needs.

Is the service caring?

People were supported by kind and caring staff. We saw that staff were very kind and polite and gave people time when supporting them.

Our observations confirmed that people were encouraged to be independent but were helped when they needed any support.

Is the service responsive?

Individual care plans were developed for each person following admission. People were given choices. People had access to activities and had been supported to maintain relationships with their friends and relatives.

Complaints and comments made by people and their relatives had been responded to.

Is the service well-led?

We saw that a number of quality assurance processes were in place. These included feedback from people who used the service and their representatives.

There was a clear management team that included a registered manager who had been in post a number of years. There was an allocated co-ordinator for each of the two neighbourhoods who were supported by senior carers. Staff told us they were clear about their roles and responsibilities.

Inspection carried out on 25 March 2014

During an inspection in response to concerns

People living at Sunrise had a wide range of personal needs, varying from minimal support required to having complex needs which meant that some people were not able to tell us their experiences. Those who could, told us they were happy living at Sunrise. One person told us �it's lovely here.� Another said, "Very content and happy." We spoke with two visitors who told us, "Very kind staff," and "We visit often and the home have always involved us in our relatives care." During our inspection we observed people being supported in a caring and supportive manner. Staff we spoke with enjoyed working at Sunrise and told us, "I really like working here."

We saw that people's individual needs had been assessed on admission and wellness checks had been undertaken monthly which ensured people experienced care, treatment and support that met their needs and protected their rights. Staff were able to tell us how they cared and supported people and we noted that handover sheets continued important changes that happened during shifts that the next staff needed to be aware of.

However we found that not all records that related to individual people�s specific health needs were up-to-date and recorded correctly. This included food and fluid daily records and wound care.

Inspection carried out on 13 June 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service. Not all of the people who lived at Sunrise of Eastbourne were able to communicate with us. We used the Short Observational Framework for Inspection (SOFI). SOFI is a tool used when reviewing services for people who had conditions that meant they were not able to tell us about their experiences of living in the home.

During our inspection we found that people were involved in decisions about their care and treatment. Care plans were personalised and contained clear instructions on how people should be cared for and supported. The provider had ensured a good standard of cleanliness had been maintained throughout the home.

There were sufficient experienced and qualified staff on duty to meet people�s needs. We spoke with staff who told us they attended regular training. Staff felt the training provided by the organisation supported them in their role to deliver safe and person centred care. We saw evidence that staff received regular supervision and annual appraisals.

We found that not all records that related to individual people�s specific health needs were up-to-date and recorded correctly. However, the organisation took steps that ensured these shortfalls were immediately rectified following our inspection visit.

Inspection carried out on 16 August 2012

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke with those that could talk to us, looked at records, observed care and spoke with staff and visitors.

People who could, told us that the staff were kind, and that the food was good and tasty.

We were also told, it was �like a hotel�. One person said �very happy here, I can visit friends in Eastbourne and keep my independence�.

Relatives told us that they were kept informed of what was happening. They said that the staff were good and they had no concerns about the care delivered. They also told us that staff would always listen to any �little grumble� and take notice of what was said.

Reports under our old system of regulation (including those from before CQC was created)