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Archived: Sunrise of Bagshot Good

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This care home is run by two companies: Sunrise Operations Bagshot II Limited and Sunrise Senior Living Limited. These two companies have a dual registration and are jointly responsible for the services at the home.

Reports


Inspection carried out on 16 January 2018

During a routine inspection

Sunrise of Bagshot is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Sunrise of Bagshot provides facilities and services for up to 99 older people who require personal or nursing care. The building consists of three floors. The ground and first floor of the building are called the Assisted Living Neighbourhood. The care provided in the Assisted Living Neighbourhood includes minimal support for people up to full nursing care. The second floor of the building is called the Reminiscence Neighbourhood. The Reminiscence Neighbourhood provides care and support to people who live with dementia as their primary care need.

At the last inspection on 19 April 2016 the service was rated ‘Good.’ At this inspection we found the service remained ‘Good.’

People continued to be safe at Sunrise of Bagshot because staff were aware of their roles and responsibilities to keep people safe. Staff understood how to identify and respond to suspected abuse. People lived in an environment that was clean and the risk of infection spreading was appropriately managed. Safe recruitment practices were followed to ensure that only suitable staff were employed to safely attend to people’s needs. There were sufficient staff deployed at the home. People’s medicines were administered and managed safely. Risk assessments had been written that helped to support people to maintain their independence in a safe way.

People continued to receive effective care from staff who had received training that enabled them to carry out their roles. Staff were supported by the registered manager through regular supervision and appraisals of their work. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; there were policies and systems in the service to support this practice.

People were provided with sufficient food and drink. People were complimentary about the food and how it was cooked. People’s healthcare needs continued to be met and they were able to access all healthcare professionals as and when required.

People’s privacy and dignity was respected and they were involved in making decisions about their care and treatment. People were treated with kindness and compassion in their day-to-day care. People and their family members were involved in the writing and reviewing of their care plans. People had a range of activities they could choose to be involved in. A complaints system was in place that enabled people, relatives and visitors to raise any concerns.

The registered manager was visible at the home and all staff stated that they felt supported by the registered manager. There was a system in place to monitor the quality of care and treatment provided at the home. Records of accidents and incidents were maintained and actions to help to prevent the re-occurrence of these had been implemented.

Inspection carried out on 19 April 2016

During a routine inspection

Sunrise Operations Bagshot II Limited provides facilities and services for up to 99 older people who require personal or nursing care. The building consists of three floors. The ground and first floor of the building is called the Assisted Living Neighbourhood. The care provided in the Assisted Living Neighbourhood includes minimal support for people up to full nursing care. The second floor of the building is called the Reminiscence Neighbourhood. The Reminiscence Neighbourhood provides care and support to people who live with dementia as their primary care need. At the time of our inspection there were 91 people living at the home.

The manager was present during our inspection. He had been in post since 12 November 2015 and had submitted an application to us to become the registered manager of the home. 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.

Sunrise Operations Bagshot II Limited was last inspected on 15 and 16 June 2015 where it was rated as ‘Requires Improvement’. Four breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014 were identified. These related to safe care and treatment, staffing, consent and personalised care. Requirement actions were set in relation to these and the registered provider sent us a report that detailed steps that would be taken to make the required improvements. At this inspection we found that sufficient steps had been taken and that the requirement actions were met.

People said that there had been changes in management of the home and that the service was improving. The manager had arranged for meetings to take place with people and their representatives to obtain their views on the service they received. Staff also told us that management within the home had improved and that they now received more support and advice.

People’s medicines were ordered, stored, administered and recorded safely. The system for safely disposing of medicines was not being followed in full. We have made a recommendation about this in the main body of our report.

People said that they consented to the care they received. The home was meeting the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) for people who lived in the Reminiscence Neighbourhood. The manager informed us that mental capacity assessments were not completed for people who resided in the Assisted Living Neighbourhood. We have made a recommendation about this in the main body of our report.

People said that the food at the home was good and that their dietary needs were met. There were two separate dining facilities, one in each Neighbourhood that formed the home. In one, we saw that peoples walking frames were moved once they were seated due to limited space. In the other we observed that some people had to wait up to 20 minutes for assistance to eat. We have made recommendations about this in the main body of our report.

People had care plans in place for staff to follow in order to meet their individual needs. Monitoring systems were in place to ensure people’s needs were being met in line with their care plans. These did not always reflect people’s needs. We have made a recommendation about this in the main body of our report.

Staff levels had been reviewed and changes made to the numbers of staff allocated to shifts. For example, a nurse was now allocated to the Reminiscence Neighbourhood. Robust recruitment checks were completed to ensure staff were safe to support people.

People said that they felt safe and we observed that they appeared happy and at ease in the presence of staff. When incident and accidents occurred action was taken to minimise the chance of a re-occurrence.

Inspection carried out on 15 and 16 June 2015

During a routine inspection

Sunrise Operations Bagshot 11 Limited provides facilities and services for up to 95 older people who require personal or nursing care over three floors. The home is known and referred to as Sunrise of Bagshot. 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. Sunrise of Bagshot was purpose built and provided care to privately funded people. At the time of this inspection 61 people were living in the Assisted Living Neighbourhood and 26 people were living in the Reminiscence Neighbourhood.

This inspection took place on 15 and 16 June 2015 and was unannounced.

The service had a registered manager in post. 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. People told us staff were kind and caring and looked after them well. However all feedback indicated that the staffing levels and the high use of agency staff impacted on the standard of care, with staff rushing to complete their work and agency staff unsure of their responsibilities. We found staff were under pressure to complete their work which meant staff did not have time to provide individual care. Including providing support for people to eat in a relaxed and unhurried manner on the Reminiscence Neighbourhood.

Agency staff did not routinely undertake an induction programme and identified regular agency staff were not being used. This did not support a level of continuity for people or staff. We found staff had not received regular supervision and appraisal to support them in carrying out their duties.

The provider had not ensured a suitable individual risk assessment had been undertaken to ensure people could be safely moved in case of an emergency. This assessment should take account of staffing arrangements.

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

The registered 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.

There had been a number of changes within the management team and this was still ongoing with a deputy mangers post in the service being recently vacated. There was mixed feedback about the management team with some staff identifying a lack of appropriate direct management. The management team had not fully established systems to ensure the effective management of staff. However the new registered manager was developing a more open and listening culture within the service.

Quality assurance systems were in place and had identified some shortfalls that needed to be addressed. However key areas around staffing and the provision of regular well motivated staff had not been identified.

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

Staff working for Sunrise of Bagshot were provided with a full induction and training programme which supported them to meet the needs of people. 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 on the Assisted living Neighbourhood 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 health limitations and ability to participate. 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.

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 12 December 2013

During a routine inspection

On the day of our visit there were 95 people residing in the home. We were met by the deputy manager who explained the home was divided into two separate areas: an assisted living area on the ground and first floors, and a dementia unit on the second floor.

We found that people who used the service were always being asked by staff if they consented to their care, and their right to refuse care was being respected. The people we spoke with said that care was never forced upon them.. We also found the provider had a process in place to deal with situations where decisions had to be taken in a person�s best interest.

We found that people were happy with their care and that staff engaged with people in an appropriate manner. People said things like �we are happy living here�, �the staff are caring and we can�t fault them�. We also found that people�s needs were being properly assessed, managed and reviewed.

We found that people were being properly protected against abuse and staff were able to identify, respond to, and report abuse. All the people we spoke with said they felt safe from harm in the home.

We found that there were enough staff to provide proper staffing cover at all times. However, some people and staff we spoke with said they thought staffing was an issue.

We found that the provider was regularly obtaining feedback from people and staff. We also found that the provider monitored and assessed the whole service on a regular basis.

Inspection carried out on 12 March 2013

During a routine inspection

We carried out this inspection to check on the care and welfare of people who used the service as part of our planned schedule of inspections. The inspection was unannounced which meant the provider and the staff did not know we were visiting.

For this inspection we focussed on the reminiscence unit that provided a service for people that had dementia. To ensure they were receiving the support they needed we observed how staff interacted with them and the care practice in the home. People we spoke with commented as follows, "I'm fine". "I'm comfortable" and "I've got used to it here, I like to watch what's going on and the staff are very kind".

We saw that care records included information about how people needed to be supported and how risks had been assessed. People received the health care and treatment they needed.

Systems for the management and administration of medication were effective. This meant people were protected from the risk of unsafe medication administration practice.

Staffing levels were usually sufficient to meet people�s needs and staff received the training they needed to support people. Staff reported that felt supported by management.

People that used the service did not raise any concerns or complaints during our inspection, but said that they would complain if they needed to. The provider was able to demonstrate that complaints were responded to and managed promptly.

During an inspection to make sure that the improvements required had been made

We did not speak to people using this service during this follow up review.

Inspection carried out on 31 March 2011

During a routine inspection

People who use the service confirmed to us that they had received a pre admission assessment prior to moving into the home. We were told that they had received information about the home prior to moving in and information was available in the form of a book within the home. People who use the service confirmed that they had read the information in the book.

People who use the service told us that regular meetings are held for them and that they were able to voice their opinions. They told us they thought their views and opinions were listened to.

People using the service that we spoke to confirmed that staff gave them choices and that consent was obtained before treatment was given. People said staff always explain what they plan to do and ask if this acceptable.

People who use the service told us they were happy with the care and support they received. Some people were aware of their care plan but could not remember signing and agreeing the document. People who use the service told us they were not worried about agreeing the plan as they felt they could discuss issues with the staff regarding their care needs.

People who use the service told us that the food was very good and that they had choices for each meal. We were also told that the dining room was a pleasant environment and you could sit where you wanted to and chat with your friends. One person told us that they would like to have the bread rolls served with the soup and not after.

People who use the service told us that their bedrooms are cleaned very regularly and that they had no concerns about the cleanliness of their environment.

All people using the service that we spoke to told us they loved living at Sunrise Bagshot. They commented that their rooms were large and communal areas a good place to meet people and socialise. People we spoke to all confirmed that their bedrooms were personalised as they had bought things from home.

People that use the service told us that the staff were very kind to them and always available when they needed them. They understood there were certain times of the day when the staff would be busy.

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