Archived: Sudbury House

About the service

Sudbury House is a care home providing residential care to 4 people with learning disabilities. The service can support up to 5 people.

People’s experience of using this service and what we found

The service was able to demonstrate how they were meeting the underpinning principles of 'Right support, right care, right culture.'

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were protected from the risks associated with the spread of infection. Medicines were managed in a person centred and safe way and staff ensured that people received medicines reviews.

People received personalised care which was built around their needs and wishes. Care planning involved the person and their relatives as appropriate. People’s risks were assessed in a person-centred way. People who may become anxious or distressed had positive behaviour support plans in place to reduce the need for restrictive practices.

Right Care:

People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs. Where appropriate, staff encouraged and enabled people to take positive risks.

Care was person-centred and promoted human rights. We spent time observing interactions between people and staff and these were caring and supportive.

People were protected from abuse and poor care. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.

People were supported to achieve their goals and aspirations by a staff team who knew them well. People had their communication needs met. Staff knew the best way to communicate with people. Communication was either verbal or through observing people's reactions to suggestions or actions.

Staff engaged with people in culturally appropriate activities in accordance with their individual care plan. People were supported to maintain links with their family.

Systems were in place to ensure people and relatives could provide feedback on the care they received.

Right Culture:

People were supported by staff who worked for a provider that promoted a culture where people were valued and respected as individuals. Staff and relatives spoke positively about the management of the service.

Staff completed training in learning disability and autism so that they could support people in a person-centred way. Staff received training in other core care subjects.

The staff turnover at the service was low, which helped ensure people received consistent care from staff who knew them well.

Governance systems ensured people were kept safe and received care in line with their personal needs and preferences. The service carried out a range of audits to monitor the quality of care they provided.

The service worked jointly with other professionals to improve outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 9 February 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection on 4 January 2016 the service was overall rated Good.

At this inspection we found the home remained Good.

People in the home had complex needs and were therefore unable to provide us with verbal feedback. On the day of our inspection, all four people were out at day centres during the day. Following the inspection we spoke with two relatives and one social care professional to obtain their feedback about the service. Relatives of people who used the service spoke positively about the care provided by the home. They told us they were confident people were safe in the presence of care workers and in the home.

There were systems and processes in place to help protect people from the risk of harm and staff demonstrated that they were aware of these. Risks associated with people’s care had been identified and appropriate plans were in place to minimise potential risks to people.

Medicines management arrangements were in place in relation to the recording, storage and administration of medicines. There were enough staff to meet people's individual care needs and this was confirmed by staff we spoke with.

Care workers told us that they felt supported by management. They spoke positively about the new manager and said they had confidence in her abilities. Staff had received training in areas that helped them to carry out their roles effectively. Staff received regular supervision sessions and a yearly appraisal.

People's health and social care needs had been appropriately assessed. Care plans were person-centred, detailed and specific to each person and their needs. Care preferences were clearly documented. Care plans were reviewed regularly and were updated when people's needs changed.

The home was working within the principles of The Mental Capacity Act 2005 (MCA). The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person's best interests. We found that necessary DoLS authorisations were in place.

Arrangements were in place to ensure the nutritional needs of people were met. The home provided vegetarian food at the request of people and their relatives for cultural reasons. The menu included a variety of foods which were freshly prepared daily.

The home ensured they respected people’s individual cultural and spiritual needs. People in the home were Hindu and the home had a Hindu calendar available which highlighted special cultural and religious events. The home had organised a religious prayer for people to participate in. People were also supported to visit the temple and supported to attend religious festivals.

We found the home had a management structure in place with a team of care workers, the cook, the new manager and interim supporting manager. Staff told us that the morale within the home was good and that staff worked well with one another. They spoke positively about working at the home. They told us management was approachable and there was an open and transparent culture within the home and they did not hesitate about bringing any concerns to management.

Staff were informed of changes occurring within the home through staff meetings and we saw that these meetings occurred regularly and were documented. Staff told us that they received up to date information and said communication in the home was effective.

The home carried out checks and audits which looked at various aspects of the care provided at the home which included health and safety, infection control, staffing, medication, fire safety and documentation. We noted that there had been a period where these checks had not been consistently carried out and we raised this with the interim supporting manager. She confirmed that there had been a gap but said that these checks would be carried out consistently. We also noted that a medicines audit had not been carried out since August 2017 and raised this with management. Management confirmed that this had been an oversight and said they would be carried out consistently in the future. We made a recommendation in respect of this.

We spoke with two members of staff, including the Registered Manager. We looked at care records for the five people who used the service, and we checked the areas of the premises that had caused concern.

Four people who used the service were away from the premises when we visited. We met the fifth person, but they were not able to understand and discuss with us the areas that we were looking at on this occasion.

The provider had carried out assessments for each person of their capacity for making decisions. The assessments followed the principles of the Mental Capacity Act 2005 and specified family members for each person who should be involved in any decisions made in the person's best interest.

We found that all cleaning materials that may be hazardous to health were stored securely in an outbuilding in the garden and replaced there after use. This meant that the risk to people using the service of contact with harmful substances was minimised.

The care plans that we saw were written taking the person's views and preferences into consideration. However the care plans and reviews of care that we saw were not signed by the people concerned to show their agreement.

We found no evidence of any assessment of people's capacity to take individual decisions in line with the Mental Capacity Act 2005. There was no record of decisions taken in a person's best interest if they did not have the mental capacity to understand and make the decision for themselves.

We observed that the home was clean and that an appropriate standard of hygiene was maintained in the kitchen and bathrooms. However we observed that items that could be a risk to people's health were accessible to people in the home.

Records were kept securely and could be located promptly when needed. We saw evidence that the provider carried out regular checks to ensure that people's personal records were up to date. Training records were maintained and showed that all the training for 2013 had been completed.

We found that people were supported in promoting their independence and community involvement. Their diversity, values and human rights were respected. People seemed to like the staff and they were provided with good care and support. They felt safe and were listened to when they communicated any concern or anxieties.

We looked at staff training records and spoke to staff.. The staff felt the staffing levels allowed them to spend quality time with people. Staff felt well supported and trained. The provider had systems in place to check the quality of the service.