Sunny Bank PRS

At our last inspection we rated the service Outstanding. At this inspection we found the evidence continued to support the rating of Outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

People’s experience of using this service:

At this inspection we saw the service continued to provide outstanding care overall. The provider and registered manager continued to use research based care and treatment to improve people’s recovery from a mental illness.

Two directors both took an active part in the day-to-day running of the home. One director was a registered occupational therapist and the other director was a registered mental health nurse (RMN) who specialised in behavioural management.

People who used this service continued to benefit from an outstanding effective and well-led service. The service consistently maintained good practice in the treatment of people with a mental health illness. People we spoke with all told us they could go and talk to the directors when they liked and had confidence that they would be listened to. People made comments such as, “The [directors’ name] is a hard worker and very good. You can talk to [name of director]” and “I have no concerns. I can talk to the managers if I do.”

People received an exceptional assessment tailored to their individual needs. The assessment lasted a minimum of six weeks and took account of people’s diverse backgrounds. One person going through the assessment was from an ethnic minority. We saw that through the assessment process the person could follow their religious and cultural needs in the way they wanted to.

Each person’s recovery program commenced during the assessment process. We saw that the service ensured they took as much personal details of a person, their background, likes and dislikes as they were able. This included daily living skills as well as the psychological and sociological aspects of the person and their behaviours. This information was used to develop a detailed care plan, which was tailored to meet people's needs and preferences.

The service followed a mental health recovery program and liaised with other organisations and professionals to aim for as much independence as possible for each person. If people recovered they had the option to move to supported living under the same organisation or to independent living. This ensured people could still receive some support if they wanted it.

We found that the directors and the registered manager had substantial knowledge about ways to help enable and support people to recover from mental health illness. They were highly proactive in ensuring that the service consistently maintained and sustained high standards in the best interests of the people who used the service.

We found that the directors and the registered manager worked together to deliver exceptional leadership within the home. They promoted a positive culture that embraced everyone connected with the service. Staff we spoke with told us, “My support is very good. There are always opportunities to talk to management” and “The owners are very good to work with. They have people’s best interests at heart. The providers go above and beyond getting what is right for people. They lead by example and inspire us. Nothing is too much trouble.”

Staff were well trained and encouraged to find training they wished to do which would also benefit people who used the service.

The service had achieved accreditation from several quality assurance schemes and were recognised as a good provider by local authorities.

The service provided exceptional support to people who used the service in respect of their life skills such as cooking. This helped promote independent living.

The service provided healthy living advice and supported people to go to colleges to improve their confidence or life skills.

The service had a strong sense of promoting social inclusion and people were supported to be active members of their communities. Staff understood the Equality Act and empowered people to explore their diversities whilst supporting them to maintain their own safety.

People’s diverse needs were considered in respect of their age, gender, sexuality and religion. This included the food they prepared and any religious needs a person wished to follow.

The service was warm, clean, well decorated, had no offensive odours and provided people with a homely environment.

Medicines administration remained safe.

Staff told us they had time to sit and talk to people. Staff also arranged and supported people to go on outings or attend appointments if required.

Some activities and outings were researched based to help the recovery of people with a mental health illness.

People' care was consistently personalised to their need. During our inspection, we found many

examples to demonstrate the staff and management team were passionate about providing an innovative and excellent service.

The service asked people who used the service, stakeholders and family members what they thought of the quality of service provided and acted on the views to improve the standards of care and support.

Rating at last inspection: The service was rated as outstanding at the last inspection.

Why we inspected: This was a planned inspection based on the rating of the service at the last inspection.

Follow up: We will continue to monitor the service through information we receive and future inspections.

Sunny Bank PRS is a privately owned care home providing psychiatric rehabilitation services for up to 21 people with enduring mental health needs. The home is a large converted detached property with accommodation provided over three floors. The home has a pleasant conservatory overlooking landscaped gardens and is surrounded by fields to the side and the rear. The home also has three supported living houses within the Bury area. All bedrooms are single occupancy. It is situated close to Tottington village. Facilities available in the village centre include shops, pubs and a health centre. There are good transport links to Bury and Manchester.

There was a registered manager in place at the service. 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 were encouraged and supported to manage their own medicines where possible.

People we spoke with told us that they felt safe at the service. The staff team training record showed that all staff had undertaken training in safeguarding adults. The support workers we spoke with were able to tell us what action they would take if they had any concerns about a person who used the service.

The house was seen to be well maintained, comfortable, homely, clean, and tidy.

There was a lengthy assessment process that could take up to eight weeks. During this period, people had a gradual introduction to the service, which included overnight stays and an opportunity to develop and participate in their activities programme. This gave people and the service time to get to know one another and decide whether the placement would work before an agreement was reached to move into Sunny Bank permanently.

The staff team worked flexibly to ensure that the activities programme could be met supported people. There was a low staff turnover and most of the staff had worked for the service for many years so they knew people well.

The assessment and care plan process focussed on people’s strengths, personal preferences and their goals to take back responsibility for their lives with renewed confidence. This was done by creating a constructive programme of activities, which they wanted to participate in to help motivate them to meet their personal goals.

Staff members who we talked with told us, “We support people to move outside their comfort zone with gentle persistent persuasion to gain more control over their lives,” “We show people how to take responsibility and help them to increase their self-reliance. This is a slow and often frightening process for people but success breeds success.”

People told us that, “The food is nice and we can have an alternative if we don’t like what’s of offer,” “The food is really good and there is a wide variety. They don’t give me anything I don’t like” and “The new chef is brilliant.” We saw that as part of the activity programme that people were involved in the preparation and cooking of food depending on their individual level of ability. Taster evenings took place to help people try new meals that they might want to add to the menu.

People said, “I take part in the exercise group. I love it and it is really good for me. I get fresh air and eat the right food,” and “I am feeling healthy since I have been here. I go to the gym and play badminton and table tennis. I smoke less and don’t smoke in the night anymore. I see the chiropodist.”

The service worked in partnership with other health and social care professionals. This meant that people had access to the support they needed.

The atmosphere at the home was calm and relaxed and interactions between people and the staff team were seen to be frequent and friendly.

People who used the service spoke positively about the staff team. They told us, “The staff are helpful and they know me well,” and “The staff are kind and considerate and they understand where I am coming from.” We saw that the service recognised that sometimes living together can be difficult and had produced a leaflet call ‘RESPECT find out what it means to me’. This leaflet gave ‘top tips’ for living in a communal environment which included, to treat people as you would want to be treated and that if people respect one another dignity will automatically follow.

People who used the service told us, “I am involved in my care plan and risk assessments.” “I choose to attend most of my review meetings.” We looked at the care records for three people who used the service. We saw that the records were person centred and highly detailed. The service worked in partnership with the person’s allocated health or social care professional to help ensure progress was being made in relation to people’s planned goals.

People we spoke with told us that ‘without a doubt’ that the best things about living at Sunny Bank were the trips out, activities within the local community and group work, which had helped them to regain their independence. One person said, “They do more here than other places I have lived at. I have been involved in a lot of activities during my time here such as the gym, cinema, trips out, meals out, which they pay for. I have also got a push bike.”

The director said that, “We use our imagination to give people coming to live at Sunny Bank opportunities they have not had in their lifetime. We look at anything and everything from coffee mornings in the village, to go karting and the rugby league final.” A staff member said, “The activities programme is packed. We are always looking for new activities to keep it varied.” Another said, “It is a very get up and go place. Non-stop!”

People were encouraged and supported to be as independent as possible.

People were encouraged to maintain contact and rebuild relationships with their families and friends. For people who had no family and friends contact extra activities to help support people were included in the activity programme to help encourage and support other relationships and friendships.

People did not have any complaints but told us that they would have no issues raising them if they did.

We saw that there was a qualified and competent management team in place. People who used the service and staff spoke highly of the management team. They told us that the managers of the team were always approachable and supportive. A staff member said, “I think the managers are brilliant. If I have any worries or concerns, I can approach them for advice. They engage with everyone.”

Systems were in place to show the service was under constant monitoring and review, which included external assessment.

We found that people who use the service received care in a way that met their needs and preferences. People's care records contained enough information to show how they were to be supported and cared for. People's health, safety and welfare was protected because the provider worked in co-operation with other health professionals.

We found there were arrangements in place to manage medicines safely. The people we spoke with told us the staff prompted them when they needed to take their medicines and they were always given their medicines on time.

The people we spoke with told us the staff were helpful and friendly. They told us there was always a member of staff around when they needed them. We found that people were cared for by a sufficient number of staff that were properly qualified, skilled and experienced to meet people's needs.

We found there was regular monitoring of the services and facilities provided to help protect people against the risks of inappropriate or unsafe care.

We looked at two peoples' care records. We saw that people were actively involved in planning their care and support. People were given information to allow them to make informed decisions about the options available. Plans were regularly reviewed to ensure they continued to meet peoples' specific needs.

Sunny Bank PRS is a large converted detached property with gardens to the front and rear. The property and grounds were well maintained. The home was clean and fresh. Furnishings were in good order.

The home was staffed by a small well established team. Staff benefitted from a comprehensive induction programme, regular ongoing training and professional development opportunities. Staff were supported by annual appraisals and regular supervisions sessions with their line manager.

The Manager told us that no complaints had been received at the home. We saw that there was a complaints procedure in place. One person living at the home told us there was "nothing I would want to change about Sunny Bank"