Sunningdale Nursing Home

Sunningdale Nursing Home is a care home providing personal and nursing care to up to 42 people. At the time of our inspection there were 35 people using the service. The services provides support to both younger and older people, some who may have physical disabilities.

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

People were protected from the risk of harm and abuse by well trained staff who knew people’s needs well. Risks were assessed and managed safely. The home was clean, and staff adhered to infection prevention control principles. People received their medicines in a safe and timely way.

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. Nutritional needs were met, and people received a balanced diet which was varied and tailored to individual needs and preferences. Staff worked alongside other professionals to ensure people received access to healthcare as required.

The registered manager and the senior leadership team promoted a positive and open culture where people, their relatives and staff contributed to the day-to-day running of the service. Governance systems were in place to ensure the safety and quality of the service was continually monitored and improvements were made where necessary. The provider was visible and approachable. People, their relatives and staff held spoke highly of them.

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 July 2019).

Why we inspected

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. This included checking the provider was meeting COVID-19 vaccination requirements.

The inspection was prompted in part due to concerns highlighted at an inspection of the provider’s previous location. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained the same based on the findings of this inspection. We found no evidence during this inspection that people were at risk of harm from this concern.

Please see the safe, effective and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sunningdale nursing home on our website at www.cqc.org.uk.

Follow up

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

Sunningdale Nursing Home is a residential and nursing care home in Tamworth, providing personal and nursing care to 36 people at the time of the inspection. The service was registered to support up to 42 people. The service accommodates people in one adapted building across different wings and floors.

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

People’s experience of using the service was overall very positive. However, we found improvement was required with regards to safety checks, record keeping, which included the planning of person-centred care, and governance. The provider and registered manager were responsive to our feedback and addressed the issues.

We note that we found that overall this was a very good service with some particularly positive aspects. However, we needed to see these in the context of the whole inspection. This means we balanced findings within different areas of improvement needs including those that could put people’s safety at risk. This was particularly when considering whether the service was caring, responsive and well-led. This is reflected in the individual ratings of questions and the overall good location rating.

We found a truly positive, inclusive, warm and welcoming atmosphere throughout our inspection. People using the service, relatives and staff often laughed together, which reflected the “family like” feel we heard about from those we spoke with. The service was particularly centred around the needs and quality of life of people and their families within an at times remarkably caring service.

The provider and managers promoted a culture of continuous improvement. The service particularly stood out with its significant investment into activities that involved people, provided stimulation and reduced isolation. One person said about the activities staff, “They are amazing. [Name] seems to know what I need before I do.” We heard many examples from people and relatives that showed just how particularly caring staff were. What was remarkable was the humility and matter-of-fact approach with which staff did this, as staff told us, “It is just what we do.” Everyone we spoke with talked highly about the service, its managers and provider.

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. We highlighted some improvement needs when people’s capacity might fluctuate.

People felt safe living at Sunningdale Nursing Home. Together with their relatives and staff they were actively involved in the design and delivery of the service. There were enough staff to meet people’s needs and staff felt supported and acknowledged as part of a well-working team.

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 21 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We carried out a focused inspection on 23 May 2016 as we had received concerns from the local authority about how people received their support and care. We found improvements were needed as the provider had not identified that some people may not be receiving their care in a safe and effective way; We also identified there were no staff available in communal areas due to the deployment of staff and managing staff breaks. This meant at those times, some people were not able to summon prompt assistance from staff. During this inspection we found some improvements had been made.

Sunningdale provides accommodation for up to 42 people who require nursing or personal care. At the time of our inspection 34 people were using the service.

There was 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 were asked for their consent before care was delivered although where people lacked capacity to make some decisions; it was not clear how this had been assessed. Where restrictions had been identified, application to ensure these were lawful had been made.

Where people needed to have their food and drink monitored, systems were not in place to ensure health support was sought promptly to ensure people were well. Where specific health care tasks were needed, we found this had not always been done promptly to ensure people’s care and dignity. Action was taken by the registered manager and provider following our inspection to make these necessary improvements.

How people received their medicines had been reviewed and people were now receiving their medicines at the time they needed these. People’s medicines were managed, stored and administered safely.

Staff understood their responsibilities to protect people from harm and knew how to raise any concerns. There were enough staff on duty to meet people’s needs and checks were carried out to ensure staff’s suitability to work in social care. Staff received training and support and when they were new to the service they were able to work alongside experienced staff and spend time with them so they knew how to provide the care they wanted.

People were cared for by kind and compassionate staff who understood them. Staff knew about people’s individual preferences for care and their likes and dislikes. People and their relatives were involved in planning and agreeing how they were cared for and supported. Care was planned and reviewed to meet people’s individual needs, abilities and preferences. People were able to engage in activities that interested them in the home and could go out if they wanted to.

The premises and equipment were checked to ensure they were suitable and maintained to ensure risks to people’s safety were minimised. Quality checks of people’s care and health, medicines management, meals and suitability and management of the premises were completed. Accidents, incidents, falls and complaints were investigated and actions taken to minimise the risks of a re-occurrence.

Sunningdale provides support and nursing care for up to 41 people. There were 31 people living in the home on the day of our inspection.

The service had a manager who had applied to become the registered manager for this 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.

Systems were in place to assess and monitor the quality of the service. However, the provider had not identified that some people may not be receiving their care and in a safe and effective way; these concerns had been identified by the local authority. The care records did not always show how risks associated with catheter care and skin damage were managed to ensure people received the most appropriate care.

There were sufficient staff on duty who provided respectful care to people. On occasions, there were no staff available in communal areas due to the deployment of staff and managing staff breaks. This meant at those times, some people were not able to summon prompt assistance from staff.

Staff now understood the importance of safeguarding people and their responsibilities to report this. Staff knew how to recognise the signs of potential abuse and knew what to do when safeguarding concerns were raised.

Following concerns identified by the local authority the medication system had been reviewed. The provider had made arrangements for a different pharmacy to dispense all the medicines and provide support to ensure people received their medicines as prescribed.

There was a homely and relaxed atmosphere and people were generally treated with care and compassion. People told us the staff were kind and treated them respect. People liked the staff who supported them and had developed good relationships with them.

When new staff started working in the service, recruitment checks were carried out to ensure that they were suitable to work with people.

The new provider had spoken with people who used the service and staff to ensure they had all the information about how improvements were being made.

Sunningdale provides accommodation for up to 42 people who require nursing or personal care. At the time of our inspection 33 people were using the service.

There was 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.

During our previous inspection, we identified concerns with how people were provided with dignified care and able to make choices. During this inspection, we saw improvements had been made. Staff were respectful and people chose how they wanted to be supported. People received individual support to eat and drink and staff spoke with people and included them in conversations during the meal time. People had a choice of what to eat and drink and specialist diets were catered for.

Improvements were needed to ensure people were provided with activities to meet their interests. There were limited opportunities for people to engage in activities and as the lift was not in operation, people were spending long periods of time in their room unoccupied and with limited opportunities for socialising with others.

Communication was not effective from the provider, and people, their relatives and staff were unsure of what was happening in the home and in the future. Meetings were held with people and staff but there was not an effective system in place to ensure people had up to date information about any changes or developments.

People’s risks were assessed and there were sufficient numbers of staff to promote people’s safety. However, some care records still needed to be updated to ensure they reflected current information about how people wanted to be supported.

People were confident that staff supported them in a manner which protected their welfare and they told us they felt safe. Staff had a good understanding and knowledge of safeguarding people and understood what constituted abuse or poor practice. Where harm or abuse was suspected, the staff knew how to respond to protect people.

The staff had received training that enabled them to meet people’s needs. Care was provided with kindness and compassion and people’s independence and dignity were promoted. People’s health and wellbeing were monitored and they received their medicines as prescribed. The staff worked with other professionals to ensure people received medical, health and social care support when required.

People made decisions about their care and staff helped them to understand the information they needed to make informed decisions. Staff sought people’s consent before they provided care and support. Where people were not able to make decisions for themselves, they were supported to make decisions that were in their best interests with the help of people who were important to them. Where restrictions were placed upon people these had been assessed and applications made to appropriate authorities to ensure any restriction was lawful.

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

We spoke with people who used the service, their relatives and staff.

We found that people's care and welfare needs were being met. One person told us; 'They (staff) are good, they look after me well'.

We saw that the service was clean and had systems in place to prevent the spread of infection.

We found that equipment was well maintained and suitable for its intended use.

The service followed the correct procedures when recruiting new staff.

We saw that the service had a complaints procedure which was readily available for people who used the service or their representatives to raise any concerns they might have had.

Sunningdale was compliant in the five outcome areas we looked at.

We saw that staff treated people with consideration and respect. We found care plans provided a thorough assessment of people's needs and were updated as people's needs changed. Care workers and nurses referred to the care plans and risk assessments to ensure the care met people's individual needs. When we spoke with some of the people who lived at Sunningdale they told us positive things about their care, "I do like it here"; "the staff are very good"; "lovely food". A relative of one person said, "I am confident that Mum is well looked after".

The staff we spoke with had completed safeguarding training and they were clear about their responsibilities to protect people from any risk of abuse. They told us they had confidence in their managers and the home's owners to take appropriate action to keep people safe. When we visited, we observed that there were enough staff to meet people's needs. They worked well as a team and they had received regular training.

We saw that the provider company Restful Homes Ltd had robust systems to monitor the quality of the service.