Sunnybank House is a care home providing personal and nursing care to up to 60 people. There were 38 people using the service when we inspected. The accommodation is arranged over three floors. The Rose Unit is on the ground floor and provides residential care for people with less complex needs. Dahlia Unit is on the first floor and is a registered nurse led unit supporting people with a range of more complex clinical needs. Nemesia Unit is on the top floor. This unit had only recently reopened after being redeveloped as a specialist unit for people living with dementia.
People’s experience of using this service and what we found
People were safe and we observed care being provided in a caring and unhurried manner. However, we also received feedback which indicated that there were times when staff were not able to be fully responsive to people's needs. Medicines were not always administered as planned due to not being available or out of stock or because staff had not always been sufficiently proactive about overcoming other barriers to administration. Risks to people’s care had been assessed and planned for. A range of health and safety checks were taking place to ensure that the building and the equipment within it were safe to use and had been serviced and maintained regularly. As part of CQC's response to the coronavirus pandemic we conducted a review of infection prevention and control (IPC) measures in the home and were assured by the systems in place. There were systems and processes in place to safeguard people from the risk of abuse and to learn from safety related events. We did identify one potential safety related concern in relation to how food for people who required a modified diet was being prepared.
We have made a recommendation about how the International Dysphagia Diet Standardisation Initiative (IDDSI) is used within the service.
Staff completed a suitable induction and undertook a wide range of training, relevant to their role.
Assessments were completed to establish people’s needs and to ensure these could be fully met. People’s nutritional needs were met. Staff worked with other agencies to ensure people had access to healthcare services. The design and layout of the building was suitable and had been developed with the needs of people living with dementia in mind. Staff were well informed about the principles of the Mental Capacity Act 2005.
We have made a recommendation that the service develop specific DoLS care plans which show how the liberty of people, with a DoLS authorisation, is being promoted.
People told us that staff were kind and caring and treated them with respect. People were supported to maintain their independence and autonomy where able. Staff sought people’s consent before delivering care and care plans included information about people's preferences and wishes and the relationships that were important to them.
People had access to a range of events and activities which helped to boost their well-being and keep them engaged and entertained. The number of agency staff used had reduced which helped to ensure that people received care from staff that knew them and their needs well. People’s communication needs continued to be identified and planned for. Complaints had been responded to appropriately. Staff worked with local health care professionals to provide responsive and compassionate end of life care.
People benefited from a well led service and the registered manager and provider had shaped a culture where staff strived to provide person centred care. The registered manager maintained a visible presence within the home and actively supported staff and interacted with people on a daily basis. Staff were clear about their role and responsibilities and spoke positively about the registered managers leadership and their impact on the service since their appointment. There were effective quality assurance systems in place that lead to improvements that had positive outcomes for people. People were encouraged to give feedback about the care they received.
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 ‘Requires Improvement’ (published October 2019).
Why we inspected
This was a planned inspection based on the previous rating.
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.
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.