Archived: Sunrise Operations Purley Limited

Sunrise Operations Purley Limited provides residential and nursing care for up to 119 older people. Accommodation is spread over four floors with passenger lift access. A separate specialised reminiscence neighbourhood is situated on the second floor for people living with dementia. Some people use the service for respite care breaks. There were 112 people using the service at the time of our inspection.

When we inspected, there was no registered manager at the service. A new manager had been appointed in August 2016 and was in the process of applying to register. 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 told us they felt safe and well cared for. There were robust systems and processes in place to protect people from the risk of harm. Staff knew how to recognise and report any concerns they had about the care and welfare of people and how to protect them from abuse. People's safety was promoted because risks that may cause them harm had been identified. Suitable risk assessments were in place to keep people safe.

People lived in a safe, clean and comfortable environment that was designed and equipped to meet their needs. The reminiscence neighbourhood promoted engagement and wellbeing for people living with dementia, using decoration, signage and other adaptations. Appropriate checks of the building and equipment were undertaken to ensure health and safety for people and staff was maintained.

The provider’s recruitment and employment processes were robust and protected people from unsafe care. When we inspected, there was enough staff to meet people’s needs although continuity of care was affected by staff turnover and the use of agency staff at times. The provider was taking action to improve this.

Staff received a structured induction and essential training at the beginning of their employment. This was followed by ongoing refresher training to update and develop their knowledge and skills. Staff also undertook training specific to the needs of people they cared for and to keep up to date with best practice. Staff were supported in their roles and the standard and quality of their work was kept under review through ongoing supervision and performance appraisal.

People’s rights were protected because the provider acted in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This legislation is intended to ensure people receive the support they need to make their own decisions wherever possible. The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them. Conditions on authorisations to deprive a person of their liberty were being met. Staff had completed training and understood their responsibilities where people lacked capacity to consent or make decisions.

People’s health needs were monitored and they had access to health care services when they needed them. Any advice from external professionals was included in their care and acted on accordingly. Medicines were managed safely and people had their medicines at the times they needed them. New audit and monitoring systems had been introduced to further ensure that people received their medicines as prescribed.

People’s care needs had been fully assessed prior to moving to the home and these were regularly monitored and reviewed to make sure the care was current and relevant. Care records contained information about the care and support people required and were written in a way that recognised individual needs and preferences. Staff worked well with external health and social care professionals to ensure people received the care and support they needed.

People were treated with kindness and respect and made decisions about their care and support, with family members involved where appropriate. Staff were mindful of people's privacy and dignity and encouraged people to maintain their independence as much as possible. The service worked closely with families and relevant professionals so that people received dignified care at the end of their lives.

People were provided with a choice of food and drink that met their nutritional needs. Mealtimes were unrushed and people were encouraged and supported to eat a healthy diet that also recognised their choices. People received the assistance they needed to eat and drink well and staff involved other relevant professionals when people were at risk of poor nutrition or dehydration.

There was a varied range of activities and entertainment for people, which included group activities or one to one outings. Staff understood the importance of preventing social isolation and ensured that they offered companionship and interaction with people where necessary. People were supported to maintain relationships with family and friends who were important to them. Relatives and friends were welcome to visit when they wished and invited to participate in social events at the home.

Systems were in place that encouraged feedback from people who used the service, relatives, and staff and this was used to improve their experience at the service. People knew how to complain and told us they would do so if required. Procedures were in place to monitor, investigate and respond to complaints. There was monthly auditing to make sure that lessons could be learnt.

The registered provider had values for the service, which were known and followed by the staff team. Staff were clear about their roles and responsibilities and felt supported by management.

Consistent audits were undertaken to monitor the quality and health and safety of the service. Where improvements were needed or lessons learnt, action was taken. Records supported that audits were effective and supported the provision of safe and appropriate care. The provider worked in partnership with other agencies and professionals to support care provision and service development.

Sunrise Operations Purley Limited is a large well maintained Victorian style home. During our inspection we observed the environment to be suitably furnished, warm and clean. The home has access to several outdoor spaces including a well presented landscaped garden. There were several communal areas for people to use including a bistro area for residents & their visitors.

At the time of our inspection there were 118 people residing at Sunrise Purley. We used different methods to help us understand the experiences of people who use the service as not everyone who lived at the home was able to communicate verbally with us in a significant way. To help us to understand the experiences people have we used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record whether people have positive experiences.

During our inspection we observed positive staff interactions with people using the service. Staff interactions were generally characterised by genuineness, warmth, understanding and acceptance.

On the day of our inspection we met and spoke with 10 people who live at Sunrise Purley, 6 family members or visitors to the home and 9 members of staff including the registered manager. Feedback from people who use the service was generally positive. They told us they were happy with the care and support provided at the home and felt the staff who worked there were kind and compassionate, however comments were made on the amount of staff working during specific times throughout the day. One person told us 'The staff are always very kind and friendly but I do have to wait on occasions for someone to help me' and another person said 'Staff are helpful and I have no concerns. The food is good and the dining staff are wonderful'.

Relatives we met told us they felt the way the service was managed had improved but there had been many changes with staff leaving and staffing levels were observed to be poor at times. Comments included 'There has been a big change in staff which is not easy. Yes there are times when people in the bistro do have to wait for staff and when you can't find staff, but this is not a frequent occurrence' and 'All the staff are nice but not usually around, you can't find anyone if you want someone'.

People were not always protected against the risks associated with taking their medication because the provider did not have appropriate arrangements in place for monitoring medicines which were through an electronic medication system. We found that medicines were not always stored correctly and at the correct temperature, which could increase the risk of medication errors and causing potential harm to people.

People were cared for or supported by suitably qualified, skilled and experienced staff. Appropriate checks were undertaken before staff began work. In records we reviewed staff had DBS (Disclosure and Barring System) checks in place and references were sought and checked by the provider from previous employers. The provider had a suitable staff induction process and procedure in place and frequent training was provided and appropriate to meet the needs of people who use the service.

Everyone living at Sunrise Purley has a single room, however they offer ten 'muse suites' which mean people living in these share a kitchenette and bathroom. All suites are well appointed with built in wardrobes and TV. Many suites we were invited to look at where personalised with individuals furniture. Living within the home are two cats and a small dog. Sunrise Purley welcomes pet owners and pets who are considering moving into the home.

At the time of our inspection there were 104 people residing at Sunrise Purley. We used different methods to help us understand the experiences of people who use the service as not everyone who lived at the home was able to communicate verbally with us in a significant way. To help us to understand the experiences people have we used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences.

On the day of our inspection we met and spoke with 24 people who live at Sunrise Purley, 8 family members and or visitors to the home and 15 members of staff including the deputy manager. Feedback from people who use the service was generally positive. They told us they were happy with the care and support provided at the home and felt the staff who worked there were kind and compassionate. One person told us 'I love it here. I can't fault the place' and another person said 'staff are lovely and always helpful. I feel lucky to live here'. Relatives we met also told us they felt the way the service was managed had improved and was good.

During our inspection we observed positive staff interactions with people who used the service. Generally staff interactions were characterised by kindness, warmth, understanding and empathy.

We saw the service had adopted various ways to ensure that people who use the service were supported fully and individual's needs were being met. These included regular residents committee meetings with everyone who used the service invited to attend and residents and family members annual opinion satisfaction surveys that were completed and any changes requested or required put into action.

The home was well maintained, comfortably furnished, warm and clean. The ground floor had a large reception area with a 'Bistro' where people could have coffee, tea, cold refreshments and snacks throughout the day and evening. People told us that they enjoyed, 'meeting friends and sitting chatting' in this area.

There were enough staff available to meet people's needs effectively and people told us there were always enough staff to support them.

There was an appropriate system in place for people to make complaints and the people and relatives spoken with told us that they knew how to make a complaint.

We saw some positive interactions between staff and the people living at the home and the relatives we spoke with were generally happy with the care being provided to their family member. However, we observed some poor and unsafe practice and there were gaps in the care records which meant that people's needs were not always being met effectively.

We found that appropriate systems were not followed in order to ensure that people and/or their representatives gave consent to their care and treatment and that this was appropriately recorded to inform staff of their wishes. There was also a lack of evidence to show that decisions had been made in people's best interests.

People using the service that we spoke with were all very happy with the care and support they received.

Comments we received included 'we're happy, safe and warm and well fed',' the place is comfortable, you don't get stressed out' and "I'm very happy with the care here'

Other people told us 'everyone is very friendly; I get the care I need' and 'any moan I've ever had has been dealt with'.

People told us that they felt quite safe in the home. They told us that they had never heard anyone raise their voice or be disrespectful to anyone. They said that should they need to raise a complaint or concern they would speak to the staff. We did not see any evidence of restraint on this visit.

Most people we spoke with told us that they never had to wait long for help when they rang their bell. However, one person did say that sometimes there was a delay if they rang their bell at night. Another told us 'carers are really pushed for time'.