Sunnymeade Quality Care

Updated 8 April 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by an inspector and assistant inspector.

Service and service type

Sunnymeade Quality Care is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. Two managers were in the process of registering with the Commission.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the provider, manager, senior care staff and six care staff. We also spoke with one relative and four people who used the service.

We reviewed a range of records. This included three people’s care plans, medication records and management records. We looked at two staff files in relation to recruitment. We reviewed supervision records.

After the inspection

We requested records for staff and resident meetings, service certificates and training matrix. We continued to seek clarification from the provider to validate evidence found.

Updated 8 April 2022

About the service

Sunnymeade Quality Care is a residential care home that was providing personal care for up to 31 people. At the time of the inspection 28 people living at the service.

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

Changes from a paper reporting system to an electronic recording system for care and managing risk had been slow to be implemented. Some people were at high risk of falls. These were being reviewed and responded to by the manager. There had been a choking incident. This person’s risk assessment had not been updated at the time. However, recent review and changes meant the current risk assessments were satisfactory and any risks to people were minimised. There was no evidence of reporting on patterns or trends of incidents and what additional measures had been put in place to mitigate risk. The current management team had recognised this and created an area on the electronic system to report falls and review patterns to manage this in the future.

Systems to assess and monitor the quality and safety of the care provided were being developed. However, these systems were still being implemented and were not yet fully effective in assessing quality or identifying and driving improvement.

People’s capacity had not always been assessed following the principles of the Mental Capacity Act 2005 (MCA). Where people lacked capacity there had been no assessment or applications made to the local authority for any Deprivations of Liberty Safeguards that were necessary to keep people safe.

Health and safety checks of the environment and equipment were in place. However, the services environmental fire risk assessment had not been reviewed since 2019. The records stated it was due for review in October 2020. This had not occurred, but had been recently identified by the management team who were in the process of updating this assessment.

People’s medicines were managed safely. However, there were gaps in the temperature monitoring of the medicine refrigerator. The manager took immediate action to address this by reminding staff responsible.

The service had suitable safeguarding systems in place. Most staff had received training, however there were some gaps where training updates had lapsed. Staff spoken with were able to explain how they recognised abuse and what to do if they suspected abuse was occurring. The managers had identified where updates were required and this had been factored into the training plan.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.

Staff were informed about people’s changing needs through effective shift handovers and records of the daily care provided for people.

People were offered a range of healthy meal choices.

Relatives told us they were happy with the care their family member received and believed it was a safe environment. Comments included, “Yes, it all seems very good. The place is very clean and does not smell at all. (Person’s name) is very happy here” and “The care, love, and dignity you treated our relative with was above and beyond. The sincerity that you afforded me when I was with my relative in the final hours will always be remembered”.

Staff were recruited safely. The service had experienced staffing shortages and was a nationally identified issue. Staffing rotas identified where gaps had occurred and what action had been taken to fill those gaps. The staff team and managers were supporting each other to ensure people’s needs were being met.

There was an active recruitment process in place. It was anticipated staffing levels were improving. Agency staff were also supporting any gaps. Staff told us, “We have struggled like everywhere else. We are not fully staffed but this week as one of us is on holiday, we get on with it, we are a good team and we are currently on a bit of a programme and when there are three of us and we are blitzing rooms and it is nice because we are slowly getting back up to where we should be.”

Many staff had been provided with supervision this year, although this had not been as regularly as planned due to the impact of recent staffing pressures and the challenges of the pandemic. We saw a more robust programme of supervision and competency checks which was being implemented for all staff.

The training rota had recently been reviewed and updated. There had been some gaps in training during the COVID-19 pandemic period. However, they had been identified and dates were in place to carry out this training.

The building was clean, and there were appropriate procedures to ensure any infection control risks were minimised. Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Suitable visiting arrangements were in place for families to visit as per current government guidance.

Staff supported people in the least restrictive way possible. Changes in policies and systems in the service supported staff. People who wished to remain in their bedroom did so. Those spoken with confirmed this was their choice.

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 (report published 13 February 2019).

Why we inspected

We received concerns in relation to safeguarding people. Intelligence showed there was inconsistency in the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-Led sections of this report.

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

Enforcement

At this inspection we have identified breaches in relation to governance, risk and monitoring systems.

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 any concerning information is received, we may inspect sooner.