Archived: Sunrise of Banstead

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

The home can accommodate a maximum of 97 people in two 'neighbourhoods.' The reminiscence neighbourhood provides care to people living with dementia and the assisted living neighbourhood supports older people who may have mobility and health needs. There were 83 people living at the home at the time of our inspection.

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 and associated Regulations about how the service is run.

Although staff were caring, one person was subject to restrictions which affected their experience of care and their life at the home. Although it affected only one person, this restriction was significant and breached the person’s human rights.

Overall people were safe although we identified an area for improvement in the use of equipment. We made a recommendation about this.

Overall people’s medicines were managed safely although we identified an area for improvement in the use of medicines prescribed ‘As required’ (PRN). We made a recommendation about this.

People felt safe and secure at the home. There were enough staff on each shift to meet people’s needs. Staff understood safeguarding procedures and were aware of their responsibilities should they suspect abuse was taking place. People were protected by the provider’s recruitment procedures.

There were plans in place to ensure people would continue to receive their care in the event of an emergency. Health and safety checks were carried out regularly to keep the premises safe for use. The home was clean and hygienic and staff maintained appropriate standards of infection control.

People’s needs were assessed before they moved into the home and kept under review. People’s care was provided in line with the Mental Capacity Act 2005 (MCA). When assessing people’s capacity to make decisions, staff had followed an appropriate process to ensure their rights under the MCA were protected. Staff understood that any restrictions should only be imposed upon people where authorised to keep them safe.

Staff had access to the induction, training and support they needed to do their jobs. Staff attended all elements of mandatory training during their induction and refresher training at regular intervals. Staff had access to further training relevant to the needs of the people they cared for. All staff attended regular one-to-one supervision, which gave them the opportunity to discuss any further training they needed, and an annual appraisal.

People enjoyed the food provided and were involved in developing the menu. People’s feedback about meals and mealtimes was encouraged and their suggestions were implemented. People’s nutritional needs had been assessed and were known by care and catering staff. Staff supported people to maintain adequate nutrition and hydration.

People’s healthcare needs were monitored effectively and people were supported to obtain treatment if they needed it. Referrals were made to healthcare professionals if staff identified concerns about people’s health or well-being. Any guidance about people’s care issued by healthcare professionals was implemented and recorded in people’s care plans.

People were supported by caring staff. People told us they had developed positive relationships with staff and enjoyed their company. They said the atmosphere in the home was friendly and welcoming. Staff supported people to maintain relationships with their friends and families. People said staff treated them with respect and maintained their dignity. Staff encouraged people to remain as independent as possible. People’s care plans were personalised and reflected how they preferred their care to be provided.

People had opportunities to take part in activities and to attend events and outings. People were protected from the risk of social isolation.

People and their relatives were given information about how to complain and felt able to raise concerns if they were dissatisfied. Complaints were investigated and responded to appropriately and used as opportunities to improve the care people received.

The home was well managed. People told us they saw the registered manager and senior staff regularly. They said they were encouraged to give their views about the home and how it could be improved. There was an open culture in which staff felt able to express their views and raise any concerns they had. Staff felt well supported by their managers and the senior management team. They said they were valued for the work they did. The provider recognised staff who strove to provide excellent care.

Staff communicated important information effectively. Staff at all levels met regularly to share information about people’s needs and any changes to their care. The provider had effective systems of quality monitoring and improvement. Key areas of the service were audited regularly and discussed at clinical governance meetings. Where opportunities to improve the service were identified, these were incorporated into the home’s development plan.

We identified a breach of the Health and Social Care Act 2008. You can see what action we told the provider to take in the full version of this report.

The home was run by a registered manager, who was present on the day of the inspection. 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 and associated Regulations about how the service is run.

People’s human rights could have been affected because the requirements of the Mental Capacity Act were not always followed. Some mental capacity assessments and best interest decisions had occurred where people lacked capacity to make decisions about their care.

Where people’s liberty may be restricted to keep them safe, the provider had not always followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected. DoLS applications had not been made for two people who had their freedom restricted. Since the inspection, the registered manager has confirmed that the applications have been completed. We have made a recommendation.

People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

There were sufficient staff to keep people safe. There were recruitment practises in place to ensure that staff were safe to work with people. There were sufficient staff numbers deployed to meet people’s needs.

People’s medicines were administered, stored and disposed of safely. Staff were trained in the safe administration of medicines and kept relevant and accurate records.

Staff had written information about risks to people and how to manage these. Risk assessments were in place for a variety of tasks such as personal care, use of equipment and some health needs and they were updated frequently. The registered manager ensured that actions had been taken after incidents and accidents occurred.

People had sufficient to eat and drink. People were offered a choice of what they would like to eat and drink. For those people that needed it, weights were monitored on a regular basis to ensure that people remained healthy.

People were supported to maintain their health and well-being. People had regular access to health care professionals.

Staff were trained and had sufficient skills and knowledge to support people effectively. There was a training programme in place to ensure staff could meet people’s needs. Staff received regular supervision.

People were well cared for and positive relationships had been established between people and staff. Staff interacted with people in a kind and caring manner.

People, relatives and health professionals were involved in planning peoples care. People’s choices and views were respected by staff. Staff and the management knew people’s choices and preferences. People’s privacy and dignity was respected.

People received a personalised service. Care plans contained sufficient detail for staff to support people effectively. We have made a recommendation about detailing people’s life histories. People were supported to maintain their independence.

There were range activities in place which people enjoyed. Activities included drives out on the minibus, sewing groups, tea dances, reminiscence and physical exercise.

The home listened to peoples, relatives and staff views. There was a complaints procedure in place. The registered manager had responded to complaints in line with the provider’s policy.

The management promoted an open and person centred culture. Staff told us they felt supported by the manager. People and their relatives told us they felt that the management was approachable and responsive.

There were robust procedures in place to monitor, evaluate and improve the quality of care provided. Staff were motivated and aware of their responsibilities. The manager understood the requirements of CQC and sent in appropriate notifications.