Sunnymede

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The service was no longer in breach of legal regulation in relation to safe staffing.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Relatives told us they felt their relative was safe and told us the service told them if their relative had been involved in an incident.

Systems were in place to record accidents and incidents that happened at the service. Action was taken including referrals to other health and social care professionals following incidents. Audits took place to look at themes. For example, falls audits took place regularly to identify any areas of improvement.

The provider showed how the service had improved how people’s health information is recorded and shared, following learning from a safeguarding incident. However, these changes were new and not yet fully embedded in practice.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Systems were in place to ensure people had a transfer into hospital.

Assessments were made of people’s needs prior to moving into the service. Referrals were made to health professionals where people’s health needs had changed, and plans were in place to ensure people were admitted safely to hospital.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Processes were in place for staff to raise safeguarding concerns, Staff had received safeguarding training and were confident about the actions they would take to raise any safeguarding concerns.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. People who required them had applications made for DoLS. These were being followed up by the management.

The provider worked with people to understand and manage risks in a holistic way. Staff supported people to receive care that was safe, responsive, and focused on what mattered to them in their daily lives.

People and relatives told us they were involved in developing and reviewing care plans. Risks to people's safety were identified and assessed and care plans contained clear information about how people’s health care needs were supported. These included guidance for staff on recognising signs of deterioration in health conditions and action to take to keep people safe.

The provider detected and managed potential risks in the care environment. They made sure equipment; facilities and the layout of the service supported the delivery of safe care.

The provider carried out regular checks of the safety of the environment. Equipment was inspected by appropriately qualified professionals to ensure it was safe. Staff were able to describe fire evacuation procedures and confirmed they took part in regular fire drills and knew how to use fire safety equipment.

However, some areas of the service appeared tired and less welcoming. For example, a shared shower did not have a homely appearance. The manager said they how would address this.

One relative said the environment would benefit from more long-term investment. They said, “There is no long-term investment plan. There is a problem with burst pipes under the floor. Quite often they get someone to fix a leak. The whole place needs inspecting and a work plan in place.” The registered manager said they had experienced an issue with leaking drains which had now been dealt with. The registered manager also confirmed their plans for improvements to the environment.

The provider did not always ensure the services provided enough staff to consistently meet people’s needs.

We received mixed feedback regarding staffing levels. Staffing levels were assessed and planned, and families did not raise any concerns about people’s safety or the care provided. However, people using the service and staff told us that staffing could feel stretched at times. One person said, “Staff do come when I call, it might take a bit of a while because they are busy with other people, but they will come.”

A relative also commented that there appeared to be a shortage of staff currently but felt this was not affecting their relative’s care. Staff also described their work as being ‘busy’, although they had not formally raised this as a concern. Overall, this feedback indicated that staffing levels were sufficient to maintain people’s safety but may not always be enough to consistently meet people’s needs without pressure, particularly during busier periods.

However, staff were now recruited safely. In the last assessment there was no activity co-ordinator. In this assessment an activities coordinator was in post. We saw people were joining in with the activities offered during the visit. The activities co-ordinator said they also offered visits to people who preferred to stay in their rooms.

Staff had received appropriate training and supervision in line with the provider’s policy and staff confirmed this. New staff had an induction, completed the provider's mandatory training and worked alongside experienced, knowledgeable staff.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

On the first day of the assessment, we identified some infection prevention and control concerns. These included a lack of soap and towels in the sluice room and some floor surfaces that were not clean. These were addressed on the day of assessment, and leaders put systems in place to ensure regular checks were completed. We also found that fridge temperatures had not always been checked and recorded and food was not consistently stored in line with best practice. This increased the risk of food contamination and infection for people using the service.

Staff told us there were not enough cleaning staff at the service due to a vacant post and this sometimes impacted on the cleanliness of the environment. Leaders said they were actively recruiting for this role.

However, relatives felt the service was clean. They told us there was continuous cleaning of shared areas. Staff had access to Personal Protective Equipment, (PPE) clothing or equipment to reduce the risk of spreading infection. For example, gloves and aprons were worn by staff when needed and staff washed their hands after providing personal care.

The provider ensured medicines were managed safely and in ways that met people’s needs and preferences. People were involved in decisions about their medicines, including when changes were made. We observed medicine being given in a caring and person-centred way, and medicines, including controlled drugs, were generally stored and managed safely.

Care plans included information about how people preferred to take their medicines. Guidance was in place for medicines taken “when required” and for higher risk medicines. During our visit, we identified some gaps in risk assessments for medicines that could cause serious swallowing-related side effects and issues with the storage of prescribed creams. Staff took prompt action to address these concerns. Staff worked closely with GPs and Pharmacists to resolve medicines issues and support regular reviews. Policies, audits, and staff training were in place to help ensure medicines were managed safely.