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Sunrise Day Care Services Ltd Requires improvement

We are carrying out a review of quality at Sunrise Day Care Services Ltd. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 16 April 2019

During a routine inspection

About the service: Sunrise Day Care Services Ltd is a domiciliary care agency and registered for ‘personal care’. This service provides personal care to people living in their own houses and flats. At the time of this inspection 10 people were using the service.

People’s experience of using this service:

• Risks to people's health and safety were not always identified and assessed to ensure safe care delivery for people. Care records did not reflect people’s current support needs. The provider did not have effective systems in place to monitor the quality of the services provided for people, including accuracy of care records. This was a repeated breach of Regulation 17 of the HSCA 2008 (Regulated Activities) Regulations 2014.

• Staff’s understanding about safeguarding and the Mental Capacity Act 2005 (MCA) was limited and some of the training refresher courses had not been delivered since 2015. This was a repeated breach of Regulation 18 of the HSCA 2008 (Regulated Activities) Regulations 2014.

• Staff were required to undertake checks before they were employed by the service. However, records were not always available to support the employment decision, but the registered manager agreed to address this as necessary.

• The registered manager was not fully aware of all the statutory notifications they had to submit to CQC. We will check their knowledge at our next comprehensive inspection.

• Staff followed the provider’s procedures to support people if they noticed them being at risk of harm or when incidents and accidents took place. There were no allegations of abuse or incidents and accidents that had taken place since the last inspection.

• Staff were trained and had access to policies and procedures for infection control.

• People had assistance to prepare their meals according to their culture and choices.

• Staff understood their responsibility to contact healthcare services should they noticed people’s health needs rapidly deteriorating.

• The MCA principles were understood and applied in practice by the registered manager as necessary.

• People told us they were well treated, and that staff kindly attended to their care needs.

• Staff supported people to enhance their independence and express their choices where possible.

• People were encouraged and provided feedback about the services they received which was positive and they had no complaints.

• People felt that the management team was approachable and responded well if they wanted to make changes to their care delivery.

• Family members were involved and supported people to make important decisions about their care.

• Staff received the necessary guidance to perform in their role well and made decisions about the service delivery.

Rating at last inspection:

• The service was previously inspected on 22 May 2018 and was overall rated Requires Improvement, with Requires Improvement in safe, effective and well-led. We found two breaches of the Regulations in relation to good governance and staffing.

Why we inspected:

Enforcement:

• Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspection will be planned in line with our re-inspection programme. If any concerning information is received, we may inspect the service sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 22 May 2018

During a routine inspection

Sunrise Day Care Services Ltd is a domiciliary care agency. This service provides personal care to people living in their own houses and flats. It provides a service to older adults between 30 and 94 years old some of whom may have physical and learning disabilities and dementia. At the time of inspection 12 people were receiving support from this service.

Sunrise Day Care Services Ltd is a specialist service offering assistance and support to ethnic minority groups in Merton. Whilst the inspection was to cover support in the people’s own home, the organisation also offered people day centre services.

This inspection took place on 21 and 22 May 2018 and was announced. We contacted the service 48 hours before the inspection to let them know that we would be coming to inspect them. We wanted to make sure that the registered manager will be available on the day of inspection.

The service had a registered manager in place. 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.

At the last inspection the service was rated overall Requires Improvement, with Requires Improvement in safe and well-led. We found two breaches of Regulations relating to people’s care records and quality assurance processes.

At this inspection we found that the service continued requiring improvement. We identified breaches of regulation and rated the service Requires Improvement, with Requires Improvement in safe, effective and well-led. This was in relation to people’s risk assessments, staff’s training and good governance. You can see the action we have told the provider to take with regard to these breaches at the back of the full version of this report.

Risks to people's health and safety were not sufficiently identified and robust risk management plans were not in place. Care plans were not always reflective of people's individual care needs and preferences.

Staff were not provided with regular refresher training courses and the registered manager had not kept accurate records regarding staff training so they could track who needed an update. Staff had not received regular appraisal meetings to determine their developmental needs and check on progress.

The provider did not have robust systems in place to check the quality and accuracy of people’s care records and staff’s training needs.

People and their relatives told us that staff attended their shifts on time as required. Staff followed the services policies and procedures to protect people from potential abuse and incidents and accidents occurring. Staff undertook appropriate recruitment checks to determine if they had the necessary skills to work with people. Systems were in place to protect people from the risk of infection.

Staff followed the service’s manual handling procedures to support people to move safely. People had assistance to choose what they wanted to eat and staff were aware of their meal preferences. The service asked people’s consent to share information about them as necessary. Staff monitored people’s health conditions and approached medical staff if they saw people’s’ health needs changing.

People had assistance from staff that were caring, respectful and attentive to their support needs. Staff assessed people’s abilities to carry out activities independently and helped people to undertake personal care tasks if they needed assistance. People were supported by staff that had the necessary skills to meet their religious and cultural needs and staff were able to communicate with people in their preferred languages.

People were involved and had a say in meetings where they had their care and support needs reviewed. People were provided with contact details for who to approach should t

Inspection carried out on 7 June 2017

During a routine inspection

Sunrise Day Care Services Ltd is a domiciliary care service that provides people with personal care and support. The service specialises in supporting older people from ethnic minorities living in the community. At the time of our inspection 11 people were using the service.

At our last inspection on 22 April 2015 the service was rated Good for four of the key questions and overall. They were rated ‘Requires Improvement’ for the key question ‘Is the service effective?’ At this inspection on 7 June 2017 we found there were two of the key questions requiring improvement.

Risks to people’s health and safety were not sufficiently identified and robust risk management plans were not in place. Risks, specifically in relation to people’s mobility, falls and pressure ulcers, had not been sufficiently mitigated.

Accurate and complete records were not maintained in regards to risk assessments and care plans. They had not been updated since people had been receiving care and were not always reflective of people’s current care needs.

Staff were aware of their responsibility to safeguard people from harm and the processes to follow if they had concerns about people’s safety. There were sufficient staff to meet people’s needs and attend people’s appointment at the scheduled time. Robust recruitment procedures remained in place. Staff checked people had taken their medicines.

Training was provided to staff to ensure they had the knowledge and skills to undertake their duties. However, accurate staff training records were not maintained. The registered manager told us they would improve their recording processes. Staff continued to adhere to the Mental Capacity Act 2005 (MCA) and provided any support people required with their health and nutritional needs.

There was consistency in the staff supporting people and they had built caring relationships with the people they supported. Staff were matched to people ensuring they spoke the same language and could meet people’s communication needs. Staff respected people’s choices and respected their privacy and dignity.

Staff were knowledgeable about the people’s needs and continued to provide them with the level of support they required. Staff told us they maintained records of the support they provided through completion of daily log books, which were checked by the registered manager. A complaints process remained in place.

Staff felt well supported by the registered manager and able to have open and honest conversations with them. There were processes in place to obtain feedback from people about service provision. The registered manager undertook regular spot checks to review the quality of care delivery.

We found the provider was in breach of legal requirements relating to safe care and treatment and good governance. You can see what action we have asked the provider to take at the back of the report.

Inspection carried out on 16 February 2016

During an inspection to make sure that the improvements required had been made

We carried out an announced focussed inspection of this service on 4 November 2015 at which a continuing breach of a legal requirement was found. We noted that people were not protected from risks associated with unsafe care and support because staff had not received the necessary training and supervision to ensure they had the skills and competencies to carry out their role. We issued a warning notice in regards to the continuing breach and gave the provider until 18 January 2016 to undertake the necessary action to address the concerns. After the inspection, the provider wrote to us to say what they would do to meet the legal requirement in relation to staffing.

We undertook an announced focused inspection on the 16 February 2016 to check that they now met legal requirements. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Sunrise Day Care Services Ltd’ on our website at www.cqc.org.uk.

Sunrise Day Care Services Ltd provides personal care to people in their own homes and at a day service. At the time of our inspection 12 people were being supported. The service specialises in supporting older people from ethnic minorities living in the community and who use the associated day care centre.

A registered manager was 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 2008 and associated Regulations about how the service is run.

At this inspection we found that appropriate action had been taken to address our concerns. Staff were well supported and had completed training to ensure they had the knowledge and skills to meet people’s needs. The staff team have completed the care certificate training and specific training relating to moving and handling, and medicines administration. The Care Certificate is a nationally recognised tool to provide staff with the basic knowledge and skills to undertake their roles within a care setting. Staff had received supervision to review their performance and compliance with the service’s policies and procedures. The provider was now meeting the legal requirement relating to staffing.

Inspection carried out on 4 November 2015

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 22 April 2015 at which a breach of legal requirement was found. We found that people were not protected from risks associated with unsafe care and support because staff had not received the necessary training and supervision to ensure they had the skills and competencies to carry out their role. After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirement in relation to staffing.

We undertook a focused inspection on the 4 November 2015 to check that they now met legal requirements. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Sunrise Day Care Services Ltd’ on our website at www.cqc.org.uk.

Sunrise Day Care Services Ltd provides personal care to people in their own homes and at a day service. At the time of our inspection 10 people were being supported. The service specialises in supporting older people from ethnic minorities living in the community with their families and who use the associated day care centre.

At this inspection we found that the necessary action had not been taken to address the breach of legal requirements. Whilst the registered manager had sourced relevant training courses, staff had not attended any training and therefore there was a risk that they did not have the knowledge to support people appropriately. One staff member had received formal supervision but this had not been carried out for the other six staff members.

The service remained in breach of the legal requirement relating to staffing. We are taking action against the provider and will report on this when our action is completed.

Inspection carried out on 22 April 2015

During a routine inspection

This inspection took place on 22 April 2015 and was announced.

Sunrise day care services is a domiciliary care service that provides personal care for people with personal care and support needs. There were 13 people using the service when we visited. The service specialises in supporting older people from ethnic minorities living in the community with their families and who use the associated day care centre.

The service had a registered manager who was also a director of the company that owned the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Care workers had not received updated training in areas of their work identified as essential by the provider. They had also not received regular or documented supervision required for them to carry out their role and responsibilities effectively. When we discussed this with the registered manager, they agreed and started making arrangements for care workers to receive training and regular supervision. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

People and their relatives told us they felt safe with the service they received at home. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service, their relatives and staff about how to report suspected abuse.

People had risk assessments and risk management plans to reduce the likelihood of harm. Staff knew how to use the information to keep people safe.

The registered manager ensured there were safe recruitment practices to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

People were involved in planning their care and their views were sought when decisions needed to be made about how they were cared for. The service involved them in discussions about any changes that needed to be made to keep them safe and promote their wellbeing.

Care workers respected people’s privacy and treated them with respect and dignity.

People indicated that they felt that the service responded to their needs and individual preferences. Car workers supported people according to their personalised care plans, including supporting them to access community-based activities.

The provider encouraged people to raise any concerns they had and responded to them in a timely manner. People were aware of the complaints policy.

People gave positive feedback about the management of the service. The registered manager and the care workers were approachable and fully engaged with providing good quality care for people who used the service. The provider had systems in place to continually monitor the quality of the service and people were asked for their opinions via feedback surveys. Action plans were developed where required to address areas for improvements.