Sunnybrook Care Home Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.The service was in breach of legal regulation in relation to need for consent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People had care plans in place describing their needs and support required. However, we found there was also some inaccurate or incomplete information regarding people’s support and care needs. Some care plans were comprehensive, evidence based and person-centred while some other records did not reflect the actual needs of people. We considered this under the question whether the service was well-led.

People and their families were involved in the initial assessment of their needs, and they felt support was provided where needed to maximise their involvement. People could not remember if they had any reviews of their care plan. However, relatives told us people’s needs were met and understood by the staff team, and they were regularly informed of any changes. One relative added, “It is very important that they communicate well. I get regular updates. I have no complaints about [the service].”

The provider did not always consider people’s care and treatment in line with legislation and current evidence-based good practice and standards. People’s nutrition and hydration needs were mostly met in line with current guidance. People and relatives were positive about meal times and choices. However, some improvements were needed. For example, a few people needed support eating. This was done inconsistently and a few different staff helped people then left, then came back. There were periods when staff were not around to help people eat thus people sat waiting. We observed some staff were standing while supporting people to eat rather sitting at their eye level. We observed one person’s meal was mashed, so it was all mixed together looking not unappetising and not thoughtful.

The staff said they followed a menu plan, but it had not been changed season by season. Staff made occasional changes when staff said people were too hot to eat a cooked meal, which they changed for sandwiches. Staff told us they tried to accommodate people’s choices, but most people seemed happy with the meals and food provided. Staff said the menu was not very flexible as they ordered each week what was on the menu planner. However, it did not demonstrate people were actively involved in devising the menus to ensure their favourite meals were included. People were able to receive snacks and drinks between the meals. There was a station with drinks and snacks in the communal areas. However, we noted to the registered manager most people would not be able to access it independently as they needed staff support.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. People and relatives felt staff knew what they were doing. The staff also contacted relatives to keep them informed if they had any changes or concerns about people’s health or wellbeing. Staff also contacted emergency services if required.One relative said, “[Staff] do have to prompt [the person] to eat and drink. Previously [the person] was on supplements and they have supported her to becoming a healthy weight and that’s all thanks to the service. They also promote ice lollies in the hot weather. [The person] eats a wider variety now since coming to [the service].” Relatives were kept up-to-date with people’s care and support and informed about any changes. People and their relatives had been included in discussions and reviews around their care and how this was to be delivered.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.People received care and support from the staff team who knew them and their needs well. This meant people received person-centred care that was meaningful to them. The information was shared between teams and services to ensure continuity of care and when people were referred between services. We observed staff speaking with each other throughout the inspection and planning tasks.

People were able to access some health services without needing to leave the premises. The registered manager worked in collaboration and effectively across teams and services to support people as they moved between services so that people had positive outcomes. When people transferred from other services, there was a process to manage initial assessments and plans of care were compiled to ensure they considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. Relevant staff, teams and services would be involved in assessing, planning and delivering people's care and treatment and staff would work collaboratively to understand and meet people's needs. One relative said, “The manager is constantly trying to get answers from [local health] team…[the service] and the social worker, have an excellent working relationship.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People said they were supported to remain as healthy as possible. Relatives agreed they were informed what was going on with people, any changes in their health or wellbeing. People were referred to various health professionals to address any health issues or changing needs in a timely manner.

Staff monitored and worked with people to continuously improve their outcomes. For example, staff spoke respectfully about one person who was an extremely anxious person and needed constant attention from a staff member to settle. They felt such support helped this person. Night staff confirmed they completed one or two hourly welfare checks throughout the night.

Relatives told us they have seen positive changes in people’s health and wellbeing. They said, “Yes, [staff] are able to anticipate [person’s] needs and help as required” and “[Me relative] looks better. [The person] just looks so well despite declining health. I feel very comfortable with the care.”

The provider did not always tell people about their rights around consent or respect these when delivering care and treatment. People’s rights were not always respected in line with the Mental Capacity Act 2005 (MCA).People’s consent forms for different aspects of care or support were signed by family members who did not have legal right to do so. Different decisions were made without clear capacity assessments and best interest decision meetings to demonstrate people’s involvement and consideration of their wishes.Where a capacity assessment was completed, it did not demonstrate the person was presented with information about that particular decision in the way they understood and communicated to maximise their involvement. When responses from people did not fit the question, it was determined people did not have capacity. Staff completing assessments used leading questions to assess capacity which could undermine the outcome of the assessment.We reviewed minutes from best interest decisions. The records did not evidence people were fully involved and consulted during the process, if they received all information in the way they understood to make specific decisions.

The service was using CCTV surveillance in the service. Although these were not placed within people’s bedrooms or bathrooms, they were in use across communal areas such as the garden areas and hallways.People and some relatives were not aware CCTV was in use. The registered manager told us they emailed the relatives about it. The policy described the process how to manage CCTV such as completing a privacy impact assessment and consult people, staff, visitors about any concerns regarding their privacy to support such assessment. However, this was not completed. The provider did not maximise people’s participations in making such decisions and seeking their consent. It was not evident that less restrictive options had been considered. This meant the registered manager did not always ensure people’s rights were protected and respected in line with the MCA.Staff sought people's consent before providing care or support. We observed staff were polite and respectful towards people and respected their decisions. If people did not want to do something or take part in an activity, the staff responded appropriately. Relatives were complimentary about staff’s support and the way they treated people.