Archived: Sunnyside Residential Home

Updated 1 March 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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. 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

The inspection was carried out by two inspectors, one medicines inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Sunnyside Residential Home 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, both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 13 January and ended on 24 January 2022.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from local authority colleagues and reviewed information we held about the service. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and nine relatives about their experience of the care provided. We spoke with 11 staff including the registered manager who is also registered as the nominated individual, the deputy manager, senior care and care workers and a consultant who had been contracted by the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included eight people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits and policies and procedures were reviewed. We made observations of care being provided to help us understand the experience of people who could not talk to us.

After the inspection

We continued to seek clarification from the provider to validate the evidence found. We looked at training records, health and safety certificates and additional policies. We sought regular feedback from the consultant working with the provider and from colleagues at the local authority involved in supporting the service.

Updated 1 March 2022

About the service

Sunnyside Residential Home is a care home providing personal and nursing care for up to 27 people over three floors. At the time of the inspection, 19 people were living at the home

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

People were not always kept safe from the risk of harm. We identified at our last inspection in June 2021 appropriate steps had not been taken following a serious safeguarding incident. At this inspection some action had been taken, however, training to improve the managements’ understanding of how to support the person involved in the incident had not been undertaken. Other safeguarding concerns were identified at this inspection. Feedback from a consultant involved with supporting the service and from staff raised concerns about a ‘closed culture’ at the home. Medicines were not managed safely, while we were unable to identify impact, continued gaps in medicine records were identified. People’s dependency had not been assessed and staffing levels were not sufficient to meet people’s needs. While some staff training had been arranged and undertaken since our last inspection, significant gaps remained; this included gaps in the management team’s training, learning and development. Infection control practice had improved slightly but remained unsafe.

Audit and governance systems had not been developed since our last inspection and the registered manager acknowledged audits were not always completed. Staff reported feeling unsupported by the management team. The consultant contracted by the provider to work with the management team to improve compliance with regulations raised concerns regarding the registered manager’s integrity, ability and motivation. We identified inconsistencies in people’s records, including monitoring charts, risk assessments and care plans, this has continued to be unaddressed. The provider had failed to display their most recent rating on their website. The rating was displayed in the home but not was not accessible to visitors.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The provider supported people who would need to be supported in accordance with ‘Right Support, Right care, Right Culture’ guidance. Their statement of purpose and registration had not been updated to reflect this.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 16 August 2021) and there were breaches of regulation. The provider did not complete an action plan after the last inspection to show what they would do and by when to improve; we monitored progress through regular meetings with the local authority. At this inspection we found the provider remained in breach of regulations.

This service has been in Special Measures since 6 March 2021. During this inspection the provider was unable to demonstrate that improvements have been made. The service continues to be rated as inadequate overall and in the key questions of Safe and Well-Led. This service remains in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

We have found evidence the provider needs to make improvement. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service remains inadequate. This is based on the findings at this inspection.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

Following our inspection in January 2021, we started enforcement proceedings against the provider and decision was made to cancel the providers registration. We have inspected the service on three occasions since then, including this inspection and found practice related to the safe and well-led key questions has consistently deteriorated.

We have identified breaches in relation to person centred care, safe care and treatment, safeguarding service users from abuse and improper treatment, meeting nutritional and hydration needs, good governance, staffing and the need to display performance assessments.

The provider withdrew their appeal against the notice of decision to cancel their registration.

Follow up

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.