Archived: Sunridge Court

Sunridge Court accommodates 43 people in one purpose built building and caters specifically for the Jewish community. The home is over three floors, with the top floor being used for training purposes. There is a large living room with a sun lounge and people have access to a large well-kept garden. At the time of the inspection there were 40 people living in the home.

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 2008 and associated Regulations about how the service is run.

At the last inspection on 22 and 28 January 2016 we asked the provider to take action to make improvements to how individual risks to people using the service were documented. This included guidance provided to staff to help minimise the known risks to people that they worked with. We also asked the provider to take action around providing staff with regular supervision and appraisal and to ensure that people’s care was documented and delivered in line with The Mental Capacity Act 2005 (MCA). At this inspection we found that these actions had been completed.

We have made a recommendation about the safe management and documentation of medicines.

Risk assessments gave staff detailed guidance and ensured that risks were mitigated against in the least restrictive way. Risk assessments were reviewed and updated regularly.

Staff understood what safeguarding was and were aware of how to report any concerns if they had them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff had received training in infection control and were aware of how to control and prevent infection.

Staff received regular, effective supervision and appraisal.

There were individualised care plans written from the point of view of the people that were supported. Care plans were detailed and provided enough information for staff to support people. Care plans were regularly reviewed and updated immediately if changes occurred.

People and relatives were encouraged to help plan end of life care in a tailored way. Staff were compassionate regarding caring for people at the end of their lives.

The home recognised that stimulation and enjoyment were essential to people’s wellbeing. There was a wide variety of activities that people could choose to take part in. people were supported and encouraged to access the community and stay in contact with relatives and friends.

People were supported to communicate using technology and training for people around using the internet had been provided.

Staff, people and relatives were positive about the culture of the home and the management.

Audits were carried out across the service on a regular basis that looked at things like, medicines management, health and safety and the quality of care. Surveys were completed with people who used the service and their relatives. Where issues or concerns were identified, the manager used this as an opportunity for change to improve care for people.

In view of our concerns we served two warning notices informing the provider that they needed to take action to address the areas of non-compliance identified by 31 March 2014.

At our inspection of the service on 23 May 2014 we found that improvements had been made and the provider had complied with both warning notices. We spoke with a group of three people using the service who commented, 'staff are much happier,' and 'the manager is making environment changes for the best.'

Governance arrangements for the service had been strengthened. We saw quarterly meetings are held to discuss the strategic aims of the service.

At our inspection of the service on 21 February 2014 we found that the provider had made some improvements, but there were still a number of systems not in place. We found a lack of systems in place to assess and monitor the quality of the service in relation to the number of falls involving people who use the service and audits were not in place for ensuring care plans and risk assessments were accurate and up to date. Most records for people who used the service were not accurate and up to date. We spoke with the newly appointed Executive Director who told us that since our last inspection nothing had been done. She told us about her appointment and her role and responsibility in ensuring that the service is compliant with CQC regulations. We wrote to the provider regarding the lack of information in respect of action to be taken to improve records for people using the service. However, we did not receive a response.

People were protected from the risk of inadequate nutrition and hydration. We saw that people were given a choice of food and drink at lunchtime. Although some people felt there could be some improvement, most people we spoke with were happy with the food and said they were given a choice. We saw that the service worked in cooperation with other healthcare professionals to meet the needs of people living at the home, such as the district nurse. Staff were supported to carryout their respective roles, staff records confirmed that most staff had received recent supervision.

The provider did not always have effective systems in place to monitor the quality of care. The registered manager told us that they did not have a formal system in place for assessing and monitoring the quality of the service in relation to the numbers of falls involving people who use the service. We noted that policies were missing in key areas of provision, such as, care planning, risk assessment and complaints and records relating to people using the service were not accurate or fit for purpose.

The provider failed to notify the Commission without delay of a notifiable incident involving a resident who had a fall and sustained a fractured hip and a death whilst services were being provided in the carrying on of regulated activity