Sunnyhill Residential Care Home

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

Staff were recruited safely, with the correct checks being made to ensure they were suitable for their role. Staff had a thorough induction and completed ongoing training. The environment and equipment was regularly checked for safety and any issues quickly resolved. Medicines were managed safely and staff had received appropriate training and competency checks. Staff were knowledgeable about abuse and knew how to raise concerns and alerts. Documentation and records were not always clear, and work was ongoing to improve this. Information from complaints and safeguarding enquiries had not been recorded in detail and tracked to show themes and trends which would help when planning improvements to the quality of care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us that they felt able to raise issues and concerns with the staff team and management, and that their concerns were dealt with in a timely way.

Staff told us they received regular training and supervision and had developed a good team spirit that supported a good learning culture. One staff member said, ‘We can learn from each member of staff and can find different ways of doing things just by listening to other staff members views and learning from their experience.’ The registered manager said, “We have listened to feedback from our staff saying they would like more face to face training, and have arranged with our sister home to give staff what they have asked for.”

Records showed that some events were recorded in detail and were tracked for patterns and themes. There was a falls risk analysis in place and the registered manager had carried out analysis and used this to make changes and improvements to falls prevention. However, there was no similar tracking for complaints, or for safeguarding concerns which would ensure that there could be learning and improvement from incidents and issues raised. A service improvement plan had been recently implemented and some areas of the service added to it, but it was not yet being fully utilised or embedded as a learning tool.

Relatives told us that there had been a smooth process when people moved in to the service. One relative told us, “The care is really great! From the time he got there from the hospital, everyone was great.” Another told us, “My [relative] is happy at Sunnyhill. I can relax knowing he is safe and cared for.”

One staff member told us that referrals are made to specialists when they need expertise and advice and guidance. Staff were able to give us examples of individuals and the specialist teams they had been referred to for support, such as the SALT team.

Reports from recent safeguarding outcomes had identified issues with inconsistent and inaccurate records, which required improvements. These findings had been shared with the Registered Manager who had themselves identified issues with the new system and was taking action to address these shortfalls.

Records showed that referrals had been made to seek specialist advice for people. The registered manager had sought specific training from health specialists for staff to improve their skills and confidence. The registered manager confirmed that information was printed from the care documentation to accompany people when they were admitted to hospital. This contained basic relevant information on contacts and health.

People who were able to speak with us, told us they felt safe. One said, “Yes, I do feel safe here – I have everything I need.” One relative told us how the staff were very responsive when they shared their concerns about their [relatives] low mood.

Staff had received training on safeguarding and understood they needed to take action quickly if any safeguarding concern was raised. Staff told us they would contact the management team immediately for advice and action to be taken. They said the manager or senior staff were always available. The manager had recently worked closely with the local authority to ensure the safety of people.

People were relaxed and comfortable in the company of staff. They sought out staff to talk to and to spend time with. It was clear from our observations staff knew people well, and there was a cheerful and friendly atmosphere in the home.

Staff had information on safeguarding and referral system to use if needed. Safeguarding and whistleblowing information was displayed in the hallway and contained the emergency contact number for the local authority to refer any safeguarding concern. Although staff were knowledgeable about safeguarding and how to raise concerns, the safeguarding policy had not been updated to reflect latest guidance or contact details. More up to date information was posted around the home for staff to refer to. A safeguarding log was used to record any allegations or abuse. The records did not contain details of action taken, any dates or timelines, and no information recorded in the log of lessons learned or improvements made as a result of the outcome. Safeguarding incidents were not included in the service improvement plan.

Relatives told us that they were kept included and updated about their loved one’s risks and care plans. One relative said, “The manager’s door is always open. They discussed with us the dangers and risks of bed guards, taking the time to go over the reasons, and explained other things that they could put in place, for example lowering the bed.” Another relative said they felt risks were managed well, “Yes, you get all the help you need here.”

Staff understood people had varied risks that impacted on their health and wellbeing. These were assessed and managed according to individual need. For example, some people had heightened emotions any risks associated with this had been assessed. Staff responded with patience and kindness. One staff member told us, ‘It’s so important to be nice to people. X responds to staff better when they are ‘up-beat’ with her. They like the mention of tea.’

For those people who had risks associated with eating we saw suitable measures were in place to reduce these risks. For example, people had adapted meals and staff were available to support safe eating and reduce any risk of choking. We observed a staff member supporting a person to walk safely using their walking frame, and saw that they were patient and kind, encouraging the person to place their hands in the correct way on the frame for better balance.

Documentation supporting risk management was not always kept up to date. For example, records relating to one person confirmed that they could weight bear, but this was not the case and always needed to be hoisted. The manager confirmed some records did contain out of date information, and therefore, did not reflect the care and support being provided. The deputy manager told us they were working through everyone’s records to ensure they were accurate.

Relatives told us that the environment was safe. One said, “He is safe here, and is happy as can be.” We saw that people’s views had been gathered by the activity co-ordinator and that many people reflected how much they love to visit the garden and be outside in the sunshine.

Staff told us that they knew the procedure to follow if they needed to report any maintenance or safety issue, and said these were dealt with quickly. Staff told us that regular observations and checks were carried out in the service to check that the environment was safe. One staff said, “We keep it safe for people, with checks in the environment of equipment like the tumble dryer, and the fire panel.” Another said about fire safety, “We have personal evacuation plans for everyone.” The registered manager told us that the garden area is fully accessible.

People’s rooms were clean and well maintained. An annual fire risk assessment was completed and we noted that fire evacuation sheets were strategically placed within the service to aid a speedy evacuation if needed. Each person had a Personal Emergency Evacuation Plan (PEEP) to support this evacuation. An emergency evacuation bag was available in the hallway and contained safety information on people and space blankets to keep people warm if needed. The garden area was attractively planted and had a summer house and seating areas.

Systems were in place to ensure suitable checks and maintenance were carried out on equipment and the environment. Any environmental risks were assessed and monitored. For example, all lifting equipment including the passenger lift were serviced regularly and had safety checks completed. Daily checks were completed to identify any new risks or maintenance issues. Routine checks were completed to support the health and safety of people. For example, checks were completed on hot water supplied to ensure safe temperatures were maintained.

People and relatives said there were enough staff with appropriate skills to respond to their specific care needs. Relatives told us, ‘They do seem to have enough staff including when I have visited at weekends. They are always busy and up against it, but I don’t see any issues,’ and ‘I have been in on occasional week ends and it is a little bit more relaxed in terms of timing and stuff, but I see the manager there and two seniors running it.’

Staff told us there were enough staff to support people in a safe way. There was a strong team spirit between staff that supported staff cohesion and effectiveness of staffing. Staff said, ‘We have enough staff and the manager and deputy will always come and help if needed. There is always a staff member in the lounge to monitor’. Another staff member said, ‘I am happy to stay here staff are all supportive, staff all gel, happy working here, the place is nice and calm and we work as a team’. Staff said they had access to good quality training and had attended an experiential session on dementia care. One staff said, “After the training, I thought about what people with dementia are going through. It makes a difference to how we work with people.” Another staff member told us that they had found their fire marshall training very useful as it was a face to face session.

People’s needs were attended to in a timely way. Staff had time to interact and chat with people.

A duty rota was used to plan staffing and to notify staff of their working hours. The rota confirmed staffing numbers were maintained and included a senior carer on each shift. Agency staff were used to cover any shortfalls, but this was minimal. The manager confirmed the staffing arrangements were reviewed regularly, and she undertook unannounced checks to ensure staffing levels were appropriate. A daily allocation sheet was used to ensure staff understood their responsibilities and scheduled break times. This maintained suitable staffing levels throughout the day. Staff were recruited safely. Appropriate checks were completed to ensure staff were suitable to work at the service. This included, references, Disclosure and Barring Service (DBS) checks and employment histories. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Records of staff recruitment and checks made for suitability in their roles were not organised in a way that meant they could be reviewed or checked easily. Training for staff included mandatory training and additional skills to meet the needs of people who live at Sunnyhill and their particular conditions. Training was refreshed regularly and audits and checks were carried out by the Registered Manager to ensure that staff kept up to date with their training.

Relatives had been positive in feedback about cleanliness of the service. One relative said, “[relative] always has clean bedding, the bed is always stripped down.” Another told us that they had spoken with staff about tidiness of drawers, and said, “The cleaner has sorted it out. They soon got on top of it.”

Staff received training on infection control with cleaning staff having specific training that included the use of cleaning substances. The cleaning staff were committed to maintaining high standards of cleanliness. They confirmed they felt well supported and able to fulfill their role.

The service was clean and cleaning staff worked in the service each day. Practice observed confirmed staff followed good infection control measures -For example, red bags were used in the laundry room to separate laundry that was contaminated. There was liquid soap and paper towels at hand washing areas and additional hand sanitizers throughout the service.

Monthly audits included visual inspections of communal areas, equipment, cupboards, cleaning equipment and materials, storage of chemicals and management of waste. Signage relating to infection control was appropriate and up to date, and PPE (Personal Protective Equipment) was in good supply and easy to access for staff. Areas requiring action were recorded and signed off once completed. Staff training in infection control was up to date. Products had been chosen that were environmentally friendly and safe to use with no harmful chemicals.

People received their prescribed medicines at appropriate times. People were monitored for any expressions of pain and staff responded to health care needs effectively.

Staff received training and had their competency assessed before they were allowed to complete medicine administration. Staff told us they felt they had the skills and training to administer medicines safely. Observation confirmed staff followed good practice guidelines when giving medicines. For example, dealing with medicines in an individual way. Ensuring people had a drink to help them take their medicines and referring to all supporting medicine documentation.

Systems followed ensured medicines were dealt with in a safe way. Audits were completed and included regular stock checks.