Sunnywell

Sunnywell Care Home is a residential care home providing the regulated activity of personal care for up to 15 people in one adapted building. The service provides support to people who primarily have a learning disability and autistic people. At the time of our inspection, there were 9 people living at the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance the Care Quality Commission CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were not protected from the risk of harm. Medicines were not always managed safely. Cleaning procedures within the home did not ensure a clean and hygienic environment for people. Not all staff had sufficient training to support them to carry out their roles effectively.

People living at the home each had unique and complex health needs and staff mostly knew people and understood risks to people.

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

Right Care:

Support plans and risk assessments relating to people's health needs and the environment were completed but needed more person-centred information to help protect the health and welfare of people who used the service. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards

There were sufficient staff deployed to meet people's needs and wishes. Staff recognised and responded to changes to individual's needs. Staff provided kind, caring, person-centred care and support. Staff communicated with people in ways that met their needs.

Right Culture:

Governance arrangements were not as effective or reliable as they should be. Further improvement was needed in the quality assurance processes to identify shortfalls and to drive improvement.

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

Rating at last inspection

The last rating for this service was good(published 8 December 2017).

At our last inspection we recommended the provider consider current guidance on health action plans. The provider had made improvements.

Why we inspected

The inspection was prompted in part due to concerns received about people’s safe care and treatment, management of incidents and lack of person-centred care. A decision was made for us to inspect and examine those risks.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements.

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

Enforcement

We have identified 3 breaches in relation to safe care and treatment, medicines management, staff training and oversight and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Sunnywell is a service for 15 people with learning disabilities. At the time of this inspection 12 people were using the service.

The service had a registered manager. 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.

People felt safe living at Sunnywell. We saw they were comfortable with the staff who supported them and people told us they could talk to their personal worker, other members of staff and the manager if they had any concerns.

Risks to people had been identified, assessed and managed through the care planning process. Within people’s care plans there was guidance around how people’s needs should be met. People had person centred activity programmes that identified what they were doing throughout the day and included what people did at home and what they did when they went out.

Medicines were usually managed safely; additional checks were being introduced to make sure people had an adequate supply of medicines and topical creams were applied effectively. People were involved in the planning, preparation and cooking of meals. We reviewed menus and saw most of the time these were varied and nutritionally balanced.

We saw from people’s records they attended regular health appointments. The provider was liaising with health professionals because people did not have up to date health action plans. We have made a recommendation about plans for what help a person needs to stay fit and well. Staff we spoke with understood their responsibilities around the MCA and confirmed they had attended training. People were encouraged to make decisions and where a person lacked capacity to make decisions appropriate systems were in place to support them.

Staffing arrangements were appropriate and systems were in place for allocating workers to support people on an individual basis. Staff received training and supervision to help them understand how to deliver appropriate care. Staff had a clear understanding of their role and responsibilities. They told us they enjoyed working at Sunnywell and felt well supported.

The registered manager was knowledgeable about the service and had a clear vision for development and improvement. We received positive feedback about the registered manager and the management team who supported them. People were encouraged to share their views and put forward suggestions. People who used the service and staff attended regular meetings. The provider had effective quality management systems. They told us they would develop medicine auditing to make sure they picked up similar issues to those identified at the inspection.