Sunnyfield Lodge

Updated 11 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 11 and 15 October 2018 and was announced on both days. We gave the provider 48 hours’ notice of the inspection visit, because the service is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The inspection team consisted of one inspector on both days.

Before the inspection we gathered and reviewed information we held about the service. This included statutory notifications the provider had submitted to CQC to inform us of certain events affecting the service. We reviewed the Provider Information Return (PIR). The PIR is information we require providers to send us at least once annually, to give some key information about the service, what the service does well and improvements they plan to make.

We contacted the local authority commissioning and safeguarding teams and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used this information to plan our inspection.

During our inspection we looked at the care files of four people and three people’s medication records. We reviewed documentation and policies relating to the running of the service including staff rotas, team meeting minutes and the safeguarding policy. We looked at the recruitment for one member of staff and the supervision records of three members of staff.

We spoke with four people who used the service and four members of staff. Three professionals spoke with us to tell us about their experience of working with the service. We spoke with four care workers, a team leader and the registered manager.

Updated 11 December 2018

Sunnyfield Lodge was inspected on the 11 and 15 October 2018. The inspection was announced on both days. This was the service’s first inspection following registering with the Care Quality Commission (CQC) in December 2017. The service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Sunnyfield Lodge is a purpose built ‘extra care’ housing scheme consisting of 40 flats for adults 55 years old and over. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. At the time of inspection 13 people were receiving a regulated activity from the service. Not everyone using Sunnyfield Lodge receives a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The house scheme has accessible communal areas. The housing provider arranges for lunches to be are served in the dining room at an extra charge. An accessible bathroom and treatment room is available. The housing scheme includes a shop, run by a local voluntary organisation.

The service provides planned care visits and a 24-hour emergency responder facility to those people living in the flats. The service had very recently started to provide care visits to people living in rural, hard to reach areas.

The service is registered to provide support for people with dementia, learning disabilities or autistic spectrum disorder, mental health needs, older people, people with a physical disability and those with sensory impairment. At the time of inspection the majority of people receiving a service were older people.

Where services support people with learning disabilities or autism we expect them to be developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any other citizen. There were no people with a learning disability or autism using the service when we inspected. Therefore, we were unable to assess and monitor if the service was following this guidance.

There was a registered manager in post. A registered manager is a person who has registered with CQC 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.

Staff supported people to be safe within the service. They responded to accidents and incidents and recorded details of the events. ‘Near miss’ forms did not always show the support people had received to reduce risks to their safety. Staff knew what potential signs of abuse to look for and how to raise their concerns.

Staff provided support with medicines according to individual’s needs and people received their medicines as required. Staff completed medicines training and their competency was regularly assessed. Topical medicine records and ‘When required’ medicines were not recorded in-line with best practice guidance. We made a recommendation about the recording of ‘when required’ medicines. The provider’s medicine policy was in the process of being updated.

The service worked closely with the housing provider to create a community atmosphere. The registered manager and housing estate manager were clear of their separate responsibilities. They worked closely to assess the needs of people wanting to live in the housing scheme. There was an ongoing dialogue between the services to share information and support people to access events and activities happening within the extra care setting.

People received personalised care. When people required changes to their support arrangements if their health deteriorated or they were approaching the end of their life staff provided responsive, appropriate care. We saw an example of end of life where staff were dedicated to visiting the person outside of their working hours. Professionals praised this approach at going above and beyond their role.

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. People were supported to live healthy lives and maintain their food and fluid intake. People’s consent was obtained prior to them receiving care. The service worked with health and social care professionals to support people’s needs.

The service had an inclusive ethos, ensuring people’s equality and diversity were respected. Staff were aware of people’s emotional needs and provided appropriate support. People’s dignity and privacy was upheld. Staff respected people’s privacy.

Staff received training to support them in their roles. They had taken on ‘champion’ roles where they had specific interests in health conditions and wanted to further their knowledge.

The service had a clear management structure. Team leaders and the registered manager had separate responsibilities for auditing and overseeing the service.

Quality visit forms were used to engage people in the service and obtain their views. Staff meetings were used to engage staff in the running of the service and remind them of provider procedures.