Sunnyborough

Updated 31 October 2019

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 Care Act 2014.

Inspection team

This inspection was carried out by two inspectors.

Service and service type

Sunnyborough is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with CQC. The manager in post was on sick leave. An application has been received to register the deputy operations manager employed. Once registered this means 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 was an unannounced inspection on day one. We told the provider we would be visiting on day two.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. We used all of this information to plan our inspection

During the inspection

We spoke with nine people who used the service and two of their relatives about their experience of the care provided. We also spoke with the manager for the service, deputy operations manager and the governance manager who was supporting with the inspection. In addition, we spoke with nine members of staff including the deputy managers, senior care workers and care workers.

We reviewed a range of documents. This included four people’s care plans and multiple medicine records. We looked at three staff files including recruitment, training and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

Following the inspection we sought some clarity on issues with the operations manager and deputy operations manager and we reviewed multiple records relating to the management of the service.

Updated 31 October 2019

About the service

Sunnyborough is a care home providing residential care for up to 19 people with learning disabilities, autism and associated complex needs. At the time of our inspection 18 people were living there.

Sunnyborough is a large property divided into three separate living areas. Nine people lived in the area called the ‘residential service’, five people lived in the ‘annex’ and four people lived in their own self-contained flats.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

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

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles. Where interventions were used the manager agreed to record where lessons could be learnt to evidence the work carried out to reduce the likelihood it would occur again.

We have made a recommendation the provider reviews its approach to governance of the service to ensure they record all checks they make to assure themselves legal requirements are met, and performance is good. We have also made a recommendation the provider implements the Accessible Information Standards fully. This will ensure a full assessment of people’s communication needs is completed and recorded.

Staff felt supported and a plan was agreed with the provider to ensure they received better training around people’s mental health needs and regular supervisions and appraisals.

People had good access to healthcare professionals. Work to promote healthy lifestyles including healthy eating needed to be more specific to individuals to reduce the likelihood of ill health.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and systems supported this practice. People were provided with information they needed and were encouraged to be involved in all aspects of their care. Where they needed support with decision making they were made in their best interests. Records to evidence this good work needed to improve. Staff always asked for people’s consent before they carried out support.

The principles of Registering the Right Support were embedded in the culture of the provider and service. This meant people were supported to have meaningful lives, that they were in control, had choice and their independence was promoted. People lived as full a life as possible and achieved the best possible outcomes for them. This included access to the community, friends and family.

People, their relatives and staff all agreed the service was well-led. People received person centred care based on their preferences and aspirations. People had developed their skills with staff support to work to achieving more independence in the future.

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 good (published 3 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.