We carried out a review of the data available to us about Sunnyborough on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Sunnyborough, you can give feedback on this 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.
We last inspected the service in November 2014 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.
Staff were knowledgeable about what action they should take if abuse was suspected and had clear policies and procedures to follow. The local authority safeguarding team informed us that were no on-going safeguarding matters regarding the service.
Checks and tests had been carried out to ensure that the premises were safe. People could choose how they wished their bedrooms to be decorated and furnished.
Recruitment checks were robust and there were sufficient numbers of staff deployed to meet people’s needs. Records confirmed that training was appropriate to people's roles and staff were suitably skilled. Staff were supported though supervision and appraisals.
People's nutritional needs were monitored and their special diets catered for. People were supported to access healthcare services when required. Medicines were managed safely.
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.
We observed positive interactions between staff and people who lived at the service. Staff promoted people's privacy and dignity.
Care plans were in place which detailed the care and support to be provided for people. People were involved in their care and support and had the freedom to choose their every day activities.
There was a complaints procedure in place. Complaints had been dealt with in line with the service policy.
Audits were carried out to monitor all aspects of the service and action plans developed which highlighted areas for improvement. Staff were very positive in their comments about the registered manager. They said they enjoyed working at the service and felt supported.
Further information is in the detailed findings below.
This inspection was unannounced and took place on 6 November 2014. At our last inspection we found breaches in regulations relating to the care and welfare of people and how the service assessed and monitored the quality of the service. At this inspection we found that the required improvements had been made.
Sunnyborough is registered to provide personal care and accommodation for up to 19 adults aged 18-65 with a learning disability. There were 10 people living there on the day of the inspection.
Sunnybrough is a purpose built two storey detached property built around a central quadrangle outside space. The service is split into three defined units. Staff are on duty 24 hours a day and people are supported to develop practical skills to help them live as independently as possible
At the time of the visit a manager had recently been appointed and had applied to the commission to be the registered manager. They have since been registered. 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.
The service was safe. The policies and procedures for the recruitment of staff helped ensure only suitable people were recruited to work with vulnerable people. People who used the service were included in the interview process and their views were taken into consideration when appointing new staff.
Staff had received a variety of training to assist them to carry out their roles. This included training with regard to safeguarding adults and mandatory health and safety training.
Staff demonstrated a good understanding of the issues regarding safeguarding adults and they understood the action to take if they suspected abuse. Staff also talked with us about the specialist training they had completed to make sure they were able to meet people’s individual needs. For example, supporting people with autism.
From our observations and discussions we saw staff knew people well and had developed good relationships. We saw staff interacting with people sensitively and enjoying light hearted banter.
The service was well led. Staff acknowledged that the service had been through a difficult period but all appreciated the skills and experience the acting manager had brought to the service. They said they felt well supported and clear about their roles and responsibilities. The new manager had already worked for the provider; from our discussions it was evident they held the same values and vision for the service to develop.
There were effective quality assurance systems in place to monitor the service.
At the time of our inspection there were seven people living in Sunnyborough. During our visit we spoke with the acting manager; and two senior managers from Millennium Care Services. The managers acknowledged the service had experienced difficulties in recent weeks as they had uncovered issues relating to the management of medication and clients monies. They told us they had reported the concerns to other appropriate agencies. They carried out internal investigations into the concerns which resulted in disciplinary procedures being followed for the registered manager and two senior staff members. At the time of the inspection, the registered manager was no longer in post and the home was being managed by a registered manager from another Millennium Care Services home.
We spoke with three people who lived in the home who said they were happy living in the home, and said they felt safe.
The staff we spoke with were aware there had been a number of changes within the service due to the concerns identified. Staff told us there were still a number of areas that required more work, including updating people's care records. Staff said morale was much better within the home for both staff and people who lived there.