Archived: Sunnyside Care Home

Updated 21 August 2015

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.

This inspection took place on 3 and 11 June 2015 and was unannounced.

The inspection team on 3 June 2015 consisted of four adult social care inspectors, one adult social care inspection manager and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for a person who uses this type of care service. The expert by experience on this occasion had experience in providing care and support to older people. The inspection team on 11 June 2015 consisted of one adult social care inspector. Before the inspection we reviewed all the information we held about the service including notifications. We had also received information of concern from the local authority regarding staffing, care and welfare of people who lived the home and safety and suitability of the premises. We had not sent the provider a ‘Provider Information Return’ (PIR) form prior to the inspection. This form enables the provider to submit in advance information about their service to inform the inspection.

We used a number of different methods to help us understand the experiences of people who lived in the home. Not all the people who used the service were able to communicate verbally, and as we were not familiar with everyone’s way of communicating we were unable to gain their views.

During the inspection we spoke with three people who lived at the home and three visiting relatives and four relatives on the telephone. We also spoke with quality manager, the team leader, a registered nurse, three care assistants, four ancillary staff and a management consultant who was providing support to the new manager.

We spent time looking at five people’s care records and a variety of documents which related to the management of the home, including, personnel files, staff training records and maintenance of the home.

Updated 21 August 2015

The inspection of Sunnyside Care Home took place on 3 and 11 June 2015 and was unannounced. We previously inspected the service on 19 November 2013. The service was not in breach of the Health and Social Care Act 2008 regulations at that time.

Sunnyside Care Home is a converted property which is registered to provide accommodation and personal care for up to 30 older people. On the day of our inspection there were 27 people who had been assessed as having nursing needs, many of who were living with dementia, who were resident at Sunnyside Care Home. The home provides accommodation on the ground and first floor, with a dining room and a number of communal lounges on the ground floor.

The service did not have a registered manager in place. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager had commenced employment at the home three days before our inspection but had not yet commenced their application to register with CQC.

People who lived at the home told us they felt safe, however, staff were not clear about different types of abuse. We saw evidence of a potential safeguarding incident which the team leader had not been made aware of and therefore the incident had not been reported to either the local authority safeguarding team and/or CQC.

We could not evidence that peoples care and support was planned and delivered with the consent of the relevant person. This evidenced a breach of regulations 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff lacked knowledge and understanding of the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005. We saw evidence that people’s freedom of movement within the home was restricted by the use of key coded locks. We were told that no applications had been made to the local authority in regard to the restrictions placed on people’s freedom. These examples evidenced a failure to comply with the requirements of the Mental Capacity Act 2005.

This evidence demonstrated a breach of regulations 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The home was poorly maintained and had not been adapted to support people who were living with dementia to live well. There was no signage to direct people where they were or the locations of the rooms, for example the dining room. There was a lack of sensory stimulation for people. These examples demonstrated a breach of regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We also noted a number of concerns relating to poor management of infection prevention and control procedures. Two toilets were contaminated with faeces and two commode pans were urine stained. We also saw two easy chairs in people’s bedrooms which were not clean. This demonstrated a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The staffing level at the home had recently been increased following a request by the local authority.

There was a system in place for the receipt, storage and administration of medicines. However,

Medication Administration Record (MAR) did not detail the time that time critical medicine was administered.

We were not able to evidence staff received induction, regular training or supervision to provide them with the skills to perform their roles safely and effectively. This demonstrated a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

People told us the food they received was good. The food served to people on the day of our inspection looked appealing.

People told us they were happy with the care they received and the staff treated them with dignity. During our inspection we saw staff supporting people in a kind, caring and dignified manner. However, we also saw a number of examples where staff did not demonstrate respect towards people’s preferences, needs or possessions. This was a breach of regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We saw minimal evidence that people who lived at the home were engaged in meaningful activities. Relatives told us there was little stimulation or activities for people and two people who lived at the home told us they would like to go out more. This was a breach of regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Many of the relatives we spoke with told us they thought the service was well led because the care was good and staff felt the management were supportive.

People’s records were not an accurate reflection of the care and support they required. There was no evidence that the registered provider had a system in place to monitor and assess the quality of the service provided to people. Peoples records were not always accurate and did not consistently provide enough detail to ensure peoples support needs were met. These examples demonstrated a breach of regulation 17of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The overall rating for this service is ‘Inadequate’ and the service is therefore in 'special measures'.

The service will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

You can see what action we told the provider to take at the back of the full version of the report.