Archived: Sunrise of Mobberley

Updated 6 February 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 checked 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 7 and 14 November 2017 and was unannounced. The inspection was carried out by two adult social care inspectors and two experts by experience on the first day and two adult social care inspectors on the second day. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The service was aware of our visit to conclude the inspection on the second day.

The registered manager had received a Provider Information Return (PIR) before our inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. We looked at any notifications received and reviewed any information that had been received from the public. A notification is information about important events, which the provider is required to tell us about by law.

We checked to see whether a Health Watch visit had taken place. Health Watch is an independent consumer champion created to gather and represent the views of the public. They have powers to enter registered services and comment on the quality of the care. A recent visit had not taken place but we read the latest report available.

We used a number of different methods to help us understand the experience of people who used the service. During the inspection we spoke with 28 people who lived at the home and four relatives/visitors, to seek their views. We spoke with 14 members of staff including one nurse, five care staff, the registered manager, deputy manager, operations director, chef, two unit coordinators, a dining assistant and the maintenance person. We also contacted a health professional who visited the home regularly.

We looked at the care records of four people who lived at the home and inspected other documentation related to the day to day management of the service. These records included, staff rotas, quality audits, training and induction records, supervision records and maintenance records. We toured the building, including bathrooms, store rooms and with permission spoke with some people in their bedrooms. Throughout the inspection we made observations of care and support provided to people and made observations at lunch-time.

Updated 6 February 2018

The inspection took place on 7 and 14 November 2017 and was unannounced. At our last inspection in May 2016 we identified two breaches of the legal requirements in respect of the deployment of staff and the safe management of medicines. At this inspection we found that improvements had been made and that the relevant requirements had been met.

Sunrise of Mobberley 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.

Sunrise of Mobberley accommodates up to 108 people across two separate units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with dementia.

There was 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were very positive about the care and support that they received at Sunrise of Mobberley. People were cared for in a clean and very well maintained environment. We found that the focus of the service was very person centred. We found that the service supported people to express their views and were involved in making decisions about their care. There was a residents’ council meeting held every month.

Improvements had been made to staffing and recruitment. From our observations and a review of the rotas, we saw there were sufficient staff to safely meet the needs of people living in the service. People told us that there were enough staff to meet their needs, although people had noticed the impact of staff changes. The use of agency staff had decreased.

We saw that staff employed by Sunrise had been through a thorough recruitment process before they started work to ensure they were suitable and safe to work with the people who lived at the service.

We found that improvements had been made to the management of medicines and the provider had put appropriate arrangements in place to help maintain the safe management of medicines at the service. We noted that further improvements could be made around the recording of topical medicines and creams.

We found that the registered manager and staff understood their responsibility to keep people safe. Staff were able to tell us about the provider’s safeguarding policies and procedures and knew what to do if they suspected that a person was at risk of abuse.

We saw individual risk management plans were in place to keep people safe and the actions needed to minimise risks to people’s safety had been identified. However at times we found that people’s care plans did not always fully document all the actions that had been taken to mitigate some risks.

We found that staff were knowledgeable and had the appropriate skills to carry out their roles effectively. Staff undertook appropriate induction and training. Staff were supported to continually develop their skills and knowledge.

Staff understood and followed the principles of The Mental Capacity Act (2005). We observed that staff sought consent from people to provide care and treatment. Where necessary MCA assessment and best interest decisions had been made.

People were very positive about the food at Sunrise of Mobberley. The dining room had a restaurant feel and the food was of a high quality. People were consulted about their preferences. We saw that people’s nutritional needs were met. There was an effective system in place to ensure that all staff had up to date information about people’s nutritional needs.

We found that the service was very caring. There was a strong person centred culture and staff were motivated to treat people with kindness, respect and compassion. Staff members had good understanding about the people they were supporting and were able to meet their various needs. People told us that they were treated with dignity and respect.

People's needs had been assessed before they moved into the service. The assessment was then used to complete an individualised service plan (ISP) for the person, which enabled people to be cared for in a person centred way. Overall the ISP’s provided person centred information and had been regularly reviewed, we also found one example where the information had not been reviewed on a monthly basis and the level of information contained within the review of the ISP was brief and some relevant information had not been included. We noted that the template of the ISP meant that there was minimal space for staff to record updates and reviews of the different sections within the plan.

Through feedback to the service the operations director told us he had identified areas where they could improve the service further. They had plans to make improvements to general communication with relatives and ensuring that where appropriate, relatives had regular updates about their relative’s care.

There was an extensive activities programme, with several events and activities offered on a daily basis. People were supported to go out on trips. The service had good links with the community. A “Memory Café” was held at the service once per month in conjunction with the Alzheimer’s Society.

The service was well led. Staff told us that improvements had been made to the management of the service. Staff felt supported and told us that the registered manager was approachable.

We found that the management team demonstrated good knowledge about all aspects of the service, including quality issues and priorities for the service. The registered manager had a development plan in place including who was responsible for the areas of improvement and explained that she was keen to promote best practice and sought guidance from health and care professionals as required.

Quality assurance arrangements were robust and identified current and potential concerns and areas for improvement.