Archived: Sunrise of Bramhall

Updated 6 June 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.

The inspection was prompted in part by information received from Greater Manchester Police regarding a serious incident. Because of this concern the inspection was brought forward from its original scheduled date. This incident is still subject to investigation and as a result this inspection did not examine the circumstances of the incident and we are making further enquiries in relation to it. However, the information shared with CQC about the incident indicated potential concerns about the management of medicines and this inspection did examine whether there were on-going risks to people. The provider had notified us of the incident.

The inspection was unannounced and was undertaken on 13 and 14 March 2018. The inspection team consisted of two adult social care inspectors, a medicines inspector and an assistant inspector from Care Quality Commission (CQC).

Prior to the inspection we did not ask the provider to complete a Provider Information Return (PIR).

During our inspection of Sunrise of Bramhall we spoke with the director of operations, the general manager, the deputy manager, the HR manager, the nurse, administration and support staff and six members of care staff.

We looked in detail at six care plans and associated documentation, supervision and training records, six staff records including recruitment and selection records, audits and quality assurance, a variety of policies and procedures, safety and maintenance certificates. A CQC medicines inspector looked at 12 people's

medicine administration records (MAR's).

We used the Short Observational Framework for Inspection (SOFI) in the reminiscence neighbourhood. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We undertook 'pathway tracking' of care records, which involves cross referencing people's care records via the home's documentation. We observed care within the home throughout the day in the lounges, dining room and communal areas.

We observed the medicines round and the breakfast and lunchtime meal. We toured the premises and garden areas and looked in various rooms. We also reviewed previous inspection reports and other information we held about the service. We used this information to inform our judgement.

Updated 6 June 2018

This inspection took place on 13 and 14 March 2018 and was unannounced on the first day. We last inspected the service 06 and 07 June 2017 when we rated the service as good.

This inspection was prompted by information we received from Greater Manchester Police regarding a serious incident; we are making further enquiries in relation to this incident. The provider had notified us of the incident and during the inspection we saw invites to disciplinary meetings and records of discussions about recent issues linked to this incident which had led to formal disciplinary action. This demonstrated the provider addressed any staffing issues raised in a prompt manner.

Sunrise of Bramhall provides personal and nursing care and accommodation for up to 98 older people. Sunrise of Bramhall 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. Two providers, Sunrise Senior Living Limited and Sunrise Operations Bramhall II Limited have dual registration for Sunrise of Bramhall. This means both providers have joint and equal responsibility for the care and support provided at this home.

The service, which is known as a 'community', is divided into two separate neighbourhoods, the 'assisted living' neighbourhood and the 'reminiscence' neighbourhood. The assisted living neighbourhood provides nursing and residential care for up to 72 older people. The reminiscence neighbourhood provides residential care and support for up to 26 older people living with dementia.

The purpose built community is located in Bramhall Stockport. Accommodation is provided over three floors and some accommodation provides single studio suites that can be shared by up to two people.

Reminiscence rooms have a similar layout to those in assisted living and are situated on the ground floor. All bedrooms are single rooms with en-suite facilities and extensive car parking adjoins the building. At the time of this inspection 69 people were living in the assisted living community, 24 people in the reminiscence community.

At the time of inspection there was a manager in post, however they had not yet formally registered with CQC. 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.

Regular audits were carried out in a number of areas.

People living at Sunrise of Bramhall told us they felt safe and said staff were kind and caring. Staff we spoke with told us they had completed training in safeguarding and were able to describe the different types of abuse that could occur.

There were policies and procedures to guide staff about how to safeguard people from the risk of abuse or harm. Staff had access to a wide range of policies and procedures regarding all aspects of the service.

Staff received appropriate induction, training, supervision and appraisal and there was a staff training matrix in place. Staff told us they had sufficient induction and training and this enabled them to feel confident when supporting people.

We saw there were individualised risk assessments in place to identify specific areas of concern. The care plans were person-centred and covered essential elements of people’s needs and preferences. Staff sought consent from people before providing support. People’s health needs were managed effectively and there was evidence of professional’s involvement.

Equipment used by the home was maintained and serviced at regular intervals. The home was clean throughout and there were no malodours. The environment was suitable for people's needs.

There was evidence of robust and safe recruitment procedures.

Accidents and incidents were recorded and audited monthly to identify any trends or re-occurrences. The home had been responsive in referring people to other services when there were concerns about their health.

People told us the food at the home was good. There was a seasonal menu in use and this was displayed. People’s nutritional needs were monitored and met.

People told us staff treated them well and respected their privacy and dignity. We observed positive interactions between staff and people who used the service.

When people had undertaken an activity this was recorded in their care file information and there was a range of activities available for people to choose from.

The service aimed to embed equality and human rights though good person-centred care planning and people were provided with a range of useful information about the home and other supporting organisations.

The service was supported by other relevant professionals when providing end of life care. Several relatives had commended the home for the quality of its end of life care provision.

There was a complaints policy and procedure in place. This clearly explained the process people could follow if they were unhappy with any aspects of their care. There was a service user guide and statement of purpose in place.

Formal feedback from people who used the service and their relatives was sought and there were regular meetings with them.

The service worked in partnership with other professionals and agencies in order to meet people's care needs.

There was an up to date certificate of registration with CQC and insurance certificates on display as required. We saw the last CQC report was also displayed in the premises as per legal requirements.