Sundial Cottage Rest Home Ltd

Updated 12 October 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by two inspectors,

Service and service type

Sundial Cottage Rest Home Ltd is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Sundial Cottage Rest Home Ltd is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection the registered manager had recently resigned and whilst still registered, they were no longer in post. A new manager had been appointed and they were due to start in September 2022. In the interim, the provider had put in place a suitably qualified temporary management team who were very familiar with the service.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification tells us about important issues and events which have happened at the service. We used all of this information to plan our inspection.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

During the inspection

We spoke with six people living in the home. We also spoke with the interim managers, the provider, and two care workers.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We also received written feedback from a further four staff, five relatives and two healthcare professionals.

Updated 12 October 2022

About the service

Sundial Cottage Rest Home Ltd provides personal care and accommodation to up to 22 people. The home is an older style building and is arranged over two floors. Some of the people using the service were living with dementia. There were 22 people using the service when we inspected.

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

Improvements were needed to ensure the safe and proper use of medicines. There was an inconsistent approach to managing risks to people’s health and wellbeing and improvements were needed to ensure that legal frameworks regarding consent were being consistently followed. The governance systems in place were not being effective at identifying and resolving all of the areas where the safety and quality of the care being provided was compromised.

Some of the required records to support safe recruitment were not in place. Infection control arrangements within the service needed to be more effective and incidents and accidents needed more effective oversight. There were sufficient number of staff deployed to meet people’s needs. People told us they felt safe at Sundial Cottage and the provider had appropriate policies and procedures which ensured staff had clear guidance about what they must do if they suspected abuse was taking place.

There were areas of the home which remained in need of updating and refurbishment, the provider was taking action to address this. People had care and support plans that were personalised and reflected their needs. People were supported by staff who had relevant training. Feedback about the food was generally positive. Staff sought the specialist advice of a range of health care professionals to assist in achieving positive outcomes for people.

People told us staff were kind, caring and friendly and we observed a number of positive interactions where staff clearly conveyed their regard for people. Staff took steps to protect people's privacy and people were free to spend time, in private, in their rooms as they wished. Staff involved people in discussions and encouraged them to make choices about how they spent their day and which activities they took part in.

Staff knew people well and this enabled them to engage effectively and provide person centred care. People had access to regular and meaningful activities and relatives expressed confidence that they could raise any issues or concerns with the interim leadership team or the provider. Staff worked alongside community nursing teams to ensure that people had a comfortable and pain free death.

Staff understood the values of the service and spoke of a positive culture and of the importance of providing people with person-centred care. The provider was aware of their responsibility to act in an honest and transparent way when things went wrong and engaged well with people, staff and relatives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 28 July 2021 and this is the first inspection.

The last rating for the service under the previous provider was requires improvement, published on 28 August 2021.

Why we inspected

This was a planned inspection in order to give the service a rating under the current provider.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led key question sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, fit and proper persons employed, consent and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.