Sussexdown

Updated 26 November 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 Care Act 2014.

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 carried out by an inspector and an assistant inspector.

Service and service type

Sussexdown is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Sussexdown is a care home with nursing. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with 11 people who used the service and two relatives about their experience of the care provided. We spoke with 15 members of staff including the clinical lead, team leaders, care workers and admin staff .

We reviewed a range of records. This included two people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including staffing rotas, policies and procedures, were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records, staff rotas and other records in relation to staffing numbers and people’s dependency levels.

Updated 26 November 2022

About the service

Sussexdown is a residential care home providing personal and nursing care to 53 people at the time of the inspection. The service is registered to support up to 77 people.

Care was provided across three units, one for residential care, one for people with nursing needs and a unit tailored to people living with dementia. The main building and grounds are a former convalescence home for people who had served in the armed forces which had been adapted whilst retaining its historical features. The area of the home for people living with dementia was purpose built.

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

We found the breaches of regulation identified at the previous inspections had been met, however, it was not yet clear how sustainable or embedded these improvements were. Shortfalls in relation to staff deployment remained an issue, however staffing numbers had improved since the last inspection and staffing numbers no longer impacted on the safety of people’s care. The provider relied heavily on agency staff, however there were times when agency staff were not available or cancelled at short notice. This had impacted on people’s quality of life as staff were able to spend less time with them. People spoke highly of the staff and said the care was good. They told us the staff were “kind,” “very nice” and, “caring”.

The service did not have a registered manager in post, however there were interim management arrangements in place. This included a clinical lead in day to day charge of the service with oversight by the regional support manager and the regional operations manager. The provider had recruited permanent staff to manage the service who were due to start their employment towards the end of October 2022. Staff told us the service had improved. They said they felt, “more settled with the management we have now that I did when the previous manager was here.”

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. One person told us they had, “Choices within certain parameters, my best interests aren’t always what I want. I don’t want to be in a care home, but this is a lovely place, superb, really good. I’m free to come and go as I please, although it is not in my best interests to do so. The staff are kind and helpful.”

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 provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection improvement had been made and the provider was meeting regulations, however further improvements are required.

The last rating for this service was requires improvement (published 13 January 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

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 carried out an unannounced comprehensive inspection of this service on 13 February 2020 and a focused inspection on 19 October 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve Good Governance and Staffing.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. We also inspected due to concerns we received in relation to staffing.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.

The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

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

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sussexdown on our website at www.cqc.org.uk.