Archived: Sunrise Operations Eastbourne Limited

This was an unannounced inspection which took place on 1 and 2 December 2016.

Sunrise was inspected in May 2015. Two breaches of regulation were identified. Regulation 9, Person- centred care and Regulation 12, Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider sent us an action plan stating they would have addressed all of these concerns by October 2015. At this inspection we found these breaches had been met.

Sunrise had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The manager was in day to day charge of the home, supported by the deputy manager. People told us that they felt supported by the management team and knew that there was always someone available to support them when needed. Staff told us that the manager and deputy had a good overview of the home and knew everyone well. Staff went the extra mile to provide person centred care for people and were highly motivated to improve people’s day to day lives and had an excellent understanding of their needs.

We received many positive comments from people, staff and relatives. People said that they were able to question, discuss and be involved in changes and felt part of ‘the team’. People had a varied and active daily programme of activities offered. Staff had identified specific areas of interest for people and had gone out of their way to arrange special trips, organised pets visiting the home, and taken people out to events that were important to them.

Staff told us training provided was effective and ensured they were able to provide the best care for people. Staff were encouraged to attend further training, with a number of competency checks taking place to ensure staff understanding after training completed. When errors had occurred in relation to medicines the registered manager had ensured that all staff responsible for medicines had received further training and assessment. This showed a proactive response to facilitate on going improvement. There were numerous audits and a rigorous system in place to assess the quality of the service.

All required maintenance and equipment and services maintenance had taken place. Fire evacuation plans and personal evacuation procedure information was available in event of an emergency evacuation.

Medicine documentation and policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing and checks were carried out to ensure high standards were maintained. People told us they received their medicines on time.

There was a programme of supervision for all staff. Staff told us they valued the regular supervision as it was their opportunity to discuss their development and talk about their role.

Staffing levels were reviewed regularly to ensure people’s needs were met. Robust recruitment checks were completed before staff began work. And all new staff completed a 12 week induction period, which included shadowing a buddy and receiving training and support before being deemed competent to work unsupervised.

Care plans and risk assessments had been completed to ensure people received appropriate care. Care plans identified all health care needs and had been reviewed regularly to ensure information was up to date and relevant. People’s mental health and capacity were assessed and reviewed with pertinent information in care files to inform staff of people’s individual needs. We found some areas of documentation needed to be reviewed to ensure they were clear. This was addressed during the inspection. The co-ordinator responded to this during the inspection to ensure the information was clarified.

People were encouraged to remain as independent as possible and supported to participate in daily activities. Staff demonstrated a clear understanding on how to recognise and report abuse. Staff treated people with respect and dignity and involved people in decisions about how they spent their time. People were asked for their consent before care was provided and had their privacy and dignity respected. Feedback was gained from people this included questionnaires and regular meetings with minutes available for people to access.

People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes. People gave positive feedback about the food and visitors told us they had eaten with their relative and found the food to be of a very high standard.

Referrals were made appropriately to outside agencies when required. For example GP visits, community nurses, chiropodist and speech and language therapists (SALT). And notifications had been completed to inform CQC and other outside organisations when events occurred.

At the time of our inspection the service provided care and support to 92 people.

We spoke with a number of people who used the service. People living at Sunrise Senior Living had a wide range of personal needs, varying from minimal support to complex needs which meant that some people were not able to tell us their experiences. We observed people for interaction and signs of wellbeing. The home was divided into two distinct Neighbourhoods. The Assisted Living Neighbourhood cared and supported older people and the Reminiscence Neighbourhood provided care and support for people with a dementia.

We spoke with three visiting relatives following the inspection and nine staff members during the inspection, this included the registered manager, general manager and reminiscence coordinator, three other registered nurses, care staff and two domestic staff.

Below is a summary of what we found. The summary describes what people who used the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

People had been cared for in an environment that was clean and well maintained.

Risk assessments were in place to provide information to staff to help minimise the risk of any harm to people.

Systems were in place to ensure the safe administration of prescribed medicines. The provider had established recruitment processes and these had been followed.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were able to describe when a DoLS had been put in place and why this had been used. Staff had been trained to understand when an application should be made, and the manager knew how to submit and review one.

Is the service effective?

We saw individual plans of care were in place. There was evidence to confirm that each person had their care plans reviewed on a monthly basis.

People and their relatives told us that the care provided was appropriate and met people's needs. Discussion with staff confirmed that staff knew and understood people's individual care and social support needs.

Is the service caring?

People were supported by kind and caring staff. We saw that staff were very kind and polite and gave people time when supporting them.

Our observations confirmed that people were encouraged to be independent but were helped when they needed any support.

Is the service responsive?

Individual care plans were developed for each person following admission. People were given choices. People had access to activities and had been supported to maintain relationships with their friends and relatives.

Complaints and comments made by people and their relatives had been responded to.

Is the service well-led?

We saw that a number of quality assurance processes were in place. These included feedback from people who used the service and their representatives.

There was a clear management team that included a registered manager who had been in post a number of years. There was an allocated co-ordinator for each of the two neighbourhoods who were supported by senior carers. Staff told us they were clear about their roles and responsibilities.

We saw that people's individual needs had been assessed on admission and wellness checks had been undertaken monthly which ensured people experienced care, treatment and support that met their needs and protected their rights. Staff were able to tell us how they cared and supported people and we noted that handover sheets continued important changes that happened during shifts that the next staff needed to be aware of.

However we found that not all records that related to individual people's specific health needs were up-to-date and recorded correctly. This included food and fluid daily records and wound care.

During our inspection we found that people were involved in decisions about their care and treatment. Care plans were personalised and contained clear instructions on how people should be cared for and supported. The provider had ensured a good standard of cleanliness had been maintained throughout the home.

There were sufficient experienced and qualified staff on duty to meet people's needs. We spoke with staff who told us they attended regular training. Staff felt the training provided by the organisation supported them in their role to deliver safe and person centred care. We saw evidence that staff received regular supervision and annual appraisals.

We found that not all records that related to individual people's specific health needs were up-to-date and recorded correctly. However, the organisation took steps that ensured these shortfalls were immediately rectified following our inspection visit.