The inspection took place on 15 January 2016 and was unannounced. The service was last inspected in October 2013 and was found to be fully compliant at that time. Sunnydale provides accommodation and care for up to nine people, who have a learning disability, autism or a mental health condition; some of which have complex needs. At the time of our inspection the service was full with nine people currently using the service. The home offers accommodation across two floors and is situated in heart of the village of Featherstone, with good access to local shops and services. The service did not have a registered manager at the time of our inspection, however there was a manager (from another service in the registered providers group of services) who had been overseeing the service and there was a newly appointed manager in post, who told us they would be applying to register with the Care Quality Commission when they had completed their induction and probationary period.
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 who used the service told us they felt extremely safe and well cared for. We saw the standard of care was exceptional throughout the service. There were always plenty of staff on duty to meet the needs of the people who used the service safely. The ratios of staff also meant that staff could introduce spontaneous activities which enriched the lives of all the people who used the service. We found staff were passionate in the way in which they spoke about their roles and the achievements and progress of the people they supported.
We found the staff’s understanding of each person they supported was in depth to such a degree that people who used the service described the staff and other people they lived with as their family. The level of knowledge, empathy and thoughtfulness which went into the person centred care planning and delivery meant that people were kept safe and were nurtured. We saw throughout the care plans and by speaking with staff that innovative approaches were used to support people to achieve goals which had previously been thought to be unachievable. People had made progress with the support of staff which had surpassed their own expectations and those of their families and friends.
Staff used their extensive knowledge of people who used the service as the basis for their care planning, reviews of their care plans and risk assessments. Care plans and risk assessments were continually evolving as people who used the service gained new skills and abilities and gained higher levels of independence as a result. Staff also used this personal knowledge to explore how they could introduce new experiences and hobbies which they thought would be interesting to people, based on their personality and observations of similar experiences which they had enjoyed and benefited from.
We found there were very rarely any incidents of behaviour which was challenging to others in the home, despite the complex needs and historical patterns of behaviour of some of the people who used the service. This was achieved by staff understanding the history of each person, the behaviour which would be usual for them, what may ‘trigger’ an episode of challenge and working cohesively as a team to consistently remove these triggers to create the safest possible environment.
People who used the service were actively encouraged to be involved in the planning of their daily lives, they were free to choose how their time was spent, and when outings were planned, where they went and wherever possible who they wanted to share their chosen experience with in terms of which member of staff supported them. People in the service were aware of their personal financial constraints and staff worked hard with people to enable them to understand that they needed to budget and save to achieve their more ambitious plans for holidays. For example some people had expressed a desire to go to Euro Disney in Paris, and there was a conversation around how expensive this would be and how they would need to look at saving for a period of time to be able to achieve this goal.
We found the service was extremely warm and welcoming, and felt very much like visiting a family home. Throughout the day we spent at the service people who used the service were very keen and enthusiastic in wanting to speak with us and to tell us about their experiences of using the service. People who used the service were very keen to interact with our inspector and to make sure that they were well supplied with refreshments and had everything they needed.
We found the management of the service was very visible, open and approachable. There was clear, detailed oversight of the service and input to the service by the day to day managers and people at higher levels of senior management within Millennium Care Services. There were processes throughout the service which constantly monitored the quality of the service and we saw very clear evidence that there was a programme of continuous improvement in place and this was being carried out in line with the timescales which had been put in place.