Archived: Sunrise of Westbourne

Sunrise Operations of Westbourne is a purpose built care home comprising of four floors providing accommodation, care and support for up to 114 older people, some of whom live independently and require little or no personal care. The service also provides a specialist service on part of the second and all of the third floor, the reminiscence neighbourhood. The reminiscence neighbourhood is for older people living with dementia or enduring mental health conditions. At the time of the inspection there were 106 people living at the home. There was an acting registered manager employed at the home. 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. The acting registered manager had commenced the process of becoming a registered manager with the Care Quality Commission.

During our inspection visit the home had a welcoming, friendly atmosphere with interesting, fun activities being available for people to join in with if they wished. There were also quieter areas for people to sit in which meant people had the opportunity to relax in a calm and homely area.

The premises were well maintained and sympathetically furnished to ensure people were able to sit down and rest throughout the home. The reminiscence neighbourhood was furnished and decorated to accommodate people living with dementia, with clear signage, toilet doors painted in contrasting colours to enable people with dementia to distinguish toilet doors from bedroom doors, and themed lifestyle stations for people to engage with.

People and their relatives gave positive views about the care and support they were given at the home and everyone we spoke with told us they enjoyed living there. People told us they felt safe at the home.

Staff spoke knowledgeably about the systems that were employed to keep people safe and free from harm. They knew how to prevent, identify and report abuse and the provider had systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed.

People’s needs were assessed including areas of risk, and reviewed regularly to ensure people were kept safe. People were cared for with respect and dignity and their privacy was protected.

People received their prescribed medicine when they needed it and appropriate arrangements were in place for the administration, storage and disposal of medicines.

People told us there were always staff available to help them when they needed support and they were supported promptly by staff who were friendly and caring. Relatives told us they were made to feel very welcome when visiting the home and felt the staff involved and included them where appropriate in the care of their relative.

There was a robust recruitment and selection procedure in place to ensure people were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. Staff spoke positively regarding the induction and training they received and commented they had felt well supported throughout their induction period.

Staff demonstrated a good understanding of how people liked to have their care needs met. They delivered safe, effective, person centred care to people in a friendly, professional and kind way.

Supervisions and appraisals were regularly completed with staff, were detailed, clearly written and gave staff the opportunity to comment on their performance and request further training and development opportunities if they wished. The provider had a range of staff incentive schemes to reward and encourage staff to attain their full potential.

The provider had achieved ‘Beacon’ status in the Gold Standards Framework Accreditation. The National Gold Standards Framework (GSF) is a national training scheme which provides training for staff to enable them to provide a gold standard of care for people nearing the end of their life. Beacon status is the highest grade that can be obtained.

Equipment such as hoists and pressure relieving mattresses and cushions were readily available, clean and well maintained.

The manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. These safeguards can only be used when there is no other way of supporting a person safely.

People were supported and provided with an extensive choice of healthy food and drink ensuring their nutritional needs were met. Menus took into account people’s dietary needs and people told us they enjoyed the food and could ask for different choices if they did not like what was on the menu. The provider ensured meal times were a pleasant and social experience for people and the dining areas were attractively laid out with table cloths, table decorations and staff available to ensure people received the assistance they needed.

People knew how to make a complaint if they needed to raise concerns or queries. There was a clear system in place for people to raise concerns and complaints.

There was an extensive schedule of daily activities for people to participate in if they wished. Activities were very well publicised throughout the service with an hourly schedule of activities taking place around the home. People who required assistance were supported to take trips to places of interest. The provider ran a weekly mini bus service to places of interest that people had asked to visit, such as The New Forest, Poole Quay, garden centres and local parks.

There had recently been a change of registered manager and people told us this had led to improvements in some areas of the service, particularly around the complaints process. One person told us, “It’s improved, I feel listened to now”. People felt there was a clear management structure in place with a visible, approachable management team that listened to them and the staff.

There were systems in place to monitor and drive continuous improvement in the quality of the service provided.

The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

At the time of our inspection there were 104 people living at the home. We spoke with 12 people who lived at the home as well the manager and six members of staff.

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

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People we spoke with during the inspection were generally positive about the care, treatment and support they received at Sunrise Westbourne. One person told us, "They do their best to make a difference to you.”

We found that people’s needs had been assessed and care plans put in place to meet their needs. The care plans were up to date and we saw were subject to regular reviews. Risk assessments had also been completed to make sure that care was delivered as safely as possible.

Staff records contained all the information required by the Health and Social Care Act 2008. This meant the provider employed staff who were suitable and had the skills and experience needed to support the people living in the home.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and report on what we find. The provider sought consent from people and or their relatives in relation to their care and was reviewing procedures under the Mental Capacity Act. The manager was aware of what constituted a deprivation of liberty. They were aware of the new Supreme Court ruling and had submitted DoLS applications for people living at the home.

Is the service effective?

People received care and support in accordance with their care plans. Care was planned to meet people's needs. Where a need was identified, a plan was in place to meet this. For example, one person's care record stated that they required assistance to change position. This plan detailed the frequency of position changes, the equipment required and the numbers of staff. Records showed that this care was being carried out as directed.

Members of staff we spoke with demonstrated to us that they understood people's care and support needs and that they knew them well.

We saw various audits that showed that the quality of service to people was monitored thoroughly and people were asked their views on the service provided.

Is the service caring?

We found the service was caring as people were treated with dignity and respect.

People generally spoke positively about the care they received. They also said that staff were kind, caring and compassionate. The following were examples of what people told us, “They do their best to make a difference to you.” “The food is very good, plenty of choice.” and “Very kind staff although the good ones are getting worn out.”

We saw that staff were kind and caring in their approach with people. Staff had information to be able to care for and support people as individuals.

Is the service responsive?

People's care needs were reviewed and their plans updated to ensure they received a service that met their current needs.

We saw within records that actions required of staff were carried out.

Action had been taken to make sure that appropriate staff were employed to meet the needs of people accommodated.

People accessed the services of healthcare professionals as required. Records of visits from healthcare professionals were kept. For example, we found that visits from chiropodists, district nurses, opticians and GPs were documented.

Is the service well led?

The home had systems in place for monitoring the quality of service provided to make sure that the home was run safely. Accidents and incidents were audited so that remedial action could be taken to prevent further occurrences. Other audits completed included health and safety, infection control, and medicines.

People were able to comment on the service provided via questionnaires and meetings.

As some people were mentally and/or physical frail we used a number of different methods to help us understand people’s experiences of living in the home.

We spoke with 18 people who lived at the home and seven visiting friends or relatives. We observed where appropriate the care and support people received. We looked at relevant documents and records. We watched the day-to-day activities and working practices in the home. We also spoke with 11 members of the home’s staff team to obtain their views about working there.

We brought forward this inspection from later in the year. This was because we had received information that alleged people had not received the care and support they needed. We were accompanied on one day of our inspection visit by a pharmacy specialist and found no evidence to support the allegations.

There were arrangements in place that ensured consent was obtained for the care and treatment people received. We saw that people received the support they required and wanted in accordance with their care plans.

The provider had arrangements in place that ensured; people’s prescribed medication was managed safely; there were enough staff on duty at all times with the skills and experience to meet people’s needs; the quality of the service was monitored and improved where necessary and records kept by the home were accurate and up to date.