9 May 2018
During a routine inspection
Sunrise of Banstead is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The home can accommodate a maximum of 97 people in two 'neighbourhoods.' The reminiscence neighbourhood provides care to people living with dementia and the assisted living neighbourhood supports older people who may have mobility and health needs. There were 83 people living at the home at the time of our inspection.
There was a registered manager in post. 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 and associated Regulations about how the service is run.
Although staff were caring, one person was subject to restrictions which affected their experience of care and their life at the home. Although it affected only one person, this restriction was significant and breached the person’s human rights.
Overall people were safe although we identified an area for improvement in the use of equipment. We made a recommendation about this.
Overall people’s medicines were managed safely although we identified an area for improvement in the use of medicines prescribed ‘As required’ (PRN). We made a recommendation about this.
People felt safe and secure at the home. There were enough staff on each shift to meet people’s needs. Staff understood safeguarding procedures and were aware of their responsibilities should they suspect abuse was taking place. People were protected by the provider’s recruitment procedures.
There were plans in place to ensure people would continue to receive their care in the event of an emergency. Health and safety checks were carried out regularly to keep the premises safe for use. The home was clean and hygienic and staff maintained appropriate standards of infection control.
People’s needs were assessed before they moved into the home and kept under review. People’s care was provided in line with the Mental Capacity Act 2005 (MCA). When assessing people’s capacity to make decisions, staff had followed an appropriate process to ensure their rights under the MCA were protected. Staff understood that any restrictions should only be imposed upon people where authorised to keep them safe.
Staff had access to the induction, training and support they needed to do their jobs. Staff attended all elements of mandatory training during their induction and refresher training at regular intervals. Staff had access to further training relevant to the needs of the people they cared for. All staff attended regular one-to-one supervision, which gave them the opportunity to discuss any further training they needed, and an annual appraisal.
People enjoyed the food provided and were involved in developing the menu. People’s feedback about meals and mealtimes was encouraged and their suggestions were implemented. People’s nutritional needs had been assessed and were known by care and catering staff. Staff supported people to maintain adequate nutrition and hydration.
People’s healthcare needs were monitored effectively and people were supported to obtain treatment if they needed it. Referrals were made to healthcare professionals if staff identified concerns about people’s health or well-being. Any guidance about people’s care issued by healthcare professionals was implemented and recorded in people’s care plans.
People were supported by caring staff. People told us they had developed positive relationships with staff and enjoyed their company. They said the atmosphere in the home was friendly and welcoming. Staff supported people to maintain relationships with their friends and families. People said staff treated them with respect and maintained their dignity. Staff encouraged people to remain as independent as possible. People’s care plans were personalised and reflected how they preferred their care to be provided.
People had opportunities to take part in activities and to attend events and outings. People were protected from the risk of social isolation.
People and their relatives were given information about how to complain and felt able to raise concerns if they were dissatisfied. Complaints were investigated and responded to appropriately and used as opportunities to improve the care people received.
The home was well managed. People told us they saw the registered manager and senior staff regularly. They said they were encouraged to give their views about the home and how it could be improved. There was an open culture in which staff felt able to express their views and raise any concerns they had. Staff felt well supported by their managers and the senior management team. They said they were valued for the work they did. The provider recognised staff who strove to provide excellent care.
Staff communicated important information effectively. Staff at all levels met regularly to share information about people’s needs and any changes to their care. The provider had effective systems of quality monitoring and improvement. Key areas of the service were audited regularly and discussed at clinical governance meetings. Where opportunities to improve the service were identified, these were incorporated into the home’s development plan.
We identified a breach of the Health and Social Care Act 2008. You can see what action we told the provider to take in the full version of this report.