We carried out a review of the data available to us about Sunbury Nursing Homes on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Sunbury Nursing Homes, you can give feedback on this service.
We found the following examples of good practice.
The service had robust infection control policies and systems in place for visitors to the service and people moving in. Visitors were informed of these in advance of coming to the service. The systems helped protect everyone living at the service.
Where people had tested positive for COVID-19 they spent an isolation period in their room and were cared for by a dedicated cohort of staff who used appropriate personal protective equipment (PPE).
We observed staff wearing their PPE throughout our visit and they were able to show us the correct way in which to remove it. Staff came into work wearing their own clothes changing into their uniform when on site. Uniforms were laundered by in-house staff.
The service appeared clean and hygienic. Staff were able to describe the cleaning regimes and what products and equipment were used. Additional cleaning tasks had been introduced to ensure the service remained clean and the risk of the spread of infection was reduced.
Social distancing had been considered within the internal and external layout of the service. The garden, conservatory and staff rooms had been adapted and were set out to ensure people and staff were following national guidance in relation to numbers of people gathering together.
Staff told us they had felt very supported throughout the pandemic and as such this had made them feel safe. This was due to management, the information they received, testing facilities and availability of PPE.
Further information is in the findings below.
Sunbury Nursing Home is registered to provide accommodation with nursing care for up to 57 people. At the time of our visit, there were 52 older people living at the home. Some of the people who live at the home are living with dementia, whilst others have complex needs from living with Parkinson’s disease, stroke or epilepsy. The home also provided end of life care.
The inspection took place on 29 June 2018 and was unannounced.
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 2008 and associated Regulations about how the service is run.
At our previous inspection on 27 July, 2 and 3 August 2017, we found breaches of three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action in relation to risk assessments for people, care plans and assessing and monitoring the service. The provider sent us an action plan on 20 March 2018 and provided timescales by which time the regulations would be met.
At this inspection we found improvements had been made. However, we noted inconsistencies about the information recorded in people’s care records. The impact to people was lessened due to the knowledge and experience of the consistent staff team. We have made a recommendation to the registered provider in relation to this.
People were safe at Sunbury Nursing Home. Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from harm. There were sufficient numbers of suitably trained staff to support people’s needs safely. Recruitment practices were safe and relevant checks had been completed before staff started work.
Medicines were managed safely. Any changes to people’s medicines were prescribed by the person’s GP and medicines administered appropriately.
Fire safety arrangements and risk assessments for the environment were in place to help keep people safe. The home had a business contingency plan which identified how the home would function in the event of an emergency such as fire, adverse weather conditions, flooding or power cuts.
Although we found some concerns around infection control such as dirty commodes and mattresses these were quickly remedied during the inspection. We reviewed the systems in place to prevent and control infection. After the inspection, the provider sent us an amended infection control auditing system to help ensure safe standards of cleanliness were maintained.
Staff worked within best practice guidelines to ensure people’s care and support promoted well-being and independence. We found the staff team were knowledgeable about people’s care needs. People told us they felt supported and staff knew what they were doing.
The registered manager ensured staff had the skills and experience which were necessary to carry out their role. The registered manager ensured that clinical staff abided by the requirements set out by the Nursing and Midwifery Council (NMC). The NMC is the nursing and midwifery regulator.
People had enough to eat and drink and there were arrangements in place to identify and support people who were nutritionally at risk. People were supported to have access to healthcare services and were involved in the regular monitoring of their health. Staff worked effectively with healthcare professionals and were pro-active in referring people for assessment or treatment. People’s needs were assessed when they entered the home and on a continuous basis to reflect changes in their needs.
People’s needs were met by the adaptation, design and decoration of the premises. The home was decorated and presented to a good standard.
CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. Staff understood and knew how to apply legislation that supported people to consent to care and support. Information about the home was given to people and consent was obtained prior to any care given. Where people had restrictions placed on them these were done in their best interests using appropriate safeguards. Staff had a clear understanding of DoLS and the MCA as well as their responsibilities in respect of this.
Staff treated people with compassion, kindness, dignity and respect. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. People’s privacy and dignity were respected and promoted.
People were encouraged to voice their concerns or complaints about the home and there were different ways for their voice to be heard.Suggestions, concerns and complaints were used as an opportunity to learn and improve the home.
People had access to activities that were important and relevant to them. People were protected from social isolation through systems the home had in place. There were a range of activities available within the home and community.
People received comfortable and dignified end of life care. The home obtained guidance and best practice techniques from professional bodies to assist them in providing good quality end of life care.
The provider actively sought, encouraged and supported people’s involvement in the improvement of the home. People’s care and welfare was monitored regularly to ensure their needs were met within a safe environment. The provider had systems in place to regularly assess and monitor the quality of the care provided.
People told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the home. Staff told us they would report any concerns to their manager.
During this inspection, we made one recommendation to the registered provider in relation to care records.
Sunbury Nursing Homes is registered to provide accommodation with nursing care for up to 57 people. At the time of our visit, there were 53 older people living at the home. Some of the people who live at the home had dementia, whilst others had complex medical and healthcare needs.
The service had a registered manager. 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.
Whilst we saw there were systems in place for quality assurance, this had not been applied consistently in all areas important in the delivery of care. The service did not carry out audits on people’s care records. As a result, the shortfalls we found during this inspection had not been identified and actioned.
People receiving care told us they felt safe living at the home. We received similar feedback from their relatives and some healthcare professionals. However, we noted the service did not have effective systems for the management of risk. Despite the fact that staff were knowledgeable about how to protect people from risks, in some examples, we saw that the care plans and risk assessments had not been developed to ensure this was carried out consistently.
A safe recruitment and selection process was in place. This ensured staff had the right skills and experience to support people. However, we received mixed opinions from people about staffing levels . The majority of people told us there were sufficient staff available to meet their needs. However, others shared a different view. We observed that staff were being constantly moved between areas of the home during shifts to cover workload. Staff told this caused disruption and affected continuity of care. We have given a recommendation about this in the report.
Some care plans lacked personal information about how people needed and wanted to be supported. In some examples, we observed care records contained brief details about people's health and care needs and lacked personalised information to ensure they received care in line with their preferences.
Staff received training on safeguarding adults from abuse. They could describe different types of abuse and were aware of the action they would take to protect people from harm.
Medicines were managed safely. People received their medicines as prescribed. All prescribed medicines were available at the home and were stored securely. Controlled drugs were appropriately stored in accordance with legal requirements, with daily audits of quantities completed by two members of staff. People were able to obtain their ‘when required’ (PRN) medicines at a time that was suitable for them.
Staff sought and obtained people's consent before they helped them. People's mental capacity was assessed for particular decisions. Relevant people were invited to make decisions in people's best interest, as required under the MCA 2005.
The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people's freedom had been submitted and the least restrictive options had been considered.
Each person had a personal emergency evacuation plan (PEEP) which provided staff with information about how to support them to evacuate the building in an emergency situation such as a fire or flood.
People were happy with the choice of meals provided at the home. Their nutritional needs had been assessed and food and fluid intake was been monitored when this was an area of concern.
People and their relatives told us that staff were kind, caring and patient. We observed this during the inspection. They encouraged people to be as independent as possible and respected their privacy and dignity.
People understood how to express any concerns or complaints and were encouraged to feedback their views of the service provided.
The service sought and acted on people’s feedback. People knew how to make complaints about the service and were confident complaints would be dealt with effectively. This was also the view of their relatives. The relatives described an open culture where they could visit at any time and that managers were approachable.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
Sunbury Nursing Home is registered to provide accommodation with nursing care for up to 81 people. At the time of our visit, there were 56 older people living at the home. Some of the people who live at the home are living with dementia, whilst others had complex needs as a result from living with Parkinson’s disease, stroke and epilepsy. We noted that an application to change their registration to a maximum of 57 instead of 81 people being accommodated had been approved on 28 April 2016.
The service offers 6 “step-down” beds, which is an interim accommodation arrangement with the local hospital and social services to provide care between the discharge from hospital and people moving back to their own home or elsewhere. We noted that the “step-down” bed contract ended on 30th April 2016 and all places are now occupied by long term residents. The service also provided end of life care. The accommodation is provided over three floors that were accessible by stairs and a lift.
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 2008 and associated Regulations about how the service is run.
Staff knew what to do to support people to make decisions. The registered manager and staff understood their role and responsibilities with regards to the Mental Capacity Act and Deprivation of Liberty Safeguard. However not everyone who lacked capacity was fully assessed and if necessary DoLS application completed and submitted to the local authority in accordance with current legislation.
Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from harm.
There was sufficient numbers of staff deployed who had the necessary skills and knowledge to meet people’s needs. Recruitment practices were safe and relevant checks had been completed before staff started work. Staff worked within best practice guidelines to ensure people’s care and support promoted well-being and independence.
Medicines were administered, managed, stored and disposed of safely. Any changes to people’s medicines were prescribed by the person’s GP and administered appropriately.
Fire safety arrangements and risk assessments for the environment were in place to help keep people safe. The service had a business contingency plan that identified how the home would function in the event of an emergency such as fire, adverse weather conditions, flooding or power cuts.
Staff had the skills and experience which were necessary to carry out their role. Staff had received appropriate support that promoted their development. The staff team were knowledgeable about people’s care needs. People told us they felt supported and staff knew what they were doing.
People had enough to eat and drink and there were arrangements in place to identify and support people who were nutritionally at risk. People were supported to have access to healthcare services and were involved in the regular monitoring of their health. The provider worked effectively with healthcare professionals and was pro-active in referring people for assessment or treatment.
Staff involved and treated people with compassion, kindness, dignity and respect. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. People’s privacy and dignity were respected and promoted when personal care was undertaken.
People received comfortable and dignified end of life care. The service obtained guidance and best practice techniques from professional bodies to assist them in providing good quality end of life care.
People’s needs were assessed when they entered the home and on a continuous basis to reflect changings in their needs.
People were encouraged to voice their concerns or complaints about the home and there were different ways for their voice to be heard. Suggestions, concerns and complaints were used as an opportunity to learn and improve the service.
People had access to activities that were important and relevant to them. People were protected from social isolation through systems the service had in place. There were a range of activities available within the home and community.
The provider actively sought, encouraged and supported people’s involvement in the improvement of the service.
People’s care and welfare was monitored regularly to ensure their needs were met within a safe environment. The provider had systems in place to regularly assess and monitor the quality of the care provided.
People told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the service. Staff told us they would report any concerns to their manager. Staff felt that management were very supportive.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us they were treated with respect and dignity by the staff. People told us they felt safe with the staff that provided care. We saw information displayed throughout the home from Surrey Protection committee regarding reporting any form of abuse.
We saw the nursing home was clean and that cleaning was carried out on a daily basis. We saw staff wearing disposable aprons and gloves. All of the staff were seen to be 'bare below the elbows'. This meant that staff were able to wash their hands more effectively. Residents and relatives confirmed that staff wore aprons and gloves when providing personal care. We observed disposable aprons available in holders in corridors and bathrooms. This demonstrated that there were arrangements in place to prevent and control infections.
Systems were in place to make sure that staff learnt from events such as accidents, incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve.
Recruitment and selection processes were in place and the provider carried out relevant checks when they employed staff. Policies and procedures were in place to make sure that unsafe practices were identified and people were protected.
Care plans demonstrated that people's healthcare needs were addressed. Staff carried out regular checks to ensure that people were cared for in a safe environment and risk assessments had been carried out to identify and manage any risks to people.
Is the service effective?
People told us that they could make choices about how they spent their time and that they had opportunities to take part in activities they enjoyed.
Guidelines were provided for staff in the way people preferred their care and support to be delivered. Staff communicated information about people's needs effectively and provided care and support in a consistent way. People were supported to access their local community, and to maintain relationships with their friends and families.
Records, including care records, were organised, up to date and reflected the needs of the person. There were clear operating procedures in place, which were known and understood by staff.
Is the service caring?
People were supported by kind, caring and attentive staff. A person who used the service told us 'I am more settled that I thought I would be.' They went on to say 'I am well looked after.' Another person told us 'The staff look after me extremely well.'
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Staff had worked with the people who used the service for some time and knew their needs well. This meant that people received consistent care from staff they knew and understood their needs.
The provider obtained feedback about the quality of the care and support provided as they were in regular contact with relatives and social care professionals.
Is the service responsive?
People's needs had been assessed before they began to use the service to ensure that the service was suitable for them. People received a personalised service based on their individual needs and preferences. People's needs were reviewed regularly and the provider responded appropriately if their needs changed.
People told us they knew how to make a complaint if they were unhappy. There had been no complaints this year. We saw that a complaints procedure was in place.
Is the service well-led?
The registered manager had been in post for a number of years. The service worked well with other agencies and services to make sure people received their care in a person centred way.
The service had a quality assurance system, we saw systems in place that identified shortfalls and documented action taken. As a result the quality of the service was continuingly improving.
Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and of the quality assurance processes that were in place. This helped to ensure that people received a good quality service at all times.
During our follow up visit on 8 January 2014, we saw that the provider had not made all the improvements that were required to be compliant with the regulations. This meant that people were not protected from the risk of infection because appropriate guidance had not been followed.
We saw people were respected and involved in their care, treatment and support. A relative told us 'My family member is very well taken care of; I have recommended the home to others.' A second relative told us 'My family member's needs have changed over the years, I constantly review their plan, and we work as part of a team with the home.'
People received care and welfare that met their needs. A relative told us they were '100% happy with the care.' A second relative told us 'Staff are well tuned in. They can just look at my family member and know if they are feeling alright or needed help with something.'
We saw the nursing home was clean and that cleaning was carried out on a daily basis. We raised concerns about the condition of three commodes which were stained and dirty.
The provider had systems in place for recording training. One staff member told us 'Yes I feel supported, there is lots of recognition, and nothing gets missed.' Another said 'The management are very kind and caring.'
The majority of the people we spoke with were very happy with the service. We saw that the provider had a complaints policy and that information about how to complain was available to people in a format that met their needs.
The people we spoke with told us they were happy with the care they received. They told us the staff discussed their care needs with them on a regular basis.
They told us the staff were very friendly, caring and responsive. One person said 'The staff treat people with great kindness and respect.'
They also told us that they had no concerns about the care they received and would speak to the senior staff or the registered manager if they had any concerns. Everyone we spoke with told us they felt that the people living at the home were safe.