Sunnyview House

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

During our assessment of this key question, we found the provider did not have always have effective systems and processes in place to monitor the quality of care provided in the service. All the staff we spoke to said they thought the home was well run and the manager was approachable and supportive. However, the main culture and values of the service had not been clearly communicated or monitored as staff were not always working in line with these values. Staff did not always speak up and accurately report on injuries and leaders failed to identify the poor practices in place. We could not be assured the provider had been fully open and transparent with the communication to relatives, as the investigations we were provided with did not include details of conversations and specific information shared. Whilst leaders told us the importance of the governance systems for reviewing, auditing and learning purposes we failed to see clear evidence of these being effectively implemented consistently.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us they felt communication was good in the service and demonstrated kind, caring natures in line with the values of the service. However, we did observe some practices which were not in line with the values and culture, and leaders had failed to drive improvements in these cultures.

Staff received supervisions and staff meetings took place. Staff told us they shared the values of the provider. However, the main culture and values of the service have not been clearly communicated or monitored as staff were not always working in line with these values.

All the staff we spoke to said they thought the home was well managed and run. Staff said the manager was approachable and supportive. They spoke positively about the manager and the culture of the home. Comments included, "Staff feel listened to and not every company is like that. You can air your views. Managers are open and listen to concerns and you are not judged negatively." Staff described strong teamwork and communication and their feedback about the management was universally good. We have spoken with the manager who has been in post for 3 months and whilst they have a compassionate caring nature, policies and procedures have not been completed robustly which has reduced the effectiveness and reduced the quality of care in the service. Therefore, we cannot be assured there is capable and sufficient leadership in the service at present.

The provider is under a period of change with the management at present, which had created some instability in the service due to the new peripatetic manager needing to have a period of time to settle in. The deputy manager status had also been under recruitment which meant overall the service had suffered from a lack of consistent leadership in the short term which had affected the quality of the monitoring in the service. During this time leadership and oversight had been affected, and some of the audits completed, investigations into incidents and analysis of data had not been sufficient.

Staff told us they felt the new manager was supportive and that the home was well managed. Following discussions with leaders they showed a good understanding of the systems and processes in place that should be followed to ensure good governance of the home. However, despite having this knowledge we found some outcomes and actions were not completed robustly and processes were not always followed through to the end.

The provider had a clear speaking up policy in place which staff had access to and could follow if they wished. Speaking up was covered by the provider on many occasions as a reminder for staff on their responsibilities. This was in meetings, supervisions and induction. However, despite this information being shared staff have not always spoken up and leaders have failed to identify the poor practices in place.

Staff told us they felt there was strong teamwork in the home and felt appreciated and listened to by the provider.

Staff were subject to a fair recruitment process prior to commencing employment, with health needs questionnaires completed and reasonable adjustment practices ready to be established where necessary.

Staff told us they felt the new manager was supportive and that the home was well managed. Following discussions with leaders they showed a good understanding of the systems and processes in place that should be followed to ensure good governance of the home. However, despite having this knowledge we found some outcomes and actions were not completed robustly and processes were not always followed through to the end.

The provider did not have consistently effective systems and processes in place to monitor the quality of care provided in the service. Whilst most audits and monitoring were in place, these were not always effective in identifying clear trends and patterns in incident reports, therefore some analyses were not robust. There was no system in place to formally monitor/review the daily notes and repositioning charts, which meant the provider had no evidence of actions taken being taken when there had been shortfalls. Further to this we could not be assured the provider had been fully open and transparent with the communication to relatives, as the investigations we were provided with did not include details of conversations and specific information shared.

People and relatives told us GPs had been involved with the care of their loved ones when required.

Staff and leaders were knowledgeable about how to work in partnership with professionals, and care records showed some involvement of these professionals in people's care. However, we have seen a failure in staff to report accurately on injuries, and a failure in leaders to follow up with thorough investigations and seek professional support in a timely manner. Therefore, we cannot be assured staff and leaders have the required level of knowledge and competence to gain and involve relevant health professionals consistently.

We did not receive any feedback from external partners on their experience of partnership working, however we have reviewed evidence gathered onsite for reflection on this evidence category. Documents show a good level of involvement of other professionals into people's care, and no concerns have been raised by these professionals.

We saw some evidence of partnership working with other professionals in people's care plans. This was inclusive of GP's, DN, SALTS, Mental health teams. However, we have also seen a failure to involve relevant professionals when things have gone wrong, such as failure to gain TVN support for open wounds, or medical support for potential scalds.

Whilst leaders told us the importance of the governance systems for reviewing, auditing and learning purposes we failed to see clear evidence of these being effectively implemented consistently. The systems were in place to allow for this to be implemented but actions had not always been followed through to show lessons learned.

Despite having processes and systems in place, the provider did not have robust evidence of lessons learned. Where investigations were required to ascertain causes to injuries, these were not always comprehensively completed, meaning true reflection and evaluation on practices could not take place. For example, where things had been clearly identified to have gone wrong, such as a scald to a person from a drink, no obvious actions were taken to address the temperature of the drink with staff and no investigation into how this drink was hot enough to burn took place.