Sunnycroft Care Home

Updated 7 September 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Sunnycroft is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we held about the service. This included feedback we had received since the last inspection and notifications the provider had sent us regarding the care provided. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service briefly and eight relatives about their experience of the care provided. We spoke with seven staff and received written feedback from five staff. This included care, kitchen and domestic staff. We also spoke with the registered manager, the provider’s quality manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included four people’s care records and multiple medicine records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 7 September 2021

About the service

Sunnycroft Care Home is a residential care home that can provide accommodation and personal care to up to 59 people. Care is provided over two floors, each having their own separate communal areas for people to access. At the time of the inspection, 33 people were residing in the home, most of whom were living with dementia.

People’s experience of using this service and what we found

The provider’s governance systems had failed to robustly monitor the quality of care provided to people. Risks to people's safety had not always been adequately assessed and managed and the systems in place to protect people from the risk of abuse were not effective.

There were enough staff working in the service to keep them safe but not to provide them with adequate stimulation to enhance their wellbeing. The provider had recognised this prior to our inspection, and plans were in place to improve this area.

Relatives were happy with the care provided to their family members. They felt the culture was open and that the management team and provider was approachable. However, not all staff felt this way with some telling us they did not feel confident to raise concerns for fear of reprisals. Furthermore, external organisations such as the local authority and CQC had not been notified of incidents when they should have been, to enable them to have adequate oversight of the care people received. This did not demonstrate a truly open and transparent culture.

Most of the required checks had been completed to ensure staff working in the service were safe to do so. People received their medicines when they needed them, and the service and equipment people used was clean. There were good systems in place to prevent the spread of infection including COVID-19.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for the service was Requires Improvement (published 16 May 2019) and there were two breaches of regulation. The provider completed an improvement plan to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations. The service remains rated Requires Improvement. This service has been rated Requires Improvement for the last four consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding people from the risk of abuse and the culture within the service. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained as Requires Improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to assessing and managing risks to people’s safety, protecting people from the risk of abuse, monitoring the quality of care provided and for not notifying CQC of certain incidents as is required by law.

Following the inspection, and the identified breaches, we had serious concerns about the quality monitoring systems of this service and so we took enforcement action. The provider is now required to send us a report each month to tell us the actions they are taking to monitor the service, ensure people receive safe care and treatment, and make the necessary improvements.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.