Archived: Sunrise of Bassett

Sunrise of Bassett is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

This care home is run by two providers: Sunrise UK Operations Limited and Sunrise Senior Living Limited. These two providers have a dual registration and are jointly responsible for the services at the home. This report is in relation to Sunrise Senior Living Limited. A separate report has been produced for Sunrise UK Operations Limited.

Sunrise of Bassett accommodates up to 104 people in one adapted building over four floors. The first three floors were designated for ‘Assisted Living’, where people had a range of care needs but could carry out various aspects of daily living independently. The top floor was called the ‘Reminiscence Floor’, this had been designed as a living space suitable for people living with dementia. There were 69 people at the service at the time of inspection. People living at the service were older persons, some of whom were living with dementia.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager in place at the time of our inspection. 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.

There was a clear management structure in place. There were effective governance systems in place to monitor the quality of care. The registered manager oversaw a programme of audits and checks that ensured the home was safe and they had an insight into the day to day culture of the service.

The service worked in partnership with different stakeholders to contribute to many research studies relevant to people at the service. This included trialling new technologies which promoted people’s independence and piloting new approaches to effective care for people living with dementia. Some of these studies were either in their early stages or the technology was not continued after the initial trials, therefore, it was too early to evaluate whether these have resulted in beneficial outcomes for people.

People told us the registered manager was approachable and competent in their role. They felt confident that their concerns and feedback would be listened to.

The registered manager assessed and monitored staffing levels to ensure sufficient numbers were available to support people’s needs. Staff employed had gone through relevant recruitment checks which considered their skills, work experience and character. This helped to ensure they were suitable for their role.

There was mixed feedback about how effectively the call bell monitoring system was answered. The registered manager had met with people to discuss concerns and put processes in place to monitor how quickly call bells were attended to.

People told us that staff were friendly and treated them with dignity. Staff were knowledgeable about people’s needs and understood how to provide personalised care.

Where people received care at the end of their lives, they were treated with compassion.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s care plans reflected their backgrounds, preferred routines and communication needs. The registered manager monitored care through an electronic monitoring system. This enabled them to quickly identify changes in people’s health to ensure appropriate medical advice was sought. The provider had established good working relationships with healthcare professionals including regular GP visits to the home.

The registered manager had worked hard to involve people in the running of the service, by setting up a variety of methods to gain people’s feedback. The registered manager was keen for people to be as involved as possible and had established links with the local community to provide resources and activities for people to participate in.

People told us there were a wide variety of activities available. People’s needs varied greatly at the service. This meant that some activities were organised specifically for people living with dementia.

There were systems in place to safely manage people’s medicines. The registered manager carried out audits and checks that were effective in identifying errors. When errors occurred, the registered manager took appropriate medical advice and supported staff to access training a to help ensure they possessed the necessary skills and knowledge.

Staff had access to a range of training relevant to their role with many undertaking additional qualifications in health and social care. Nursing staff were supported to maintain their professional registration and many had accessed additional training in areas such as end of life care. Staff’s ongoing learning and development was fostered through supervision, training and observation of working practice by the registered manager.

Risks relating to people’s health and wellbeing were assessed, monitored and mitigated. People’s needs were assessed using a range of nationally recognised assessment tools which helped to ensure appropriate care was put in place. Where risks were identified, plans were put in place to ensure people were safe. When incidents occurred or people’s needs changed, the provider ensured that there were processes in place to act quickly to ensure their safety was not compromised.

People were supported to stay safe from abuse or avoidable harm. The registered manager had informed CQC about significant events which occurred and referred concerns to local safeguarding teams when required.

People were supported to follow a diet in line with their preferences and dietary requirements. The provider had taken steps to ensure that people had input into the menu options available. Where people had specialists needs around nutrition, the provider had made adaptions to ensure people’s needs were met.

The home was a clean and hygienic environment and there were systems in place prevent the risk of infections spreading. The provider had made adaptions to the environment, with reference to creating an environment suitable for people living with dementia.

At the previous inspection in May 2015 we found the registered person had not ensured that people received all the nursing and health care they required. We reassessed this in May 2016 and found that whilst improvements had been made these changes were not embedded in practice and did not always ensure people received effective care. We told the provider they must take action to ensure people received effective health care. At this inspection we found that action had been taken and people were receiving effective personal and nursing care.

Also at the previous inspection in May 2015 we found that an effective system to regularly assess and monitor the quality of services provided was not in place and that procedures to protect people’s legal rights were not followed. The provider sent us an action plan telling us how they would improve. At this inspection we found that action had been taken and effective quality monitoring systems and procedures to ensure people’s legal rights were in place.

There was a registered manager 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.

There were not always enough staff to ensure people’s needs were promptly met and call bells were not always responded to in a timely manner. Recruitment practices had not ensured that all pre-employment checks were completed before new staff commenced working in the home. Staff received appropriate training and were supported in their work.

People were positive about the service they received. They were also positive about meals and the support they received to ensure they had a nutritious diet and about the activities available. People were supported and encouraged to be as independent as possible and their dignity was promoted.

People felt safe and staff knew how to identify, prevent and report abuse. Legislation designed to protect people's legal rights was followed correctly. Staff offered people choices and respected their decisions. People and visitors’ views about the service were sought in a formal and informal way and were acted on.

Care plans provided comprehensive information about how people wished to be cared for and staff were aware of people's individual care needs and preferences. Reviews of care involving people were conducted regularly. People had access to healthcare services and were referred to doctors and specialists when needed.

Medicines were managed safely and people received these as prescribed. At the end of their life, people received appropriate care to have a comfortable, dignified and pain free death.

People and relatives were able to complain or raise issues on a formal and informal basis with the registered manager and were confident these would be resolved. This contributed to an open culture within the home. Visitors were welcomed and there were good working relationships with external professionals.

Staff worked well together, which created a relaxed and happy atmosphere that was reflected in people's care. Plans were in place to deal with foreseeable emergencies and staff had received training to manage such situations safely.

Quality assurance systems were in place using formal audits and through regular contact by the provider’s representative and registered manager with people, relatives and staff.