CQC report explained · a nursing home
What the CQC found at Sunningdale Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People were protected from abuse and risks were assessed, but medicines records and competency checks needed improvement. Inspectors also raised concerns about staffing levels and recording of bathing tasks.
- Effective?
- Good
- Staff had suitable skills and training, and the home worked effectively with health professionals. People's dietary, healthcare, communication and legal decision-making needs were supported.
- Caring?
- Good
- Staff were kind and compassionate, knew people well and treated them with dignity. People were involved in everyday choices and in their care plans.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People had access to activities, communication adjustments and an appropriate complaints process.
- Well-led?
- Good
- Inspectors found a positive, person-centred culture and effective audits. The provider responded positively to feedback and put further checks in place for staffing and bathing.
What inspectors found, March 2020
Rated Good overall, but inspectors found improvements were needed in medicines records, medicines competency checks and staffing arrangements.
Inspectors visited unannounced on 3 March 2020. They spoke with six people, five relatives, ten staff members and a visiting health professional. They observed care and checked care, medicines and management records.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. Inspectors found kind staff, personalised care, suitable activities, good links with health professionals and a positive culture.
Safe was rated Requires Improvement. Most medicines were managed safely, but records for creams were not always clear and not all nurses had recent competency checks. Inspectors also raised concerns about staffing levels and whether some bathing tasks were completed and recorded.
The previous overall rating was Good, published in August 2017. The overall rating stayed Good, but the Safe rating fell from Good to Requires Improvement. The provider said it would improve medicines checks, staffing oversight and recording of bathing.
Kind and respectful care
Inspectors found staff kind, compassionate and respectful. Staff knew people well and had built good relationships with them.
“People were treated with kindness and compassion by dedicated staff.” from the report
Personalised care
Care plans reflected people's individual needs, including social needs, relationships and sexuality. Staff understood the people they supported.
“People had clear, person-centred care plans in place which demonstrated their needs had been assessed.” from the report
Activities and social contact
An activities co-ordinator provided group and individual activities. The home also maintained links with local community organisations.
“An activities co-ordinator was employed who worked across the home five days a week.” from the report
Positive management culture
People and relatives praised the care experience. Staff said morale was generally good and that they could raise concerns with managers.
“There was a positive and person-centred culture within the home.” from the report
Topical medicines records
needs fixingRecords for creams and other topical medicines did not always show clearly what had been applied or who applied it.
“Records relating to topical medicines such as creams did not always clearly demonstrate what was applied and by who.” from the report
Medicines competency checks
needs fixingAlthough medicines were given by trained nurses, not all nurses had undergone a regular competency assessment.
“Medicines were given by trained nurses, however, they had not all had their competency to give medicines assessed.” from the report
Staffing and bathing records
needs fixingSome care staff said they did not always have enough time to complete tasks such as showering. Records did not always show that these tasks had been completed.
“some care staff said they did not always have time to complete all tasks in a timely manner, including showering and records could not always provide evidence these tasks had been completed.” from the report
Icy entrance path
minorThe path to the home had not been gritted on the icy inspection morning. Inspectors raised this with the manager.
“On the morning of the inspection it was icy but the path leading to the home had not been gritted.” from the report
- 01How are topical medicines such as creams now recorded, including what was applied and who applied it?
- 02Have all nurses who give medicines now had their competency assessed, and how often are these checks repeated?
- 03How do you decide whether staffing levels are enough for people's bathing and other care needs?
- 04How do you check that bathing and showering tasks are completed and recorded?
- 05What changes were made after the inspection to monitor staffing levels and bathing regimes?
This was an unannounced planned inspection that looked at all five key questions, with observations, discussions and records reviewed. This explanation was written from the published report of 26 March 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2017
Rated Good; inspectors found safe, kind and responsive care across all five areas.
The inspection was unannounced and took place on 4 July 2017. Inspectors spoke with people living in the home, relatives, staff, managers and health professionals. They observed care and checked care records, medicines, staffing, training, recruitment and management records.
Twenty-eight people lived in the home, almost all with dementia. People said they felt safe, staff were caring and helpful, and they did not have to wait long for assistance. Inspectors found safe medicines management, suitable staffing, clean surroundings, personalised care plans and prompt attention to health needs.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The overall rating remained Good, as it had at the previous comprehensive inspection in August 2014.
People felt safe
People and relatives said they felt safe, and inspectors found safeguarding procedures, useful risk assessments and enough staff to meet people's needs.
“Staff recruitment was carried out safely and staffing levels were sufficient to meet people's care and support needs.” from the report
Safe medicines and environment
Medicines were checked, stored, given and disposed of correctly. Inspectors also found the home clean and hygienic, with maintained equipment and fire safety arrangements.
“We observed staff giving people medicines and these were given safely and carefully.” from the report
Good health and nutrition support
People had food choices, regular drinks and snacks, and prompt access to healthcare professionals when needed.
“We saw drinks and snacks were available and offered to people at regular intervals throughout the day, so they had enough to eat and drink.” from the report
Kind and respectful care
Inspectors saw staff speaking to people in a friendly and attentive way. People were supported with dignity, choice and respect.
“We saw people were relaxed and smiling in the company of staff.” from the report
Personalised support
Care plans reflected people's preferences and were reviewed as their needs changed. Staff supported activities and helped people maintain family relationships.
“These were personalised and regularly reviewed and amended as people's needs changed.” from the report
Regular management checks
The home had frequent audits covering care plans, activities, safety, medicines and infection control. Inspectors said issues found were acted on promptly.
“Audits were frequent and included care plans, activities, health and safety, medication and infection control.” from the report
Inspectors raised no specific concerns in this report.
- 01How many staff are usually available for people living with dementia during the day and at night?
- 02How will you involve my relative, or their representative, in creating and reviewing their personalised care plan?
- 03How do you check that medicines are given at the right time and as prescribed?
- 04How do you record and respond to changes in a person's health or behaviour?
- 05Has the planned change to the registered manager's responsibility for another home taken place?
This was an unannounced inspection covering all five CQC questions and the overall quality of the service; the previous comprehensive inspection in August 2014 had also rated all areas Good. This explanation was written from the published report of 22 August 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Sunningdale Nursing Home
3 rated inspections over 5 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 25 November 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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