CQC report explained · a residential care home
What the CQC found at Sunnymeade Quality Care
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People's risks were not always managed effectively. Inspectors found gaps after a choking incident, a lack of evidence about patterns in falls, some missed safeguarding training updates and a four-day gap in medicine refrigerator temperature records.
- Effective?
- Requires improvement
- Capacity and consent assessments had not always been completed. Some people were restricted without the required Deprivation of Liberty Safeguards applications.
- Caring?
- Good
- This question was not inspected during this focused visit. Inspectors saw staff respond to people in a kind, caring and dignified way, and records showed person-centred care.
- Responsive?
- Good
- This question was not inspected during this focused visit. People were supported to make choices, keep in contact with family and receive care adapted to their needs.
- Well-led?
- Requires improvement
- Management changes had disrupted audits and oversight. Infection control, fire safety and medicines audits had significant gaps, and the provider had not notified CQC promptly about a serious incident.
What inspectors found, April 2022
Rated Requires Improvement; inspectors found gaps in risk checks, consent and management oversight, although care and infection control had strengths.
This was an unannounced focused inspection on 22 February 2022. Inspectors spoke with people, a relative, the provider, managers and staff. They reviewed care plans, medicines records, staff files, training and management records.
The overall rating was Requires Improvement. Safe, Effective and Well-led were also rated Requires Improvement. Inspectors found that risks were not always recorded and monitored properly, some legal consent checks were missing, and quality audits were not yet effective.
There were positive findings too. People were supported by staff who knew them, medicines were generally managed safely, the home was clean, and staff worked with health professionals. The rating had fallen from Good at the last inspection, published in February 2019.
Kind and respectful staff
People appeared comfortable with staff. Staff responded appropriately when people were anxious or distressed.
“People were relaxed and comfortable with staff and had no hesitation in asking for help from them.” from the report
Clean and infection-safe environment
The building was clean and infection control arrangements had been updated during the COVID-19 pandemic. Visiting arrangements were in place.
“The building was clean, and there were appropriate procedures to ensure any infection control risks were minimised.” from the report
Safe recruitment
The home checked applicants through interviews, police checks, employment history and references.
“Staff were recruited safely using a process that included interviews, police checks, employment history and references to ensure potential staff were safe to work with people.” from the report
Access to healthcare
Staff recognised changes in people's health and made timely referrals to health professionals. The home worked with outside professionals to support people's wellbeing.
“Staff were proactive in making timely referrals to health professionals when they had concerns around people's health and well-being.” from the report
Risks were not always monitored
seriousA choking incident was not followed by an updated risk assessment at the time. The home also lacked evidence showing patterns in falls and what extra action had been taken.
“Failing to assess and monitor risks to people was a breach of regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Missing legal consent safeguards
seriousCapacity and consent assessments were not always completed. Some people were restricted without the required legal authorisation.
“The principles of the MCA had not been followed. This was a breach of regulation 11 (Need for consent) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Weak management checks
seriousManagement changes disrupted oversight. Several audits had not been completed for long periods, including infection control, fire safety and medicines audits.
“The provider's governance systems had not been effective in improving the service people received.” from the report
Incident not reported to CQC
seriousThe provider did not notify CQC without delay about an incident that affected a person and led to hospital admission.
“The registered provider has failed to notify us without delay of incidents they are required legally to inform us of.” from the report
Staffing and training gaps
needs fixingThe home had vacancies and had experienced occasions when staffing fell below planned levels. Some training updates and supervision had also been delayed, although action was being planned.
“There remained a number of vacancies which the service was actively recruiting into.” from the report
- 01What has been done to make sure every person's falls, choking and other risk assessments are current and reviewed after an incident?
- 02Have capacity assessments and any required Deprivation of Liberty Safeguards applications now been completed?
- 03Which infection control, fire safety and medicines audits are now up to date, and who checks the results?
- 04Has a registered manager been appointed since the inspection, and what oversight do the current managers have?
- 05How have staffing vacancies, safeguarding training updates and staff supervision been addressed?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and previous ratings were used when calculating the overall rating. This explanation was written from the published report of 8 April 2022 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, February 2019
Rated Good in every area; inspectors found safe, kind and personalised care, with some records and training needing improvement.
This was a planned inspection on 28 and 29 January 2019. Inspectors reviewed care records, staff files, training, medicines, complaints, audits and meeting notes. They spoke with seven people, two relatives, seven staff members and a healthcare professional.
The home was caring and personalised. People said they felt safe and happy. Staff knew people well, respected their privacy and supported their choices, healthcare needs, meals and activities.
Inspectors found some shortfalls. Information about how to support people when they became upset was not always recorded clearly. Some staff had not completed diabetes training, and records for some as-needed medicines did not always explain when they were needed or whether they worked.
The overall rating was Good, and all five areas were rated Good. This means the inspectors found legal requirements were met and that people’s outcomes were consistently good at the time of the inspection.
People felt safe
People told inspectors they felt safe and happy. Staff understood safeguarding duties, individual risks and how to reduce harm.
“People told us they felt safe and happy living at Sunnymeade Quality Care.” from the report
Kind and respectful care
Staff knew people’s histories, preferences and communication needs. They protected privacy, dignity and independence.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised daily life
People could choose where and how to spend their time, including their meals and activities. Staff supported people who preferred to spend time in their rooms.
“People could choose how they spent their time and were able to influence what social activities were provided by the home.” from the report
Good healthcare support
Staff noticed changes in people’s health and sought advice promptly. A healthcare professional said the home provided the correct support when needs changed.
“A health care professional confirmed staff met people's health needs and were proactive in providing the correct support when people's needs changed.” from the report
Active management
Managers worked alongside staff and used audits, feedback and incidents to identify improvements. Staff said managers listened and responded quickly.
“There was an effective quality assurance system in place to drive continuous improvement within the service.” from the report
Some support information was not recorded
needs fixingInformation about how to support people when they became upset, anxious or emotional was not always clearly written in their records. Managers said they would add it.
“Information about how to support people at these times was not always clearly recorded in people's records.” from the report
Diabetes training was incomplete
needs fixingNot all staff supporting people with diabetes had completed the relevant training. Managers booked the outstanding training during the inspection.
“Records showed staff had not all completed diabetes training even though they were supporting people who had diabetes.” from the report
As-needed medicine records needed more detail
needs fixingSome records did not explain clearly how staff would know an as-needed medicine was required. Staff did not always record whether it had worked.
“When staff administered these medicines, they checked with people whether they had worked, but did not always record this information.” from the report
The environment may need adapting
minorInspectors said the home might not remain suitable throughout as the needs of people living with dementia increased. A refurbishment was being planned.
“However, as the needs of the people in the home living with dementia increased, the environment may no longer be suitable throughout.” from the report
People wanted more involvement
minorPeople did not currently feel very involved in how the home was run. Managers planned to give people and families more control of residents’ meetings.
“People did not currently feel very involved with the way the service was run.” from the report
- 01Have all staff who support people with diabetes now completed the relevant training?
- 02How do you record when an as-needed medicine is needed and whether it has worked?
- 03Have care records been updated with clear guidance about how to support people who become upset or anxious?
- 04What refurbishment or other changes are planned to make the environment suitable for people living with dementia?
- 05How can residents and families have more involvement in running the home and in residents’ meetings?
This was a planned inspection of the whole care home, including the premises and care provided, and inspectors rated all five questions. This explanation was written from the published report of 14 February 2019 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 Sunnymeade Quality Care
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- April 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2016
Registered with the Care Quality Commission on 9 January 2016.
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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