CQC report explained · a nursing home
What the CQC found at Sunnymede
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2022
Rated Requires Improvement; inspectors found kind, effective care but ongoing recruitment, risk-assessment and management problems.
This was an unannounced follow-up inspection on 24 and 31 August 2022. Inspectors visited the home, spoke with people, staff and relatives, observed care, and checked care, medicine, recruitment and management records.
The overall rating was Requires Improvement. Safe and Well-led were also Requires Improvement. Effective, Caring and Responsive were rated Good.
People were supported by enough staff for their basic needs and staff were kind and respectful. However, recruitment checks were still not reliable, some risk assessments and medicine systems were not consistently safe, and quality audits were not always completed or used effectively.
There had been progress since the previous inspection. The home was no longer in breach of regulations about accurate care records and activities. However, this was the fifth consecutive inspection rated Requires Improvement, and the home remained in breach of the regulation about safe recruitment.
Kind and respectful staff
Inspectors saw caring interactions, and relatives spoke positively about staff. Staff knew people well and respected their privacy, dignity and choices.
“People were supported by kind staff who treated them with respect.” from the report
Enough staff for essential care
There were enough staff to help people get up, use the toilet, eat and drink. Many staff had worked at the home for a long time, which supported continuity.
“People were supported by enough staff to keep them safe and meet their needs such as getting up, getting a drink and eating meals.” from the report
Good health support
Staff recognised changes in people's health and involved doctors, district nurses and other professionals when needed.
“The management were working well with other health and social care professionals.” from the report
Improved oversight
The home had introduced audits covering areas such as care plans, health and safety and medicines. Some actions had led to improvements.
“Systems were now set up to audit a range of areas in the home with an overview of how frequently each area was looked at.” from the report
Unsafe recruitment checks
seriousRecruitment records still contained inconsistencies. It was not always clear why application details had changed or why references did not match applications, creating a risk when employing people to support vulnerable residents.
“Systems were still not ensuring people were supported by staff who had been through a safe recruitment in line with legislation.” from the report
Incomplete risk information
seriousSome care plans did not give staff clear or accurate instructions about malnutrition, catheter care or seizures. This could lead to inconsistent or unsafe support.
“People at risk of malnutrition had plans that were either unclear because staff had amended details, had incorrect details or were incomplete.” from the report
Medicine safety issues
seriousMedicine storage temperatures were too high on several occasions, and some as-needed medicine records were not consistently accurate. Inspectors also found that medicine administration did not always follow best practice.
“Medicines were not always managed safely even though improvements had been made.” from the report
Limited activities
needs fixingThere was no activities coordinator during the inspection. Some people were seen in communal areas with little interaction for long periods, despite staff trying to spend time with them when possible.
“People were seen sitting in communal areas with minimal interaction for long periods of time.” from the report
Audits not fully effective
needs fixingAudits were not always completed as planned or checked against earlier actions. The home was also not yet clearly analysing accidents and incidents for patterns and learning.
“However, the individual audits were not currently reflecting upon actions they had identified in a previous month.” from the report
- 01What changes have you made to recruitment checks so application forms and references are fully checked and any differences are explained?
- 02How have you updated risk assessments and care plans for malnutrition, catheter care, seizures and other health conditions?
- 03How do you now monitor medicine storage temperatures and check that as-needed medicines and insulin are administered safely?
- 04Has an activities coordinator been appointed, and how do you provide meaningful one-to-one time while this role is filled?
- 05How do you make sure audits are completed on time, followed up and used to identify patterns in accidents and incidents?
This was an unannounced follow-up inspection that assessed all five key questions and included checks of infection prevention and control; ratings for Effective and Responsive improved, while Safe and Well-led remained Requires Improvement. This explanation was written from the published report of 4 November 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, March 2021
Rated Requires Improvement; inspectors found some safety improvements but repeated recruitment and management failures left people at risk.
This was an unannounced focused inspection on 18 November 2020. Two inspectors and a medicines specialist visited the home, then spoke with staff and relatives, reviewed care, medicines, recruitment and safety records, and contacted the local authority.
The home had improved its medicines management, infection control, safeguarding reports and staffing arrangements. People were generally comfortable and call bells were answered promptly. However, some call bells were out of reach, equipment checks were overdue, monitoring of pressure ulcer risks was limited, and one member of staff moved between bedrooms without changing PPE.
The home was not well managed consistently. Recruitment checks were incomplete, records did not always match information given to CQC, and quality checks had missed repeated problems. The overall rating remained Requires Improvement, as did Safe and Well-led. The home had held this rating for four consecutive inspections.
Prompt response to call bells
Inspectors saw that people who used their call bells received a prompt response.
“People had call bells answered promptly when they used them.” from the report
Infection control improvements
The home had enough PPE and had improved its arrangements for preventing and managing infections. Inspectors found one occasion when PPE was not changed between bedrooms, but found no impact.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Medicines management
Medicines were given by trained and assessed staff, and stock, ordering and disposal systems were suitable. Several recording and storage problems were corrected during or after the inspection.
“Stock checks were completed to ensure there were adequate supplies of medicines.” from the report
People appeared comfortable
People told inspectors they were happy, and others appeared happy during observations. Inspectors also saw positive relationships between people and the registered manager.
“People were comfortable in staff presence. Staff understood their responsibility in relation to protecting people from potential abuse.” from the report
Incomplete recruitment checks
seriousThe home did not complete all required checks for new staff. Recruitment records were inconsistent and some interview records were missing.
“The provider was not carrying out relevant checks for new staff in line with current legislation or the provider's policies and procedures.” from the report
Safety equipment checks overdue
seriousAll stand aids and hoists were overdue for routine safety checks. One stand aid had exposed wire, although this was corrected when it was reported.
“However, all the stand aids and hoists were out of date for their routine checks.” from the report
Risks were not monitored reliably
needs fixingSome people could not reach their call bells, and the home had limited checks to show that people at high risk of pressure ulcers were repositioned as planned.
“Some people were unable to reach their call bells.” from the report
Weak management oversight
seriousQuality checks did not always find or resolve problems. Incident records did not always match information shared with CQC, and important documents were not readily available during the inspection.
“Systems were either not in place or robust enough to demonstrate the quality of people's care and safety was effectively managed.” from the report
Communication with relatives
needs fixingSome relatives felt communication about visitor arrangements and contact with family members was inconsistent during the COVID-19 pandemic.
“Relatives raised that communication with them had been inconsistent during the COVID-19 pandemic.” from the report
- 01How do you now make sure all recruitment checks and interview records are complete before staff start work?
- 02How often are hoists and stand aids safety-checked, and how do you record and act on any defects?
- 03How do you make sure every resident can reach their call bell, including after they move around their room?
- 04How do you record and check repositioning for people at high risk of pressure ulcers?
- 05How do you check that incident records are complete and match information sent to CQC?
This was a focused inspection of Safe and Well-led, with infection prevention and control also checked; the Effective, Caring and Responsive ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 26 March 2021 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 Sunnymede
6 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- November 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- May 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- August 2011
Registered with the Care Quality Commission on 22 August 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
25 live-in carers within about an hour of Bath and North East Somerset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,030 to £1,320 a week. 20 can care for a couple. 12 years' experience on average.
“She enabled mum to lead a high quality life in her own home until the very end and Lena and her family became close personal friends to me and my family.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.