CQC report explained · a residential care home
What the CQC found at Sunnyside
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- There were concerns about night staffing, risk management, infection control, PPE, social distancing and some cleaning. Medicines were generally administered safely, but some related checks and risk reviews were not up to date.
- Effective?
- Good
- People received personalised support from trained staff and had good outcomes. The home worked with health and social care professionals and supported choice, independence, nutrition and community involvement.
- Caring?
- Requires improvement
- This question was not inspected during this focused visit, so its previous rating was used in the overall rating.
- Responsive?
- Requires improvement
- This question was not inspected during this focused visit, so its previous rating was used in the overall rating.
- Well-led?
- Requires improvement
- Management had become more stable and staff felt supported, but quality checks had not identified all the concerns about infection control and risk management.
What inspectors found, October 2020
Sunnyside is rated Requires Improvement; inspectors found kind, effective support but continuing concerns about risks, night staffing and infection control.
This was a focused inspection on 1 October 2020 after concerns about risk management. Inspectors looked at Safe, Effective and Well-led. They spoke with people, relatives, staff and a professional, observed care, and checked records, medicines, the environment and management systems.
The home had improved since its previous inspection, when it was rated Inadequate and placed in Special Measures. People were supported to live more independently and received good outcomes. Staff were described as kind, supportive and knowledgeable, and the Effective rating was Good.
The home was still not consistently safe or well-led. Inspectors found problems with night staffing, risk assessments, cleaning, personal protective equipment and social distancing. The overall rating improved to Requires Improvement, and the home was no longer in Special Measures or breaching regulations at this inspection.
Kind and positive support
People, relatives and professionals spoke positively about the care and the improvements made. Staff supported people to live meaningful and more independent lives.
“One person said, "I feel happy here, the staff are kind to me.” from the report
Personalised care
Care plans were detailed, accurate and regularly reviewed. Staff knew people's needs and supported them to make choices.
“People had detailed and accurate care plans in place that reflected their needs and the support they required.” from the report
Trained and supported staff
Staff received relevant specialist training and regular checks of their skills. They said their induction prepared them for their role and that managers supported them.
“People received care and support from staff who had been trained, supported and had their competency to perform their role checked on a regular basis.” from the report
Improvement since the last inspection
The provider had acted on the previous inspection findings. The home was no longer rated Inadequate, was no longer in Special Measures and was no longer in breach of regulations.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Night staffing and gender mix
seriousThere were regular nights when only male staff were available, despite one person's care plan saying female staff must always be available if needed. Staff also sometimes had to manage escalating behaviour alone at night.
“Incident forms showed that there were times when staff had to manage a person's escalating behaviour alone due to them occurring at night when the service employed only one staff member.” from the report
Infection control was not consistent
seriousSome staff used cloth masks instead of the recommended masks, and social distancing was not always followed. There were also limited hand-washing facilities and no dedicated areas for putting on and removing PPE.
“The service had identified, assessed, managed and regularly reviewed the risks associated with infection and, specifically, Covid-19.” from the report
Cleaning standards
needs fixingMost areas appeared clean, but inspectors found heavy debris under seating and toilet brushes standing in contaminated water.
“However, heavy debris was found under the soft furnishing seating and we found toilet brushes sitting in contaminated water.” from the report
Risk checks and quality monitoring
needs fixingSome risk information was incomplete or had not been analysed fully. Quality audits had not identified all the infection control and risk management problems found by inspectors.
“The quality monitoring system the provider had in place had been mostly successful in driving improvements and although more were required, risks to people had reduced.” from the report
- 01How do you now make sure suitable staffing levels and the required gender mix are available at night?
- 02What changes have you made to ensure staff use the correct PPE and follow social distancing guidance?
- 03What has been done to improve cleaning, including the problems with seating and toilet brushes?
- 04How are risks such as escalating behaviour, changes in health and ligature points now reviewed and acted on?
- 05How do your quality audits check that infection control and risk management problems are found promptly?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 22 October 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, October 2019
Rated Inadequate and placed in special measures; inspectors found serious safety, staffing, training and leadership failures.
Inspectors visited on 22 August 2019. They spoke with people, staff, the manager and relatives, observed care, and checked care records, medicines, staff files and quality records.
The home was not consistently safe. Inspectors found risks linked to restraint, safeguarding, staffing levels, training, the building and incomplete risk assessments. Some incidents had not been reported to the CQC or other relevant bodies.
Care was not always based on people's current needs, choices or legal rights. Behaviour support plans, consent records and care plans were incomplete or out of date. Relatives also raised concerns about staffing changes, activities and social stimulation.
The overall rating fell from Good at the previous inspection to Inadequate. Caring and Responsive were rated Requires Improvement. The home was placed in special measures, with an action plan and further monitoring and inspection required.
Clean environment
The home was clean, with regular checks of cleanliness and the environment. Staff had access to aprons and gloves.
“The service was clean throughout, with no malodours identified.” from the report
Kind interactions
Inspectors saw most staff treating people warmly and having meaningful conversations. Staff also explained care tasks and knocked before entering rooms.
“We observed most staff treating people with affection and taking the time to have meaningful conversations, the atmosphere was relaxed, and people seemed to be at ease.” from the report
Food and choice
People could choose meals, and the home monitored their weights. People's different preferences about eating together or alone were respected.
“People were able to choose what they wanted to eat.” from the report
Risk of harm
seriousInspectors found that restraint was used when some staff did not have current training. Environmental risks, including possible ligature points and loose bricks, were not properly managed.
“People were not consistently being kept safe and protected from harm.” from the report
Insufficient staffing
seriousThere were not always enough staff, especially at night, to respond to incidents and meet people's needs. Staff also lacked required training and specialist mental health training.
“There were not always enough staff to be fully responsive to risks and meet people's needs, particularly at night.” from the report
Consent and restrictions
seriousThe locked front door was linked to one DoLS application, but the home had not considered its effect on other people. Capacity assessments and best-interest decisions were not consistently recorded.
“Consideration had not been given to whether this was posing a blanket restriction on the other people living at the service, or whether there were less restrictive ways of managing this risk.” from the report
Out-of-date care plans
needs fixingSome care records came from previous placements and were up to two years old. Behaviour support plans and risk records were not routinely updated after incidents.
“People who had transferred to the service from elsewhere, did not have updated, current care records.” from the report
Limited activities
needs fixingRelatives gave mixed feedback about whether people had enough activities and stimulation during the week and at weekends.
“We received mixed feedback from relatives on whether they felt people had access to enough activities and stimulation during the week and at weekends.” from the report
Weak oversight
seriousThe home's audits and checks did not find important problems identified by inspectors. Leadership had been inconsistent and the provider had overall legal responsibility in the absence of a registered manager.
“Due to poor governance systems and processes in place, people were not protected from risk of harm.” from the report
- 01How many staff are now on duty at night, and how do you make sure there are enough staff to respond to incidents?
- 02What current training do all staff have in safeguarding, restraint, medicines, the Mental Capacity Act and positive behaviour support?
- 03How are restraint incidents recorded, reviewed and reported to the CQC and the local authority?
- 04Have each person's risk assessments, behaviour support plans and care records been updated since this inspection?
- 05What activities and social opportunities are now available during weekdays and weekends?
This was a planned comprehensive inspection of the care home, covering all five CQC questions and both the premises and care provided. This explanation was written from the published report of 2 October 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 Sunnyside
3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- October 2020Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2019Inadequatedown from GoodSafe: InadequateEffective: InadequateWell-led: Inadequate
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- October 2013
Registered with the Care Quality Commission on 24 October 2013.
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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Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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