CQC report explained · a residential care home
What the CQC found at Sunnywell
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 were not always protected from risks, including environmental hazards, unsafe medicines management and poor infection control. Staff numbers and recruitment were suitable, but safety checks and incident reviews were not reliable.
- Effective?
- Requires improvement
- Some staff had not completed relevant training, and the training records were not up to date. People were supported with food, healthcare, consent and personal choices, but the shortfall in staff training affected the rating.
- Caring?
- Good
- Staff provided kind, compassionate and respectful care. People were offered choices, involved in their care and supported to express themselves and maintain their dignity.
- Responsive?
- Good
- Care was personalised and people, families, advocates and social workers were involved in care planning. Staff understood communication needs and supported people with activities, relationships and access to the community.
- Well-led?
- Requires improvement
- Management had made some improvements, but audits and checks had not found the problems identified by inspectors. Leadership, staff accountability and oversight needed to be strengthened.
What inspectors found, May 2023
Rated Requires Improvement; inspectors found kind, person-centred care but safety, staff training and management systems were not reliable.
This was an unannounced inspection on 21 and 28 March 2023. Inspectors spoke with people, relatives, managers and staff. They observed care and reviewed care plans, staff files, medicine records, audits and other records.
People were treated with kindness and respect. Staff supported people to make choices, communicate, access activities and use local services. Staffing levels were enough to meet people's assessed needs, and relatives were positive about the safety of the care.
However, inspectors found important safety problems. Medicines were not always recorded or counted correctly. Cleaning was not effective, with dirty areas, mould and strong smells. Some staff lacked relevant training, and care plans and checks did not always identify or manage risks properly.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement, while Caring and Responsive remained Good. The report says the provider must improve and that CQC will monitor progress.
Kind and respectful care
People were treated with kindness, compassion and respect. Staff offered choices and supported people's dignity and independence.
“People received care and support that was kind, caring and compassionate.” from the report
Good communication
Staff understood people's communication needs and used different methods to help people express their wishes.
“Staff used alternative methods to effectively communicate with people who had communication needs or difficulties.” from the report
Activities and community access
People had a broad range of activities and were supported to go out, develop skills and maintain interests.
“People had access to a full programme of activities which were overseen by staff.” from the report
Suitable staffing levels
Inspectors found that staff were deployed to meet people's individual needs and planned additional support hours.
“Staff were deployed to meet people's individual needs and safety.” from the report
Medicine errors and incomplete records
seriousMedicine stock counts were sometimes wrong, and records for applying creams were incomplete. The home could not always show that staff remained competent to administer medicines safely.
“We found several examples of where the stock count of medicines was incorrect meaning people may have been given more or not enough of their prescribed medicines.” from the report
Poor cleanliness and hazards
seriousInspectors found bleach hazards, dirty and disorganised kitchens, stained flooring, black mould and strong smells. Cleaning procedures were not being followed effectively.
“There were stains and marks on flooring and kitchens were dirty and disorganised.” from the report
Staff training gaps
seriousStaff had not completed all the training needed for the people they supported. The report gave the example that only 10 of 40 staff had completed first aid training.
“The provider had not ensured staff had completed all relevant training.” from the report
Weak management checks
seriousAudits and checks did not identify problems with medicines, health and safety, infection control and records. This increased the risk that improvements would not last.
“Systems and processes that monitored quality and safety required improvement.” from the report
- 01What has been done to remove the bleach hazards, black mould, dirt and strong smells found during the inspection?
- 02How are medicine stock counts, cream application records and staff medicine competency checks now being monitored?
- 03How many staff currently have the training needed for the people living here, including first aid and positive behaviour support?
- 04How are accidents, incidents and risks now reviewed for patterns and followed up?
- 05How will you show that audits identify problems promptly and that improvements are being maintained?
This was an unannounced inspection of the care provided and premises, covering all five CQC questions and infection prevention and control, with visits on 21 and 28 March 2023. This explanation was written from the published report of 4 May 2023 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, December 2017
Sunnywell rated Good overall; inspectors found kind, personalised care but medicine arrangements needed improvement.
This was an unannounced first inspection on 25 September 2017. Inspectors looked around the home, observed care, spoke with six people, four staff members and managers, and checked care and management records.
People said they felt safe and were comfortable with staff. Inspectors found enough staff, detailed care plans, respectful support, personalised activities and good systems for training, choice, complaints and quality checks.
The main weakness was medicines. Two people had run out of medicines, one prescribed cream had not been applied as recorded, and guidance for using some creams was missing. The home took action after the inspection, including improving its medicine audits and care plans.
Safe environment
Inspectors found the home clean, pleasant and well maintained. Equipment and emergency arrangements helped people stay safe while living independently.
“People lived in a safe, clean, pleasant and well maintained environment.” from the report
Personalised care
Care records included people's backgrounds, preferences and communication needs. Staff used this information to support people in individual ways.
“Care records were personalised and contained good information about people's background, which ensured staff understood people's needs and preferences.” from the report
Kind and respectful staff
People appeared comfortable with staff, who respected privacy and dignity. Staff spent time with people and understood them well.
“Staff were caring and it was evident they knew the people they were supporting well.” from the report
Choice and activities
People helped plan their meals, activities and care. Activity programmes reflected what people wanted to do at home and outside.
“People had activity programmes that identified what they were doing throughout the day and included what people did at home and what they did when they went out.” from the report
Supportive management
Staff said managers were approachable and supportive. The home had a clear improvement plan and systems for gathering people's views.
“People who used the service and staff were encouraged to share their views and put forward suggestions.” from the report
Medicines ran out
seriousTwo people did not have enough medicine. The provider acted immediately in one case, but the ordering system had not prevented this happening.
“two people had run out of their medicines.” from the report
Cream instructions and records
seriousInstructions were missing for how thickly and where some creams should be applied. One cream was recorded as not being applied over a period of time.
“We found the service was not following current guidance on external medication.” from the report
Health action plans
needs fixingPeople did not have up-to-date health action plans explaining the help they needed to stay fit and well. The provider was liaising with health professionals about this.
“We recommend that the service considers current guidance on health action plans.” from the report
Daily records
minorDaily progress notes contained useful information but did not give an easy overall picture of a person's care. Managers said they would review the recording system.
“However, it was difficult to get a holistic overview.” from the report
- 01What new checks now make sure medicines and creams do not run out?
- 02How do you check that creams are applied to the correct area and in the correct amount?
- 03Have up-to-date health action plans now been completed for every person?
- 04How do staff respond when someone refuses prescribed medicines or health appointments?
- 05How have you improved daily records so they give a clear overall picture of each person's care?
This was an unannounced first inspection covering all five CQC questions and the overall quality of the home. This explanation was written from the published report of 8 December 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 Sunnywell
2 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016
Registered with the Care Quality Commission on 18 July 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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