Inspection on 30/07/09 for Sunrise Operations Mobberley Limited (Assisted Living)

This inspection was carried out on 30th July 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sunrise Operations Mobberley... 05/11/09

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Sunrise Operations Mobberley Limited (Assisted Living) Sunrise Of Mobberley, Barclay Park Hall Lane Mobberley Knutsford Cheshire WA167DZ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Joan Adam     Date: 3 0 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 22 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Sunrise Operations Mobberley Limited (Assisted Living) Sunrise Of Mobberley, Barclay Park Hall Lane Mobberley Knutsford Cheshire WA167DZ 01565881021 01565881020 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Sunrise Home Help Mobberley Limited Name of registered manager (if applicable) Mrs Verity Williams Type of registration: Number of places registered: care home 65 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service only. Care Home with nursing - Code N To people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories:- Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is 65. Date of last inspection Brief description of the care home Sunrise Assisted Living was registered in February 2009 as a care home for people with nursing and provides twenty four hour care. It has 65 private rooms with ensuite facilities. Separate baths and showers are provided for people who need assistance. Lounges, an activities room, dining rooms and separate bistro are accessible to all Care Homes for Older People Page 4 of 22 Over 65 65 0 Brief description of the care home residents. The care home is on the ground floor of the main building with access to the first floor via stairs or lifts. The environment provides an excellent standard of accommodation. There is a pleasant garden which residents can use. Care Homes for Older People Page 5 of 22 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We made an unannounced visit to Sunrise Assisted Living on 30 July 2009. This was to assess if the home could meet the needs of people living there. During the visit we spoke to the acting manager,senior management, some staff members and some residents. Some of the comments we received is detailed in this report. Feedback was given to the acting manager and senior managers on the day of the visit. Care Homes for Older People Page 6 of 22 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 22 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 22 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are fully assessed before they live at Sunrise Assisted Living so they know their needs can be met. Evidence: We looked at the AQAA and this told us that each person and their family is given information regarding the home before they are admitted. When we visited the home we found this to be true. This information has been updated to show the new acting manager.The care plans for two newly admitted people were looked at. These contained pre-admission documents in the form of a checklist. The form had room for comments to be made and added information had been written to give a better picture of the person and their needs. These were signed and dated and had evidence that families had been involved in the assessment. Details from the hospital and social services were present in the file.This information was used to write a plan of care to let staff know what their needs were and how they could meet them. Care Homes for Older People Page 9 of 22 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans need to be kept up to date so that staff know the changes in care. Medication management need to improve so that people know they receive their medicines as prescribed. Evidence: Care plans were looked at for four people living at the home and it was found that that each person has a plan of care. These were written in a person centered way. The AQAA stated that each care plan is reviewed each month to give a desired overview to carers as to how to approach each resident. The plan gives accurate and up to date information to ensure that personal care is given correctly at all times. When we visited the home we found that some evaluations were not detailed and contained comments such as no change or needs met. We looked at a report completed by the wellness nurse which stated that the person had been non-compliant with care and she had discussed this with the GP. It was recorded that they had been prescribed some medication.The care plan did not reflect this so it was not possible to know how staff were managing this and what type of care the person was not complying with. Two of the care plans looked at had more detail in the evaluations but the care plans Care Homes for Older People Page 10 of 22 Evidence: had not been updated to reflect these changes. This means that staff would not be aware of the up to date care needed to look after these people. One person whose health had deteriorated and was now being looked after in bed requiring their position changed two hourly, the care plan had not been up dated. One person that needed increased pain relief had not had their care plan updated to show the new medication and their was no indication of how the staff were measuring how much pain the person was having. An evaluation for one person stated that they had poor diet and now needed supplements, this was not reflected in the care plan. This means that the plans do not give accurate and up to date information to ensure that personal care is given correctly at all times. A moving and handling assessment had been completed on each resident so that staff would know how to move them safely. Monthly weights were recorded.Choices were recorded such as when they liked to get up, where they spent their day and how their spiritual needs were met. Visits from other health care professionals such as G.Ps and district nurses were recorded so staff would know when these visits had taken place and why. We observed that the staff treated people with respect and appeared to have a good relationship with the people in their care. People spoken with said The staff work hard and they are lovely I love it here. One survey received by us saidthe carers are consistently helpful, cheerful and helpful in any way another said they take care of us very well The way in which the home managed medicines was looked at. On the day of the visit all Medication Administration Sheets (MAR) had been completed. The recording and administration of appeared to be satisfactory. The control drugs were checked and found to be correct and had been recorded appropriately. This home had recently commenced their new month of medications so only a few days of recording was seen on the MAR sheets. We looked at the audit system in place for checking the management of medicines had been completed each month by a designated senior staff member and these reports had been given to the the previous manager. Reoccurring errors that had been identified had not been addressed so that people could be confident that they received their medicines correctly. This was discussed fully with the acting manager and senior management on the day of the visit. We were informed that following the audits for July which were given to a senior manager the errors identified will be acted upon. Staff training has been arranged with regard to medication management for 1/08/09. Care Homes for Older People Page 11 of 22 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities take place so that people who live at the home are stimulated. Evidence: The home employs an activities co-ordinator who works flexible hours so that activities can take place at varied times. A programme of activitiies on offer is displayed in the main entrance hall and outside the activities room. Things such as chess, film shows, card making, baking club and trips out to local pubs for meals are the type of item that the home offers. There is Internet access and the people who live at the home are being taught and assisted to send and receive emails. One person said I think it is fantastic, I am using the computer to talk to my daughter via email activities are not compulsory A varied menu is on offer with a wide range of choices. One person said food is very good food can be variable but the homemade cakes are good I dont eat meat but they know that, there is always an alternative the standard of wine could be improved the chef has been to see me to discuss my food choicesThe dining room is a pleasant and relaxed environment. Extra staff are available to assist in the serving of meals. Care Homes for Older People Page 12 of 22 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Sunrise assisted living are confident that their complaints are listened to and staff have received training so that they know what to do to protect people. Evidence: The AQAA states that six complaints have been received by the home since they were registered in February 2009. We found that these had been recorded and any actions taken had been identified. People spoken with knew how to make a complaint and said that they would go to one of the senior members of staff. A copy of the complaints procedure is in the main entrance hall and in the service users guide. The home has a complaints procedure that advises people how any complaint they make will be dealt with. This is displayed within the home and a copy is in the service user guide. We considered that the complaints procedure could be improved by giving people the name of the home manager, and the name and contact details of the senior manager in the organisation for people to contact if they were not satisfied with the way the manager had dealt with their complaint, or if they wished to complain about the home manager. The home had procedures in place with regard to safeguarding adults is aware of Cheshire No secrets policy. Sraff have received training with regard to safeguarding adults so that they know what to do in the case of suspected abuse. Care Homes for Older People Page 13 of 22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a pleasant,clean and comfortable place for people to live, visit and work. Evidence: The home has been registered since February 2009. We walked round the home and looked in all communal areas, bathrooms and some bedrooms.The standard of decor and furnishings is of a high standard. The home has apartments which contain a sitting room, bedrooms with an ensiute and a small kitchenette. The corridors are wide and have small sitting areas which can be usedif people do not want to go in the main lounge. Equipment such as hoists, grab rails and pressure reliving mattresss are in place to aid the staff to care for people who need assisitance. The home was cleaned to a high standard on the day of the visit. Care Homes for Older People Page 14 of 22 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The number of staff on duty is insufficient to meet the needs of people who live at the home. Evidence: We looked at duty rotas for staff working at the home. At the time of the visit the home had forty eight people living there. At least thirty nine of those people need assistance with some or all aspects of personal care. We found that there is one trained nurse on duty for each shift. Between 8am amd 2pm there were six care staff, between 2pm and 8:30pm there were three to four carers and on the night shift there was only one carer supported by a twilight shift to 11pm. This was not sufficient numbers to meet peoples needs especially at night. People who live at the home said that At the moment they are short of staff sometimes the staff seem overworked, they seem to be cutting down on staff Survey forms received by us said that The carers are excellent but they are obviously short staffed more staff to deliver care and support the home gives good care but sometimes is understaffed This was discussed fully with the management at the home who said they will address the matter. We looked at the training for staff working in the home. This informed us that over half the care staff have achieved a national vocational qualification in care. This qualification shows that staff have had formal training to carry out their roles. We saw staff training is on-going and that all staff have received mandatory training in Care Homes for Older People Page 15 of 22 Evidence: key subjects. This means that staff have been given the skills to promote peoples health and welfare. Staff files were looked at for three new staff members staff files and found that they had the appropriate checks carried out before commencing work at the home so management was sure that people are safe to work with elderly people. Care Homes for Older People Page 16 of 22 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some areas of management need to improve to ensure that the home is well run. Evidence: The home does not have a registered manager in post at the present time. An experienced team leader is acting manager with support from senior managers. The home has formal meetings with residents and relatives and minutes are produced.Surveys received by staff stated that they felt the acting manager and senior managers communicated with them well and on a regular basis.Regular staff training sessions regarding fire safety are held to make sure staff know what to do in case of fire and there was a record of the names of staff attending. The AQAA gave us details of when equipment in the home had been checked and serviced to make sure that it continues to be safe and effective. Small amounts of residents monies are held and all transactions are recorded so people who live at the home know their money is safe. The recruitment system in place is robust so that all staff employed have the correct safety checks in place before they commence work at the home to enable the Care Homes for Older People Page 17 of 22 Evidence: manager to know if they are safe to work with elderly people. The medication audits that have been completed should be acted upon so that errors in medication management are addressed to ensure the safety of people living in the home. The numbers of staff on duty needs to improve so that the home knows the needs of people living there are fully met. Care Homes for Older People Page 18 of 22 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 19 of 22 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Evaluations need to be more 04/09/2009 detailed. So that staff are aware of what changes have taken place. 2 7 15 Care plans need to be up dated So that staff are aware of up to date care needs. 04/09/2009 3 9 13 Medication audits that report 04/09/2009 errors in medicine management must be acted upon. So that the medication management in the home is robust. 4 27 18 Adequate numbers and skill mix of staff must be provided. So that the needs of the people who live in the home can be met. 04/09/2009 Care Homes for Older People Page 20 of 22 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 22 of 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!