Care Home: Sunrise Operations Mobberley Limited (Assisted Living)

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What the care home does well The senior staff visit people wherever possible to carry out an assessment of their care needs before they move in to the home to ensure that their needs can be met there. Good information is given to prospective residents so that they can make an informed choice of whether the home is the right place for them to live. Individualised care and attention is provided and there is a welcoming cheerful environment so that people who are cared for feel comfortable and at home. People`s plans of care were well documented and reflected each person`s individual needs. We found people receive care and support that matches their expectations. Staff respond to changes in people`s health care needs and have a good understanding of the importance of treating people as individuals and promoting their privacy and dignity. Survey forms stated " " the staff are cheerful and smiling " Very good accommodation, first class management and staff" Meals were varied and offered choice and variety. A survey form included the comment that, "good variation of choice at meal times.". " meals are good" People who live at Sunrise have choices about how and where they spend their time and the home provides a varied range of activities so that people have enough to do. A good standard of hygiene was seen throughout the home and the standard of decor was excellent. Staff were seen to treat people they cared for with respect and had an easy friendly manner. Staff were seen to provide support in a sensitive and caring way. One relatives said" I always get a lovely welcome when I walk thought he door" The home is now managed by a well qualified and experienced management team. Staff, residents, and their visitors are given opportunities to express their views about the home. This helps to make sure the home is run in a way that suits residents` needs and preferences. Good recruitment procedures are followed to make sure new staff are suitable to work with vulnerable older people. All new staff complete a thorough induction programme to make sure they know how they should provide care for the people who live at the home. Most of the care staff have an national vocational qualification (NVQ) in care so they have the knowledge and skills to provide care for the people who live there. These are nationally recognised qualifications for people working in care and show they have been assessed as competent to provide good quality care. Staff have regular one to one meetings with their manager or a senior staff member to ensure that they have the opportunity to discuss any concerns they have and are given the support they need. Regular auditing shows where staff are not achieving the required standard so that the managers can address this with them to make sure that residents receive good quality care. What has improved since the last inspection? The care plans have been improved since our last visit so that all changes to care are recorded and all staff are aware of current needs. The checking of medicines has improved so that people can be sure they receive their medicines as the Doctor has prescribed them. What the care home could do better: Sunrise assisited living provides a good service to the people who live there. This is confirmed by the people themselves and the staff. The home has a good reputation in the local community and it is important for them to maintain the standards that they are currently achieving. No requirements or recommendations have been made as a result of this inspection. We saw evidence that the management are always looking at ways to improve the service they provide. 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:   two star good 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: 2 1 0 4 2 0 1 0 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 23 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 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 maximum number of people who can be accommodated is 65. 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 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 23 0 5 1 1 2 0 0 9 0 Over 65 65 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 23 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: two star good 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 carried out an unannounced visit to the home on 21 April 2010 and the visit lasted seven and a half hours. It was done by two inspectors. The report will say we when referring to what was done and found at the visit, as it is written on behalf of the Care Quality Commission. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about the home. We sent out questionnaires to the people who live in the home and the staff team to find out their views about Sunrise assisted living. Other information about the home was also reviewed. During our visit we looked at various records and the premises. We looked at the care records of four people who live at the home, to see how their needs were being met. We also looked at four staff files to ensure that thorough recruitment processes had Care Homes for Older People Page 6 of 23 taken place and that people who live in the home were safeguarded from harm and supported safely. We spoke with some of the people who live at Sunrise and the general manager, acting manager and other staff who were on duty at the time of this visit. They all gave their views about the home. Care Homes for Older People Page 7 of 23 What the care home does well: The senior staff visit people wherever possible to carry out an assessment of their care needs before they move in to the home to ensure that their needs can be met there. Good information is given to prospective residents so that they can make an informed choice of whether the home is the right place for them to live. Individualised care and attention is provided and there is a welcoming cheerful environment so that people who are cared for feel comfortable and at home. Peoples plans of care were well documented and reflected each persons individual needs. We found people receive care and support that matches their expectations. Staff respond to changes in peoples health care needs and have a good understanding of the importance of treating people as individuals and promoting their privacy and dignity. Survey forms stated the staff are cheerful and smiling Very good accommodation, first class management and staff Meals were varied and offered choice and variety. A survey form included the comment that, good variation of choice at meal times.. meals are good People who live at Sunrise have choices about how and where they spend their time and the home provides a varied range of activities so that people have enough to do. A good standard of hygiene was seen throughout the home and the standard of decor was excellent. Staff were seen to treat people they cared for with respect and had an easy friendly manner. Staff were seen to provide support in a sensitive and caring way. One relatives said I always get a lovely welcome when I walk thought he door The home is now managed by a well qualified and experienced management team. Staff, residents, and their visitors are given opportunities to express their views about the home. This helps to make sure the home is run in a way that suits residents needs and preferences. Good recruitment procedures are followed to make sure new staff are suitable to work with vulnerable older people. All new staff complete a thorough induction programme to make sure they know how they should provide care for the people who live at the home. Most of the care staff have an national vocational qualification (NVQ) in care so they have the knowledge and skills to provide care for the people who live there. These are nationally recognised qualifications for people working in care and show they have been assessed as competent to provide good quality care. Staff have regular one to one meetings with their manager or a senior staff member to ensure that they have the opportunity to discuss any concerns they have and are given the support they need. Regular auditing shows where staff are not achieving the required standard so that the managers can address this with them to make sure that residents receive good quality care. Care Homes for Older People Page 8 of 23 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 9 of 23 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 10 of 23 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: The AQAA we received told us that each person and their family is given information regarding the home before they are admitted. We looked at this information when we visited the home.The care plans for two newly admitted people were looked at. These contained pre-admission documents in the form of a checklist. The form was detailed and gave information needed to enable the trained staff to write care plans so that staff would know know what their needs were and how they could meet them. Information from other agencies was present in the file. Care Homes for Older People Page 11 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are well kept records that show people who live at Sunrise Assisted Living have their health, personal and social needs met in a way that respects their dignity and individuality Evidence: We looked at the AQAA. This told us that people who live in the home should expect to receive care in a way that they choose. The care plans have improved since the last big visit we made to the home. We made a small focused visit in February and work was in progress at that time. We saw that each person has a plan of care, which gives staff instructions on how to provide care in a way which people preferred. These were written in person centred way. All plans of care were reviewed each month so that any changes were up dated and all staff would know what changes if any had been made. Risk assessments had been completed for each area that gave staff concern such as moving and handling assessment so that staff would know how to move them safely. Areas of concern such as the nutritional needs of people living there so that staff would be able to quickly assess if the person was at risk of loosing weight. Weights were recorded on a weekly or monthly basis. The choices of people living in the home Care Homes for Older People Page 12 of 23 Evidence: 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, nursing home co-ordinators and district nurses were recorded so staff would know when these visits had taken place and why. The daily records written by staff were detailed so that a picture was painted as how the resident liked to spend thier day and all staff would know what had taken place during the shift. The manager audited the care plans on a monthly basis so that areas of concern could be acted upon. The atmosphere in the home was warm and welcoming and all staff were seen to be friendly and appeared to have good relationships with the people in their care. When spoken with staff were aware of peoples needs and their likes and dislikes. Residents spoken with said It is a lovely place to live. The staff are really good, very friendly. Relatives spoken with said The staff bend over backwards to help Survey forms received by us had the following commentsStaff are always smiling and cheerful Staff are reliable and caring. The way that medicines are managed has improved since our last visit. Policies and procedures are in place for the safe management of medications and staff training has taken place so that staff are aware of their responsibilities regarding the safety of medicines in the home. The home uses a blister pack system for medication so that staff can see which medicines have been given out each day. All medication administration sheets had been completed. Controlled drugs were looked at and the checking of these by staff had been recorded appropriately. Items with a short shelf life in the drug fridge had been dated and signed so that staff would know when these had been opened. The medication management was audited every week so that any errors were identified and dealt with quickly. Care Homes for Older People Page 13 of 23 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. Sunrise assisited living has well managed social activities and meals so they provide daily variation and interest for the people living at the home. Evidence: We looked at the AQAA which told us that the provision of activities on offer is varied and takes in to account the needs and wishes of the people who live in the home. When we visited we found this to be true. We found a varied activities programme was on offer each day for people to join in if they wish. There are two activities coordinators and the activities are on offer at varying times and at weekends. People spoken with said There is always plenty to do I like my own company but am not forced to join in The menu is varied and the food on offer looked good. Comments regarding food were food good, varied choice, improvements to food of late, standard of food good. Staff were seen to assist people to eat in a relaxed and dignified manner. Staff are employed to serve food in the dining room. Care Homes for Older People Page 14 of 23 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. The homes procedures for complaints and safeguarding are effective so that the concerns of people who live at Sunrise assited living are listened to and they are protected from abuse or harm. Evidence: When we looked at the AQAA this told us that four complaints have been received by the home since the last visit. The complaints file was looked at and we found that complaints had been fuly recorded, investigated and actions identified had been acted upon. A copy of the complaints procedure is in the main entrance hall and in the service users guide. We spoke to people who live in the home and they knew who to speak to regarding comcerns and felt that they were listened to and their concerns were taken seriously. The home had procedures in place with regard to safeguarding adults is aware of Cheshire No secrets policy. Staff have received training with regard to safeguarding adults so that they know what to do in the case of suspected abuse. Staff spoken with confirmed that they knew what to do in the case of suspected abuse. Care Homes for Older People Page 15 of 23 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 very pleasant clean place to live, visit and work. Evidence: The home has been purpose built to a high standard with apartments which contain a sitting room, bedrooms with an ensuite and a small kitchenette. The corridors are wide and have small sitting areas which can be used if people do not want to go in the main lounges. The home has adequate equipment to care for people with nursing needs and for the prevention of infections. The AQAA told us We use a microfibre cleaning system and combined with an effective housekeeping team this does ensure that our home is beautifully presented,clean and odour free. It said that it has improved the cleanliness in the last twelve months byThe appointment of a stronger and more dedicated workforce in the housekeeping and laundry department Care Homes for Older People Page 16 of 23 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 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 supported by trained, effective staff who have gone through a thorough recruitment process, so that peoples needs are met and they are safe from possible harm or poor practice. Evidence: We looked at the homes AQAA which showed us that a variety of staff are employed to provide care and support to the people who live in the home and that the staff was recruited correctly. We found this to be true. We found that staff are supplied in sufficient numbers to meet peoples needs and people who live in the home said they thought that there was enough staff on duty on each shift. The numbers of staff have been improved since the last big inspection. More trained nurses are being recriuted for night duty. We saw that some of the staff working in the home have achieved a national vocational qualification in care. This shows that staff have had formal training to carry out their roles and is above the expectations of the national minimum standards. Other staff members are undertaking the course and a further number of staff have been enrolled to commence in the near future. We saw staff training is on-going and that all staff have received mandatory training in key subjects. This means that staff have been given the skills to promote peoples health and welfare. Staff spoken with Care Homes for Older People Page 17 of 23 Evidence: confirmed that training has taken place. People who live in the home saidThe numbers of staff have increased, there are more nurses here now There are more nurses to look after us Care Homes for Older People Page 18 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management has improved and the views of people who live at the home are Evidence: The home does not have a registered manager in post, however the general manager informed us that a manager application has been sent to CQC. The acting manager is an experienced nurse with many years experience in nursing and management. She knows the people who live at Sunrise and the staff team well. The general manager had completed the information about the home we ask for each year, the annual quality assurance assessment that gave us information about the home and what had been happening there during the twelve months before our visit. This information gave us a good overview of how the home was being run. A monthly monthly visit from the a representative of the organisation that runs the home takes place and a report is produced. Meetings take place on a regular basis with people who live at the home and minutes are produced and circulated. Meetings are held with all grades of staff and day to day supervision of staff was good and regular formal supervision was being undertaken Care Homes for Older People Page 19 of 23 Evidence: with records kept. This ensures staff have a chance to discuss their work with their manager, so they can provide good quality care of the people who live at Sunrise. Staff spoken with said we are well supported things are improving Mandatory training takes place for all staff in fire safety, moving and handling and the safeguarding of adults.Training records are kept on the computer and are updated when training has taken place . 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. Safe working practices were in place in the home. There were up to date safety checks on the homes electrical wiring and gas installation. All checks with regard to fire safety were up to date and checks were also completed on the emergency lights, hot water system and call system. Small amounts of residents monies are held and all transactions are recorded so people who live at the home know their money is safe. A good robust recruitment system in place so that all staff employed have the correct safety checks in place before they commence work at the home to enable the manager to know if they are safe to work with elderly people. Audits are in place with regard medications so that errors can be acted upon quickly to ensure the safety of people living in the home. The numbers of staff on duty has improved so that the home knows the needs of people living there are fully met. Care Homes for Older People Page 20 of 23 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 21 of 23 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 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 22 of 23 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). 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