30 Sunnyfield provides care for up to three people who have a learning disability. The service helps assist people to live fulfilling lives and to become more independent. There were three people living in the home when we visited. The home has three floors. There is a self-contained flat on the ground floor, a lounge and kitchen/dining area on the second floor, two bedrooms and a bathroom on the third floor. There is a garden to the rear of the property.

The inspection took place on 12 June and 6 July 2017. The first day of the inspection was unannounced. We returned announced for a second day as two of the people who used the service were away on holiday on the first day.

An experienced registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection in November 2014 we rated the service as ‘Good’ overall, with the ‘Is the service responsive?’ domain rated as ‘Outstanding.’

At this inspection we found the ‘Is the service responsive’ domain maintained its ‘Outstanding’ rating. In addition, we found further outstanding practice relating to leadership and management, and also rated the ‘Is the service well led’ domain ‘Outstanding’. This meant we were able to rate the service as ‘Outstanding’ overall. We found strong evidence the service actively sought the views of people using the service through innovative methods, fully involving them in governance, quality and knowledge sharing. We found an extremely dedicated and knowledgeable management team committed to ensuring people were able to live as fulfilling lives as possible. Staff showed consistent attention to detail which meant people received an outstanding level of care and support that was completely centred on each individual’s needs. This promoted people’s health and wellbeing and enhanced their quality of life.

People said the standard of care and support was excellent and they were extremely well cared for. People spoke very highly about staff, the support they received and opportunities available to them. People had developed exceptionally strong relationships with staff, felt able to confide in them and saw them as role models. Staff including management knew people very well and consistently helped them achieve their dreams and aspirations.

The service fostering strong links with the local community. This empowered people to be involved in events and activities which took place in the local area. People were enabled to undertake voluntary work and encouraged to develop friendships with others. Due to the resources available and dedication of the staff team, people had access to an exceptional range of activities. These helped people achieve their dreams and build self-confidence.

The service was exceptional at helping people develop their independence through a series of well thought out goals. People were fully involved in the planning and setting of these goals. People’s achievements were celebrated by the service to help build further confidence.

There was a highly person centred culture within the service which ensured that people were put at the heart of everything. Staff were passionate about providing highly flexible care and support based on people’s preferences and preferred daily regimes.

People were involved to the maximum extent possible in their care and support arrangements. People were knowledgable about their plans of care, future goals and activities. People were encouraged and supported to be actively involved in the running of the service. People chaired meetings, attended internal and external events and disseminated learning and knowledge from these to staff and the other people they lived with.

The ser

This inspection took place on 3 November 2014 and was unannounced. At the last inspection in November 2013 there were no identified breaches of legal requirements in the areas we looked at.

30 Sunnyfield provides care for up to three people who have a learning disability. The home is a ‘stepping stone’ service for people who aspire to be more independent. There were three people living in the home when we visited. The home has three floors. There is a self-contained flat on the ground floor, a lounge and kitchen/dining area on the second floor, two bedrooms and a bathroom on the third floor. There is a garden to the rear of the property.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. However, the registered manager had recently been promoted to Care Homes Manager and was going to be cancelling their registration with CQC and an acting manager was in charge of the home when we inspected.

People told us they felt safe at the home. Risks to people were managed well and gave people freedom, yet kept them safe. Staff were trained in safeguarding and understood how to recognise and report any abuse. Staffing levels were sufficient which meant people were supported with their care and enabled to pursue interests of their choice in the community. People were supported to manage their own medicines safely.

No-one at the home was subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Staff had developed positive, respectful relationships with people and were kind and caring in their approach. People were given choices in their daily routines and their privacy and dignity was respected. People were supported and empowered to be as independent as possible in all aspects of their lives. People’s nutritional needs were met and they received the health care support they required.

Staff knew people well and were trained, skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles. People told us they were happy with the care they received, which we saw was tailored to meet their needs. People were involved in planning and reviewing their care and support. Daily routines were centred around people’s individual preferences and requirements. People were supported to lead active and fulfilling lives pursuing activities of their choice in the home and out in the community.

Systems were in place to assess and monitor the quality of the service and the focus was on continuous improvement. People and staff were actively involved in developing the service. There was strong leadership which promoted an open culture, which put people at the heart of the service.

Sandringham Court is a ‘step-up’ service which means that people living here have moved on from Sunnyfield residential home. The aim of the service is to enable people to become more independent and hopefully move on to more independent accommodation in the future. The flat on the ground floor is a way to enable people to develop skills to live a more independent life.

We spoke with one of the people who used the service and they told us that they were happy living in the home. They felt that the staff were “good at their job” and told us that staff “support me and help out”.

The staff we spoke with told us that they were happy working there. They felt the training they received was “very good and appropriate for the group of people we work with”

We looked at two care plans and we saw that they were comprehensive with an emphasis on the persons strengths. We saw that risk assessments had been carried out and risk management plans put in place to reduce risk. We saw that the risk and care plans were tailored to meet the need of the individual.

The staff we spoke with told us they had received training in safeguarding and were able to tell what they would do if they had any concerns about the way people were being treated.

We spoke with one of the people who used the service. They told us they felt safe living at the home and were able to tell us what they would do if they had any concerns.

We saw that there was a sign letting people who used the service how to complain if they were unhappy with any aspect of the service. The sign used pictograms to help people who had difficulty reading.

People said staff treated them with dignity and respect. One person told us; "I plan my weekly routines with my key worker. I am very busy and have a good life.”

People told us they received very good support from all of the staff team. One person said; “I like living here.” They also said they regularly met up with their key worker to review their care and to discuss if any changes were needed to the support they were receiving.

Staff spoken with demonstrated good attitudes towards positive risk taking. Because of this people who were using the service said they felt “trusted.”

People who wanted to have a holiday chose where they wished to go and this was accommodated.

People were encouraged to manage their own medication although they needed support with this. One person said; “I keep my own medication but need help with this, although I am hoping to be able to do it for myself one day.”

A person who was living in the home explained they had been involved in the recruitment of new staff in the past.

People spoke highly of the management and staff team and said they had a lot of involvement in decision making about how the home was run.