About the service:

Sunnybrook Close is a residential care home that was providing personal and nursing care to three people at the time of the inspection. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Sunnybrook Close is a three-bedroom bungalow with a rear back garden. Adaptations have been made to accommodate the needs of the people living there.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways promotion of choice and control, independence, inclusion e.g. People's support focused on them having as many opportunities as possible for them to gain or maintain skills and become or maintain their independence.

People’s experience of using this service:

The service was rated good in all domains. This was because we found systems were in place to ensure the safety of people living in the service. Checks had been completed on essential safety apparatus such as fire protection equipment and hoists. Services such as gas and electricity had been maintained.

One person’s relatives told us “The staff are wonderful, loving and caring. I have the highest regard for them all.”

Staff understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People were supported to have maximum choice and control of their lives through the support of advocates. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s nutritional and dietary needs were assessed, documented and care was provided in line with their needs. External professionals provided advice when needed.

People were treated equally by the staff. Training was provided to staff the area of equality and diversity.

Information about people was being recorded in a respectful and dignified way. Records were not always up to date and clear in their content. This was because people’s needs were changing quickly. The registered manager was looking at ways to ensure records kept pace with the change, to ensure information provided appropriate direction for staff in how to care for people. People’s health care needs were monitored closely.

Staff told us they felt supported by the registered manager. The staff in the service were caring. They told us they worked well as a team. They respected each other and supported each other.

They also received support through regular training, supervision and team meetings.

Staff were trained and knew how to protect people from the risk of abuse. Where concerns had been raised these had been dealt with appropriately.

A recruitment system was in place that minimised the risk of unsafe candidates being employed.

Medicines were stored, administered and disposed of by trained staff.

Effective quality assurance tools were in place to drive forward improvements, these had been used and their impact was apparent.

People participated in activities to protect them from the risk of social isolation.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensured that people who use the service can live as full a life as possible and achieve the best possib

This inspection took place on 10 and 11 October 2016. It was an announced inspection. At the time of this inspection the registered manager of the service was on long term leave. The position was being covered by the assistant manager and the operations manager. We needed to be certain someone would be available to give us access to documents and to speak with us. During this inspection the assistant manager was present.

Sunnybrook Close is a bungalow which accommodates three adults with learning disabilities.

There is a registered manager in place. 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.

Sunnybrook Close was last inspected in January 2014. It was found to be compliant with the requirements of the Health and Social Care Act 2008 Regulations 2010.

Staff were able to identify indicators of abuse and knew how to report their concerns. Risk assessments were in place to ensure any risks to people and staff were minimised. Where accidents or incidents had occurred, these were documented and actions were taken to minimise a reoccurrence.

People’s medicines were stored, administered and recorded in a safe way. People’s needs and preferences with regards to their medicines were documented. Staff were trained in how to administered medicines safely. This protected people against the risks associated with medicines.

We observed and staff told us there were sufficient numbers of staff to assist people during the day and night. Staff received supervision, training and appraisals to assist them to perform their role to the best of their abilities. Staff felt supported by the assistant manager and the operations manager. They spoke positively about the culture of the home, stating they felt listened to and any suggestions or ideas were considered and actioned if appropriate.

Care plans documented people’s needs and considered people’s preferences in how staff should support them. We observed staff had a healthy rapport with people. There were constructive interactions with people and a lot of humour was used to encourage people. Staff displayed a caring attitude towards the people they supported. People responded in a positive way towards staff.

Staff told us the team was productive and supportive towards each other. They communicated well and shared ideas and information. This assisted the service to ensure information was accurate and correct and ensured the delivery of appropriate care.

Safe systems of recruitment were in place, this protected people from the risk of harm. We found one record that did not appear to have been checked and verified. Following the inspection we received assurances from the provider, that steps had been put in place to prevent a reoccurrence, and in future the necessary checks would be carried out.

Staff were aware of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff had taken the appropriate steps to apply to the local authority where restrictions were in place to keep people safe.

People had access to health professionals, and staff were proactive in ensuring people’s health needs were monitored. Staff advocated on behalf of people to ensure they as staff got the right support to assist people with their health needs. They were not afraid to challenge health professionals if they felt people’s medicines were not having a positive effect on the person. Where medical advice had been sought this was followed through by staff.

People enjoyed participating in a range of activities both within the service and in the community, these included swimming, bowls, holidays and arts and crafts amongst others. People’s nutritional needs were monitored to assist people

The people living in Sunnybrook Close had complex needs and were unable to communicate their views to us verbally; although they appeared to be at ease, relaxed and comfortable. We observed the interactions between the people living in the home and the staff. The home was well established and the staff were responsive to the people living there. Staff appeared to understand their needs and this had been achieved, they said, through continuity of care.

The home was fresh and clean and the rooms were light and airy. We saw that people had created their own individual environments and they were well occupied with activities. During our visit one of the people went out food shopping with a member of staff and enjoyed this task.

We spoke with two members of staff and they were both positive about working at the home. They told us there was an 'acting' manager covering in the temporary absence of the permanent manager. The staff said everything was 'fine'. The acting manager was not present during our visit.

We found that care plans and records were up to date, including assessments of risk, monthly summaries and activity planners. We found that the staff were working sensitively and consistently with the new person in the home to help them to settle in.

We spoke with two relatives about the home and they were both positive. One relative said 'It is always brilliant, we have never had a problem'. Another relative said 'I cannot fault the place'.

The people using this service had complex needs and were unable to communicate their views directly to us. We saw that staff were responsive to people, showed a good understanding of people’s needs and treated people with respect. People and staff seemed at ease together.

We spoke to a relative of a person using the service. The person described the service as “Wonderful”. They said the staff were “excellent”. Their relative participated in a range of activities and enjoyed a very good quality of life. They now went out in the community more and “…never looked so happy”. From their point of view they said they now had peace of mind and were reassured to know their relative was so well looked after.

We spoke to a social care professional who had recently visited the home. The professional told us it was a clean and tidy service and that the people using it appeared to be at ease. They thought people were being well supported in the majority of areas. While there were matters to address those did not raise any immediate concerns about the care and welfare of people using the service.