Sunnyside Nursing Home is a care home with nursing and provides care for adults, some of whom have dementia. The service, which first opened in 1984, is family owned and operated. There are three floors. The ground floor has some bedrooms, all of the communal spaces and ancillary areas like the kitchen, laundry and offices. The first floor and second floor have bedrooms and there are some communal bathroom facilities. In accordance with the current registration, the care home can accommodate up to 40 people. At the time of our inspection 36 people lived at the service.

At our last inspection, the service was rated good.

At this inspection we found the service remained good.

Why the service is rated good:

People were protected from abuse and neglect. We found staff knew about risks to people and how to avoid potential harm. Risks related to people’s care were assessed, recorded and reviewed. The management of risks from the building were also satisfactorily managed. We found appropriate numbers of staff were deployed to meet people’s needs. We made a recommendation about systems for the recording of people’s incidents and accidents. People’s medicines were safely managed.

Staff training and support was good. Staff had the necessary knowledge, experience and skills to provide appropriate care for people who used the service. The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People’s nutrition and hydration was appropriate. People told us they liked the food. Appropriate access to community healthcare professionals was available. The building and grounds were very well-maintained.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

We received complimentary feedback about service. People and relatives told us staff were kind and caring. People and relatives were able to participate in care planning and reviews and some decisions were made by staff in people’s best interests. People’s privacy and dignity was respected.

Care plans were person-centred and reviewed regularly. There was a satisfactory complaints system in place which included the ability for people and others to raise concerns. People had access to a meaningful social life, and the service had expanded their in-house programme and community outings which included an activities coordinator and three community outings each week.

The management of the service was in transition at the time of our inspection. There were appropriate systems for assessing and monitoring the safety and quality of care. We found staff worked within a positive workplace environment and were well-supported by the management team. Minor improvement was required with regards to the duty of candour requirement. We made a recommendation about staff surveys.

Further information is in the detailed findings below.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. Relatives, professionals and people who lived in the home were all asked for their feedback on the service each year. We looked at the comments book and saw the comments and responses had been positive.

The people we spoke with during our visit expressed positive opinions of the care provided by the home. People said that the staff were pleasant and were there when people needed them. A carer (a relative of a person living at the home) told us this person had improved greatly since admission. He said the family were thrilled with this outcome, and he praised the staff for their "excellent and compassionate care of a very elderly person."

The home was very clean and tidy, and people were kept safe from infection by the use of a clear infection control process. There were effective systems to reduce the risk and spread of infection.

There was an effective recruitment and selection process in place. Appropriate checks were undertaken before staff began work. This ensured people were looked after by suitably qualified staff.

All aspects of the service were reviewed monthly. The manager completed these audits and noted any actions required. The monthly audit was then reviewed, to ensure that all actions had been completed within the specified time scale.

The people we spoke with during our visit expressed positive opinions of the care provided by the home.

People told us that the staff were kind and helpful and were said to be always there when people needed them.

One person said that the home could be boring at times but they also told us that it puts on activities and that people particularly enjoy the entertainers who visited.

A carer (a relative of a person who was relatively new to the home) told us that the person had improved greatly since admission. The person had plenty of room to move around the home and there were always staff around to provide guidance and support.

The carer said that since admission to the home the restlessness shown by the person at home had declined, the person was said to appear much more relaxed, and on occasions now appeared to recognise their relative and neighbours when they visited having previously apparently lost that ability.

Sunnyside nursing home provides nursing care for up to 40 people with nursing needs including people with dementia. The service has three floors which provide nursing care. Sunnyside also provides shared bedrooms.

Sunnyside had a manager in place and was currently in the process of becoming the registered manager. An application had been submitted and was being processed. 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.

This inspection was undertaken over two days and was unannounced.

People told us they felt safe living at Sunnyside. Comments included “I feel safe living here, they look after me well”, “I like it here, it’s a safe place” and “I am really well looked after.” Staff were knowledgeable about their roles and responsibilities with regards to protecting people from abuse. Where safeguarding incidents had occurred, the home had appropriately notified the local authority and the Care Quality Commission. The manager was knowledgeable about how they would respond to allegations of abuse, and how they would act upon it. Clear safeguarding guidelines were available within the reception area for visitors and relatives.

We found staffing numbers to be sufficient within the service. The service used a dependency calculator to determine how many staff would be needed on each shift. We saw staff were consistently visible and supported people when requested or required. Call bells were answered promptly and people were supported in an unrushed manner. Medicines were managed well within the service and were audited frequently to ensure people were protected from risk of harm. Where risks were identified, the service had taken appropriate action to assess the risk and potential impact. Comprehensive risk assessments were in place and reviewed regularly to ensure people were protected from potential risks. Recruitment checks were undertaken within the service.

New staff received a comprehensive induction when starting employment with the service. The induction consisted of twelve weeks shadowing and training, and being signed off as competent before lone working. Staff completed training and supervisions which assessed their competencies.  The service had a clear supervision policy in place. Supervisions consisted of topics such as mouth care, infection control and included a mixture of observations and discussions. Staff we spoke told us they felt supported by the manager and the service to undertake their roles.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. 29 people were currently subject to a DoLS or awaiting a decision from the local authority. The registered manager understood when an application should be made and how to submit one and was aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service had a DoLS lead nurse in place who was responsible for overseeing DoLS applications. We found staff were knowledgeable around their roles and responsibilities when working with people around consent and the Mental Capacity Act (MCA). Staff were able to explain what the MCA and DoLS meant, and how this affected the people they worked with. Where required, mental capacity assessments were completed along with evidence of best interest meetings.

People’s nutrition and hydration needs were met within the service. We saw nutritious meals were provided which included frequent snacks and drinks. Where people were at risk of weight loss or had specific dietary requirements, these were met by the service. Nutrition and hydration intake was recorded appropriately were required and monitored as necessary. People were complimentary about the food. Comments included “The food is spot on”, “Its lovely food” and “There is always enough.” We found the homes environment to be clean, spacious and light. People we spoke with told us the home was nice. Comments included “It’s lovely here”, “There is a lovely garden” and “They always keep my room nice and tidy.”

We found staff to be caring, sensitive and treated people with dignity and respect. People and relatives we spoke with told us “The staff are very nice”, “The staff are really lovely”, “The staff are nice and always in a good mood, sometimes we sit here laughing till we ache.” The service accommodated people who required end of life care. We found clear process in place to ensure people were supported to remain comfortable and looked after in a dignified way. The service ensured peoples wishes were recorded and reviewed regularly.

Peoples care plans were detailed and reflected their current needs. Care plans were reviewed regularly when changes occurred and people were involved in their care planning. The service maintained good links with health professionals such as Doctors, Speech and Language therapists and Chiropodists. Weekly Doctors’ visits were undertaken within the service to ensure people’s health needs were met in a timely manner. We spoke with the Doctor allocated to the home who was very positive about the service.

We found the service to be well-led. Staff and relatives we spoke with were complimentary about the management of the service. Comments included “If I have questions, they always provide me with an answer”, “I think the home is well run, everything seems to be well managed” and “It’s a well-run home, the manager is very good.” Audits were taken within the service to provide quality assurance. Comments and complaints were acted upon appropriately. We found the culture of the service was that of an open one where staff communicated and supported each other throughout their shifts. Throughout our inspection, we found the manager to be visible and available to people when requested.