Sunrise of Weybridge provides care and accommodation for people some of whom have dementia. The home is registered for 110 residents and is a purpose built home. At the time of our visit 97 people lived at the home. The home is split into two areas. One area, called ‘reminiscence’ is for people who are living with dementia. The other area, called ‘assisted living’ was for people who could live fairly independently with minimal support from care staff.

There was not a registered manager 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. The manager that had begun the registration process had moved on within the Sunrise organisation. A new manager was in post, and was in the process of applying to be registered. This manager was present at the inspection.

At out last inspection, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

Hazards to people’s safety were identified and action was taken to help them manage the risks of harm to keep themselves safe. People received their medicines safely and in line with prescription guidelines. Accidents and incidents were reviewed and action taken to minimise the risk of them happening again. There was a plan in place to ensure that people’s care would continue in the event of an emergency.

People were supported by sufficient, skilled staff to meet their needs and robust recruitment processes were in place to ensure only suitable staff were employed. Staff were aware of their responsibilities in safeguarding people from abuse.

Staff received induction and then on-going training to support them in their roles. Staff received regular supervision and told us they felt supported by the manager

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. People had enough to eat and drink and were supported with this where a need had been identified.

People were supported to remain healthy, and referrals were made to appropriate healthcare professionals should the need arise.

People’s care records were person centred and completed in detail. Care plans were regularly reviewed and updated to ensure staff had up to date guidance regarding people’s care. People had access to a range of activities in line with their interests.

People received support from staff who knew them well. Staff treated people with kindness and were aware of their preferences. People’s religious and cultural needs were respected.

Systems were in place to monitor the quality of the service provided and ensure continuous development. There was a complaints policy in place and relatives told us they would feel comfortable in raising concerns. .

Further information is in the detailed findings below.

Sunrise Operations Weybridge Limited is a care home providing accommodation and personal care for up to 110 older people, who may also be living with dementia. There were 91 people living in the home at the time of our inspection.

The inspection took place on 27 March and was unannounced.

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 2008 and associated Regulations about how the service is run.

We carried out an unannounced comprehensive inspection of this service on 19 August 2015. Two breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to staffing and the safe management of risks. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This inspection found that the provider had taken the action they told us they had. This report only covers our findings in relation to the safety of the service. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Sunrise Operations Weybridge Limited on our website at www.cqc.org.uk”.

There were now sufficient staff deployed across the service to support people in a safe and personalised way. We saw that people’s needs were met and they received support they needed in a timely way. At mealtimes, staff across the service now worked effectively together to ensure that people who required assistance with eating and drinking received one-to-one support.

There were good systems in place to safeguard people. Appropriate checks were undertaken to ensure only suitable staff were employed. Prior to starting working, information about new staff was collated to ensure they were fit to work with people whose situations made them vulnerable. Staff understood their roles and responsibilities in keeping people safe from the risk of abuse.

Risks to people were now appropriately assessed. Where risks were identified, action had been taken to mitigate the risk of avoidable harm. Staff adopted a positive approach to managing risk that carefully balanced keeping people safe with their right to lead independent lives.

Medicines were managed safely and there were good systems in place to ensure people received their medicines as prescribed.

Sunrise Operations Weybridge Limited is a care home providing accommodation and personal care for up to 110 older people, who may also be living with dementia. There were 85 people living in the home at the time of our inspection.

The inspection took place on 19 August 2015 and was unannounced.

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 2008 and associated Regulations about how the service is run.

We found that some risks to people had not always been appropriately assessed and monitored to ensure that control measures were adequate and followed. For example, we observed one person fall and two others nearly fall as a result of a certain type of chair in the dining area. The risks of this had not been previously identified by the home. Another person was at risk of falling when two care staff were not aware of the changed support needs for this person during transfers.

Staffing levels on the Reminiscence Unit during the lunchtime period were not sufficient to meet people’s needs at this time. As a result some people ate cold food, whilst others had meals that they had been unable to feed themselves taken away. Because lunchtime on this unit was not staggered in the same way breakfast was, some people had a late breakfast and were still offered lunch at 12:30pm.

There were systems in place to recruit new staff, but the policy to explore gaps in employment histories had not always been followed. The home’s own auditing had identified this and the home was in the process of gathering the outstanding information to ensure judgements about the suitability of new staff were sound.

Staff knowledge and understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards was variable. Some staff had a good knowledge in this area and were clear about the principles of capacity and how to make best interests decisions. Other staff were not clear of their responsibilities and as such some people may not always have received care in the least restrictive way.

People were safeguarded from harm because staff had a good understanding of their roles in keeping people safe and knew when they would need to report concerns. Communication across the service was good and information about people was shared appropriately, especially where there were concerns.

The home had appropriate systems in place to manage medicines safely and identify any mistakes promptly. Designated staff to manage medicines on each shift meant that staff had the time to do this important task without interruption.

The quality of food was good and people had a choice of a wide range of food and drink at every meal. With the exception of the lunchtime meal on the Reminiscence Unit, the timing of meals was flexible and people could choose where, when and with whom they wanted to eat. On the Assisted Living Unit, meals were seen to be a social occasion with lots of chat and laughter taking place. Visitors were welcomed to the home at any time and many chose to join their family members for meals. A selection of drinks and snacks were always readily available for people to help themselves to.

People described staff as “Excellent” and “Superb”. Staff had access to a wide range of training, including specialist learning in supporting people living with dementia. We saw that staff were effective in the way they supported people and took the time to assist them at their own pace. Staff had a good knowledge of people’s needs and preferences and demonstrated a genuine caring attitude towards them.

People had choice and control over their daily routines and a range of activities were available throughout the day for those who wished to take part. Dedicated activity staff spent time getting to know people and how to engage effectively with them. For other people, they enjoyed the freedom of living independently with minimal assistance.

People had opportunities to be consulted about their care and regular reviews of their needs took place. Where people needed additional healthcare support, this was sought promptly and the district nursing team visited the home twice weekly to offer support with wound care.

The registered manager had a good oversight and management of the home and worked collaboratively with senior care staff to support people effectively. The culture of the home was open with regular feedback sought from people, relatives and staff. We found that where feedback or complaints had been made, the registered manager had used the information to improve the quality and safety of the home.

We found two breaches of regulations. You can see what action we asked the provider to take at the back of the full version of this report.

We visited Sunrise Weybridge to look at the care and welfare of people who used the service. We spoke with 10 people who used the service and nine members of staff. We observed the interactions between staff and the people who used the service. We did this for the people who we were unable to verbally communicate with.

People told us they were happy living here. There was plenty to do and staff were very kind. One person told us “The staff are wonderful. I have never complained or had problems as staff go out of their way to be helpful.” Another person said “I feel very safe the staff are so kind and treat you very well.”

We spoke to staff who confirmed they had procedures in place to gain consent from people.

We found arrangements were in place to ensure people had their nutritional needs met. The menus were nutritionally complete but people were unhappy with the new style menus.

We saw that the home had systems in place to protect people from abuse and staff had received training.

We saw that the manager had carried out appropriate checks when employing new staff. This ensured staff were of good character and had the necessary skills and experience to do the job.

We were told complaints were taken seriously and would be responded to within the provider’s timescales. People that we had spoken to told us they were unhappy with the meal provision that had recently changed and the new arrangements that had been made by the provider.

The home is divided into two units called ‘Assisted living’ and ‘Reminiscence’. During our inspection we spoke to six people in ’Assisted living’ and carried out observations on the ‘Reminiscence’ unit during the lunch period.

People told us that they were involved in decisions everyday about things they would like to do at the home. We were told that the activity provision was very good. One person said “I get myself involved in the various clubs that are available here.” Another person told us “I like to go out on the minibus and shopping is a favourite.”

People told us that staff were very kind and that they felt safe at the home.

We observed lunch on the ‘Reminiscence’ unit and saw good interactions between staff and people who used the service. The atmosphere was lively and happy with conversations that took place between staff and people. We observed choices were given to people about food and drinks and we saw that people were not rushed.

Staff told us that Sunrise provided a variety of training for them. We were told that this enabled them to do their job effectively.

People who use the service told us that they were aware of their care plans and had been given the opportunity to contribute to them. They told us that family members had also contributed.

Most people told us that staff gave them their medicines and confirmed that they received these medicines when they wanted them. Those people that had responsibility for their own medicines told us they were kept in their room in a locked cupboard.

People who use the service told us that they were aware of their care plans and had been given the opportunity to contribute to them. They told us that family members had also contributed.

Most people told us that staff gave them their medicines and confirmed that they received these medicines when they wanted them. Those people that had responsibility for their own medicines told us they were kept in their room in a locked cupboard.

People using the service who we spoke to told us that they attended the resident meetings held at the home. That it enabled them to be involved in some decision making and they felt they could air their views.

We were also told staff always knock on their bedroom door before entering and that they always consult with them prior to carrying out any personal care.

People who use the service told us they were happy with the care and support they received. Some people were aware of their care plan. One person using the service told us that her son deals with those matters.

Some people told us that they did not have a care plan as they were at the home prior to it becoming a nursing home.

People told us they thought that the food was good. They said that there was some food they didn’t like but an alternative was always available.