This inspection took place on 1 November 2018 and was unannounced. Sundridge Court Nursing Home is a ‘care home’. 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. Sundridge Court Nursing Home accommodates up to 30 people in one adapted building. There were 19 people living at the service at the time of our inspection.

The service had 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.

At this inspection we found improvement was required because the provider’s systems for monitoring the quality and safety of the service had not identified outstanding work which was needed to improve the safety of the home’s electrical system and to reduce the risk of legionella. This work was undertaken promptly following our inspection.

Risks to people had been assessed and staff acted to manage identified risks safely. There were sufficient staff deployed at the service to safely meet people’s needs. The provider followed safe recruitment practices. People were protected from the risk of abuse because staff received safeguarding training and were aware of abuse reporting procedures.

People’s medicines were safely managed. Staff worked in ways which reduced the risk of infection. They were aware of the need to report any accidents and incidents which occurred. The management team reviewed accident and incident records regularly and took action to reduce the risk of repeat occurrence.

People’s needs were assessed before they moved in to the home to help ensure the service’s suitability. Staff were supported in their roles through an induction, regular training and supervision, and an annual appraisal of their performance. People were supported to maintain a balanced diet and told us they enjoyed the food on offer at the service. They had access to a range of healthcare services when needed in to maintain good health. Staff worked with other agencies to ensure people received effective joined up care across different services. The service was adapted to meet people’s needs.

Staff sought people’s consent before providing them with support. 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. Staff treated people with care and compassion. The respected people’s privacy and treated them with dignity. People were involved in making decision about their care and treatment.

Staff received training in equality and diversity, and worked to meet people’s diverse needs in regard to their race, religion, sexual orientation, disability or gender. People had been involved in the planning of their care and were supported in line with their individual needs and preferences. They were able to take part in a range of activities which they told us they enjoyed, and were supported to maintain the relationships which were important to them.

The provider had a complaints policy and procedure in place. People and their relatives knew how to complain and expressed confidence that the registered manager would address any issues they raised. Staff provided people with responsive, good quality treatment and care at the end of their lives.

The provider had systems in place for seeking feedback from people and their relatives. Feedback from a recent survey showed that people were experiencing positive outcomes whilst living at the service. The registered manager was aware of their regulatory responsibilities. They had submitted notifica

This inspection took place on 03 and 04 May 2016. The inspection was undertaken by two inspectors and a specialist advisor and was unannounced. At our previous inspection on 20 May 2014 we found the provider was meeting the regulations in relation to outcomes we inspected.

Sundridge Court is a nursing home located in the London Borough of Bromley. The home is registered to provide accommodation and support for up to 30 people and specialises in providing nursing care for the elderly. At the time of our inspection 27 people were using the service.

There was 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.

People using the service said they felt safe and that staff treated them well. Their privacy and dignity was respected by staff. Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported. Staff told us they sought consent from people when offering them support. The registered manager demonstrated a clear understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS)..

There were enough staff to meet people’s needs and appropriate recruitment checks took place before they started work. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

Risks to people using the service were assessed; care plans and risk assessments provided clear information and guidance for staff on how to support people with their needs. People and their relatives [where appropriate] had been involved in planning for their care needs. People They were being supported to have maintain a balanced diet, and had access to a range of healthcare professionals when required People received appropriate end of life care and support. When necessary additional support was provided to the home by visiting health care professionals.

Regular residents and relatives meetings were held so that people could talk to the registered manager and provider about the home and things that were important to them. The provider took into account the views of people using the service and their relatives and staff through surveys, and took action to make improvements to the service in response to the feedback. There was a range of appropriate activities available to people using the service to enjoy. People knew about the home’s complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

Staff said they enjoyed working at the home; they received plenty of training and good support from the registered manager. Unannounced spot checks, including weekend and night time checks, were carried out by the registered manager to make sure people received good quality care at all times.

We gathered evidence against the outcomes we inspected to help answer our five key questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe living at the home and that staff treated them well. One person said “They treat me gently when I need their help and they don’t rush things with me.”

Safeguarding procedures were robust and staff demonstrated a clear understanding of the types of abuse that could occur, the signs they would look for and what they would do if they thought someone was at risk of abuse or harm including who they would report any safeguarding concerns to.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

Is the service effective?

People’s health and care needs were assessed with them and their relatives if appropriate. Visiting relatives said that the staff were “Very good and always available to help.” They said they were kept informed of any changes to their relatives care and they were fully involved in care planning and reviews.

People said there were always enough staff around to support them. One person said “The staff are very good. There seems to be enough of them around when I need them, they answer the call bell quickly when I use it.” Another person said “They all work so hard but they always come when I call them.”

The home manager had carried out unannounced night time and weekend checks at the home to make sure people using the service where receiving appropriate care and support.

Is the service caring?

People said their choices and wishes were listened to and respected. They felt their health care needs were attended to and they could see the doctor or dentist if they needed to. One person said “If ever I’m not feeling too well staff look after me and if needed they would call the doctor.” Visiting relatives said that the staff were “Very good and always available to help” and “The communication with the home is good.”

We observed how people were being supported and cared for at lunchtime. We saw that people were spoken to respectfully and their menu choices were confirmed. Some people required support with eating and staff respected people’s wishes if they wanted to remain independent.

We observed that call bells in people’s bedrooms were placed close at hand. Whilst in one bedroom, we activated the call bell. A member of staff came very promptly within a minute.

Is the service responsive?

People using the service and their relatives said they knew how to make a complaint if they needed to and they were confident the provider would do something about their complaint. One person said “If I have any issues or concerns I know I can tell a member of staff and these will be addressed”.

Satisfaction surveys had recently been sent to people using the service, their relatives and professionals with an interest in the home. The home manager told us they would collate the feedback from the surveys and produce a report which would be used to improve on the quality of service provided at the home.

Residents meetings took place on a regular basis where people using the service and their relatives could express their views and opinions about the home. We saw a copy of the minutes from the last meeting, April 2014. The meeting was well attended by people using the service, some of their relatives and managers and staff from the home. People said they could also raise any queries they had with staff if they needed to.

Is the service well-led?

We found there were effective systems in place to regularly assess and monitor the quality of service that people received.

Staff told us they liked working at the home, there was good teamwork and they were well supported by other staff and managers. They told us had received lots of training and they had received regular supervision from the manager.

The London Borough of Bromley commission services at the home. We contacted Bromley’s Contract Compliance Team. They told us that in the last three or four months, a new regional manager, home manager and RGN team had been recruited and significant improvements had been made.

In this report the name of a Registered Manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

We spoke with some people who used the service and some people's relatives. Each person we spoke with told us they were happy with the quality of care they received, and people's relatives were equally happy with the care their family member received. One person told us that they received all the care they needed, and another told us there were happy living at the home and they were well looked after. People told us they were supported by good, friendly staff, and one person's relative told us they were always made to feel welcome.

We checked to see whether the provider had made improvements following our previous inspection in relation to people's care and welfare. We found that overall people's care was adequately assessed and planned, and that people received the care they needed. However, we found that the care records, in particular care delivery records, maintained by the provider did not always evidence that people's planned care had been provided.