We carried out a review of the data available to us about Sandhills Court Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Sandhills Court Care Home, you can give feedback on this service.
Sandhills Court is a residential care home providing accommodation and personal care for up to 77 older people and younger adults including people living with dementia. At the time of our inspection 51 people were living at the service.
People's experience of using this service and what we found
A system was in place to monitor the quality and safety of the service, however these were not always effective in identifying and addressing issues.
We have made a recommendation in relation to capturing information to support service delivery.
The provider ensured staff received mandatory training to carry out their roles. However, staff did not always receive training to meet people’s individual assessed needs.
We have made a recommendation in relation to accessing additional training for staff were needed.
Staff had been recruited safely and there were enough staff on duty. People were happy with the care they received, they felt safe and well looked after.
Staff received training in safeguarding and followed clear guidance which helped to protect people from abuse. Care plans included risk assessments for known risks and staff followed support plans to help keep people safe. Accidents and incidents were monitored to identify and address trends and actions were implemented to reduce risk.
People received care and support that was developed to meet their individual needs as reflected in their care plans.
People were supported to take their medicines safely as prescribed.
People felt consulted about their wishes and they knew how to make a complaint if they wished to.
People had access to health care and support from other health professionals, which supported them to maintain their health and wellbeing.
The home was clean and tidy and additional cleaning ensured people were safe from the risk of infection.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 10 December 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended the provider developed a system to assure themselves staff had the right competence and knowledge in relation to The Mental Capacity Act. We also recommended the provider followed best practice guidance in relation to reviewing and updating care plans. At this inspection we found the provider had acted on these recommendations and improvements had been made.
Why we inspected
We carried out an unannounced inspection of this service on 03 November 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, consent and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective, responsive and well-led.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last inspection, by selecting the ‘all reports’ link for Sandhills Court on our website at www.cqc.org.uk.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Sandhills Court is a residential care home providing accommodation and personal care for up to 77 people, including people living with dementia. At the time of our inspection 54 people were living at the service.
People’s experience of using this service and what we found
The service was not always well-led. The provider's quality assurance systems were not effective in identifying and addressing issues.
Risks associated with people's care had not always been clearly recorded in their care plan or risk assessments with measures which were in place to reduce the risk of harm.
The principles of the Mental Capacity Act 2005 were not always followed. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
We have made a recommendation in relation to staff's knowledge about the Mental Capacity Act.
People's care plans did not always contain sufficient information to ensure staff were fully aware of their needs.
We have made a recommendation in relation to care planning.
Medicine practices were not always in line with best practice guidelines.
People were happy with the care they received, they felt safe and well looked after. Staff had been recruited safely.
The home was clean and tidy and additional cleaning ensured people were safe from the risk of infection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 2 March 2019).
Why we inspected
The inspection was prompted in part due to concerns received about medicines and risk management associated with incidents and accidents. A decision was made for us to inspect and examine those risks.
Due to the concerns received, we undertook a focused inspection to review the key questions of 'safe' ‘responsive’ and 'well-led'. When we arrived, we also had concerns about areas covered by the 'effective' domain. We decided to include this 'effective' domain in our inspection. No areas of concern were identified in the other key question. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. We informed the provider of our most urgent concerns and they advised they would take action to mitigate these risks.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Sandhills Court on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This included a breach of regulation 12 (safe care and treatment), regulation 11 (consent), and regulation 17 (good governance).
Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We have requested an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The service can accommodate a maximum of 77 people. At the time of this inspection 56 people were using the service. The property is a purpose-built care home with dedicated nursing and dementia units. It is built across three floors with en-suite bedrooms, bathroom facilities, relaxation lounges and dining facilities located across all floors.
At the time of the inspection a registered manager was 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 felt safe and trusted the staff. Staff were knowledgeable in recognising signs of potential abuse and understood their responsibilities and duty of care. Risks to people's safety and wellbeing were appropriately managed. Staff were aware of the risks to people's wellbeing and what action they had to take to minimise risks. All risk assessments were reviewed monthly or sooner if circumstances changed. This helped to protect people.
Staff were recruited using safe recruitment procedures and processes. We observed that the staffing levels provided on the day of our inspection met people's needs. Staff were knowledgeable about their roles and responsibilities and were trained in a variety of subjects to develop and maintain their skills. Staff received a thorough induction at the start of their employment. Training was updated, as required and staff received regular supervision and annual appraisals.
Medicines were administered safely by staff who had received training and were competent in this task. Records of medicines administered were regularly checked to minimise the risk of errors being missed.
Staff knew the people they were supporting well and care plans were in place detailing how people wished to be supported including people's likes and dislikes. The registered manager and staff had a good understanding of the Mental Capacity Act (MCA). People's health and nutritional needs were assessed and staff worked well as a team liaising with relevant organisations and professionals for advice to help maintain people's independence and wellbeing.
People were cared for with kindness and compassion. They were treated with dignity and respect and supported to maintain their independence by staff that knew them well. Staff supported people to maintain and develop their relationships with those close to them, their social networks, and local community. Care and support plans were person-centred and included people's views. This ensured people chose how to spend their time and were able to make choices about their daily lives.
The service provided activities which were meaningful to the people living in the home. This meant that people were supported to pursue interests and hobbies that were important to them. Activities were continually evaluated to ensure that they remained appropriate to people's needs and individual preferences. People accessed the local community either independently or with support. The registered provider encouraged community involvement and invited people into the home on a regular basis.
The service supported people and their families to consider and record their wishes for end of life care. They worked closely with health care professionals to ensure people's end of life experience was comfortable and dignified.
A complaints procedure was in place. People who used the service and their relatives knew how to make a complaint. Processes were in place to investigate and resolve complaints.
People who used the service, staff and relatives told us the service was well-led. People praised the management team for their caring and positive leadership. The staff team were enthusiastic, and clearly enjoyed their jobs.
The registered manager undertook a variety of audits to help monitor the quality of the service. The registered provider visited regularly and checked audits had been completed. Any issues or concerns were addressed through action plans to ensure service improvements.