Archived: Sandon House

We found the following examples of good practice.

Staff were required to undertake COVID-19 testing and wear personal protective equipment (PPE) in line with current Government guidance. A detailed risk assessment was in place for ensuring safe visits, this included testing, health screening and use of PPE. Staff had received training in infection control and prevention, handwashing and correct use of PPE. People who lived at the home had also been offered the same training. There were procedures in place to allow people to move into the home safely.

Whilst restrictions on visiting had been in place based on Government guidance, staff and the registered manager had ensured people kept in touch with their friends and relatives. There were lots of activities for people to take part in to help support people’s well-being. They had maintained links with a local school and children had exchanged letters and artwork with the people who lived at the home. Religious services were being offered via video link.

The environment was very clean and clutter free. Clear and detailed cleaning processes and procedures were in place.

The registered manager had been in regular contact with the local authority and public health teams. Each staff member had a health risk assessment. Staff were offered access to a variety of support and well-being initiatives. The service had detailed risk assessments and policies and procedures in place to manage the risks of COVID-19. The registered manager and provider had a range of auditing and monitoring in place to ensure infection control procedures were being followed properly.

Sandon House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

We last carried out a comprehensive inspection of this service on 26 April and 2 May 2017. At that inspection we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because there was a lack of accurate records in relation to the care people who used the service received and the providers systems of checks and audits was not sufficiently robust.

We also made one recommendation that the provider reviews their procedures for ensuring and recording peoples consent and involvement in care planning.

Following the last inspection, we asked the provider to complete an action plan to tell us what they intended to do and by when to improve the key questions; the service is safe, effective and well led to at least good. At this inspection, we found that improvements had been made in all areas.

Sandon House is a large purpose built establishment located in the village of Mossley which is in the Tameside area. The home provides 24 hour care and support for up to 42 people who require residential care without nursing. At the time of our inspection there were 32 people living at the home.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 who used the service spoke very highly of the registered manager and the way the service was run. We found the registered manager to be polite, friendly and helpful.

Staff were positive about working at the home and the changes the provider had made. Staff told us they enjoyed working with the people who lived at Sandon House. We observed staff had a kind and caring attitude towards people who lived at the home.

Staff were trained in safeguarding adults and were aware of how to identify and respond to allegations and signs of abuse. Staff were aware of the whistleblowing (reporting poor practice) policy, and how to raise any concerns.

Recruitment procedures were in place which ensured staff had been safely recruited. There were sufficient staff to meet people’s needs. Staff received the training, support and supervision they needed to carry out their roles effectively.

Medicines were stored safely and securely and procedures were in place to ensure people received medicines as prescribed.

Accidents and incidents were appropriately recorded. Appropriate health and safety checks had been carried out and equipment was maintained and serviced appropriately.

People had access to a range of health care professionals. People at risk of poor nutrition and hydration had their needs regularly assessed and monitored.

We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. The registered manager was meeting their responsibility under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people's rights were considered and protected.

Everyone we spoke with told us staff at Sandon House were caring. During our inspection we observed staff had a kind and caring attitude towards people who lived at the home. The atmosphere was calm and relaxed.

Care records contained risk assessments and care plans that were person centred, detailed and written using respectful terms. People told us they received the support and care they needed.

There were a range of activities and social events in the home and in the community on offer to reduce people’s social isolation. People told us they enjoyed the activities.

There was a system in place to gather people’s views about the home and to record complaints and the service’s responses to them. People told us they didn’t have any complaints but were confident that they would be listened to and action would be taken to resolve any problems they had.

Staff meetings were held regularly where staff had an opportunity to raise any issues and were used to look at developing good practise. Staff we spoke with liked working for the service and told us they felt supported in their work.

There was a robust system of weekly, monthly and annual quality monitoring and auditing in place to help improve the quality of the service provided.

The service had notified CQC of any accidents, DoLS, serious incidents, and safeguarding allegations as they are required to do. The provider had displayed the CQC rating and report from the last inspection on their website and in the home.

This was an unannounced inspection which took place on the 26 April and 2 May 2017. The inspection was undertaken by one adult social care inspector and an expert by experience.

The service was last inspected in November 2014 when it was rated as Good.

During this inspection we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because there was a lack of accurate records in relation to the care people who used the service received and the providers systems of checks and audits was not sufficiently robust. You can see what action we have told the provider to take at the back of the full version of the report.

We also made one recommendation that the provider reviews their procedures for ensuring and recording peoples consent and involvement in care planning.

The providers systems of checks and audits had not been sufficiently robust. They had not ensured the recommendations of the reports about the condition of the electrical and fire alarm systems had been requested or completed in a timely manner, that action was taken following none administration of one person’s medicines, that correct procedures were followed for gaining people's consent to the support they were receiving and had not identified that records of care and support were not accurate or complete. We found the new registered manager had improved the system of weekly and monthly quality monitoring and auditing in place to help improve the quality of the service provided.

Staff received training in administration of medicines and had their competency checked regularly. Medicines were stored safely and securely. However, we found one person had not received their medicine as prescribed for 14 days and action had not been taken to identity the cause and rectify the issue.

Care records were person centred and contained sufficient information to guide staff. However we found that records of the care, support and treatment given were not always accurate or complete. This meant we could not be sure people had always received appropriate care.

People and their relatives told us they been involved in planning and reviewing the care provided. However records did not always show if people had been consulted about their care or given their consent to how the care was provided. The provider was meeting the requirements for the Deprivation of Liberty Safeguards (DoLS).

People told us they felt safe living at Sandon House. Staff we spoke with were aware of how to protect vulnerable people and had safeguarding policies and procedures to guide them. Staff were confident the registered manager would deal with any issues they raised.

The service is required to have 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. The service had a new registered manager, who had been at the home for eight weeks, who was present during this inspection.

People who used the service, their visitors and staff we spoke with were very positive about the new registered manager and the way the service was being managed. People told us the new registered manager was approachable, pleasant, very nice and listens to people. We spoke with the new registered manager throughout our inspection and found them to be open, confident, enthusiastic and committed to providing a person centred service.

Recruitment processes ensured that people were protected from the risk of unsuitable staff. Staff personnel files contained references and criminal convictions checks. There were sufficient staff to meet people’s needs. Staff received the training, support and supervision they needed to carry out their roles effectively.

Accidents and incidents were appropriately recorded. Risk assessments were in place for people who used the service, staff and the general environment. Appropriate health and safety checks had been carried out.

People had access to a range of health care professionals. People at risk of poor nutrition and hydration had their needs regularly assessed and monitored. Most people told us they liked the food, it was home cooked and they were always offered choices.

The service had an infection control policy. The home was clean and homely. Improvements had been made to the decoration, furnishings and fittings of the home.

All the people we spoke with were positive about the support they received and the caring attitude of the staff. People said, “I think staff are very kind and they do treat us with respect” and “From a caring point of view, it’s all good here. The staff are kind. They treat us with respect and they do listen to what we say.”

We found that the new registered manager and all the staff we spoke with knew people who used the service well and knew their likes and dislikes. We found staff were caring in their approach and were responsive to people’s needs and requests for support.

There were sufficient activities available for people if they wished to join in. People told us they were happy with the activities on offer.

We saw there was a system for gathering people’s views about the service. There was a system in place to record complaints and the service’s responses to them. People told us communication and the service response to complaints or concerns had improved.

Staff were positive about the new registered manager and the changes they had made at the home. They said, “I find the new manager is very approachable and will listen to any concerns. I think the home will continue to improve with better monitoring procedures and working practices” and “The new manager is making a difference and there have been noticeable improvements. I do feel much happier with this current situation. I love my work with the residents here.”

The service had notified CQC of any DoLS authorisations, accidents, serious incidents and safeguarding allegations as they are required to do.

The CQC rating and report from the last inspection was displayed in the entrance hall.

Many of the people who used the service were unable to fully express their views due to their varying levels of dementia and limited abilities to communicate verbally. People who were able to talk with us they told us: “I’m quite happy here”. Another said “I like it here too” and “They are really good”.

Relatives told us: “My [relative] is looked after well” And: “The staff are very nice they stay on and do more”.

Care plans and associated risk assessments were in place and all had been regularly reviewed.

The home had systems in place and staff were suitably trained so that people who used the service received their medicines in a safe manner.

We found that the home had a robust recruitment and selection process in place for staff and kept appropriate records.

We found that there were sufficient numbers of staff on duty at the time of our visit.

A comprehensive complaints policy was in place and people received sufficient information on how to make a complaint if needed. Records we saw indicated that complaints were dealt with in a timely and appropriate manner.

Some of the comments we received included:

"The staff have been great. They have helped me to feel at home and bring my own things and this means a lot to me."

"I can't fault the staff, they are always there if I need them."

"If I have a problem I go to the office to see Veronica (the manager). She always sorts it and gets it fixed. I'm always asking about something but she never gets tired of listening to me."

When we spoke with relatives and friends of the people living in the home they were positive about the care and support provided by staff and one person told us that staff were always kind and helpful to her relative.