Archived: Sandfield House

We spoke to the relatives of one person, who told us they were satisfied with the care provided, although they expressed concerns that there was a lack of leadership because there was no manager in post. Staff also raised concerns about the management and leadership.

We found that the care provider had not taken appropriate action and had not made the necessary improvements to comply with the six outcomes that we assessed as non-compliant at the inspection in June 2012. People did not always experience care treatment and support that met their needs and protected their rights. People were not protected from the risk of infection because appropriate guidance was not always followed. The provider had not taken reasonable steps to provide care in an adequately maintained environment. There were not enough qualified, skilled and experienced staff to meet people's needs or to carry on the regulated activity. Staff were not supported to deliver care safely and to an appropriate standard. The care provider did not have an effective system in place to identify, assess and manage risks to the health and safety and welfare of people who used the service and others.

Where areas of non-compliance have been identified during inspection they are being followed up and we will report on any action when it is complete.

We spoke with one visitor who told us they were a close relative of a person who used the service and had visited on a frequent basis. They told us they were very happy with the care being provided. They said, 'They involve GPs and are very good at meeting healthcare needs. It's the same staff working with people which is good. Personal care is good; (Name of person) is always smart and always wears his own clothes.'

We spoke to three staff and they told us systems were in place to promote people's privacy, dignity and independence, and respect people's rights. Although people who used the service had complex needs and needed support to make decisions staff told us people could still make choices.

Although we were told people received appropriate care other evidence showed that people were not always protected against the risks of receiving inappropriate or unsafe care.

Staff told us some people who used the service could get aggressive and would shout and hit out at others. We looked at two of these people's care plans. They did not provide enough information about people's behaviours or how staff should support them. Their needs had not been properly assessed and care plans did not have enough guidance for staff about the way each person should be supported and cared for.

The representative for the care provider told us they had had a manager in post who had worked at the home from December 2011 but had been absent since April 2012. The deputy manager returned to work in May 2012 after a nine month absence but worked most of her hours providing care to people. There were no other managers or senior care staff working at the home; all other care staff employed to work at the home were care assistants. It was clear at this inspection that there was no leadership and the service was not being appropriately managed.

Staff we spoke with said some days they were very busy and sometimes there was not enough staff to meet people's needs; other days they were not so busy and there was enough staff to meet people's needs.