Archived: Sandhall Park

Sandhall Park provides accommodation for up to 50 people who require support with their personal care. The service provided personal care and support for older people and people living with dementia. The premises are on ground floor level and split into two separate areas. The Honeysuckle area supports people with residential needs and Jasmine area supports people living with dementia. On the first day of the inspection there were 46 people living at this service.

The provider is required to have a registered manager in post. There was a registered manager and they had been in post since August 2014. 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 our previous inspection in December 2016 we rated the service Good. During this inspection we found the provider to be ‘Requires Improvement’ in safe and well-led. We found evidence to support that the provider was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Quality assurance systems and audits were in place. However, these did not identify all the issues we raised during the inspection. In addition, where the internal audits had highlighted areas that required improvements, at the time of our visit these had not been fully actioned.

People received care and support from care workers that had good knowledge about their needs and preferences. However, risk assessments when reviewed did not always take into account deterioration in people’s health needs and some scores were incorrectly totalled. Records showed us that people’s consent to their care was sought and documented in care plans.

People’s health care needs were recorded and monitored so that appropriate referrals could be made to health professionals for advice and guidance.

Relatives told us they always felt welcomed when they visited the home and that they had no restrictions around visiting times within reasonable hours of the day. The majority of relatives felt the communication was good and that they knew what was going on, although some felt concerns were not always addressed effectively.

Care workers completed online and face to face training courses. Senior care workers checked that staff completed refresher training to ensure that skills and knowledge were current. The majority of care workers felt supported, although we received mixed feedback about whether they would feel comfortable raising concerns to the registered manager.

Care workers received monthly supervisions and annual appraisals. Recruitment checks were conducted but improvements were required to make recruitment practices more robust.

Safeguarding concerns were recorded in accidents and incidents, and individual’s care folders. The central safeguarding log did not contain all the concerns, or always show actions taken or the lessons learnt.

Overall medicines were administered and stored safely. People were supported if necessary to attend their annual medicine reviews. However, some labels for creams did not include sufficient information to guide staff on where they should be applied. Records for pain relief were not monitored for their effectiveness and when required medicines protocols were not in place.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to this breach. We undertook this focused inspection to check that they had followed their plan and to check that they now met legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Sandhall Park on our website at www.cqc.org.uk

Sandhall Park provides accommodation for up to 50 people who require support with their personal care. The service provides support for older people and people living with dementia. There are two separate units. Honeysuckle unit supports people with residential needs and Jasmine unit supports people living with dementia. At the time of this inspection there were 48 people using the service.

The registered provider was required to have a registered manager in post. On the day of the inspection there was a manager that had been registered and in post for the last twenty months. 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.

During this inspection we found that improvements had been made to systems in place for the safe management of medicines. Changes had been made to the way medicines were ordered, receipted and stock checked. We found that the management of medication was safely carried out.

People were protected from the risk of harm because the registered provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns. Risks were also managed and reduced on an individual and group basis so that people avoided injury of harm at all costs.

The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. Staffing numbers were sufficient to meet people’s need and we saw that rosters accurately cross referenced with the staff that were on duty. Recruitment policies, procedures and practices were carefully followed to ensure staff were ‘fit’ to care for and support vulnerable people.