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Inspection Summary


Overall summary & rating

Good

Updated 30 November 2017

This unannounced inspection took place on 5, 6, 11 and 18 October 2017.

The Sands Care Home is registered to provide care and accommodation for up to 96 older people. The home cares for people who require nursing or personal care. Care is provided on a 24 hour basis by registered nurses and care staff, including waking watch care throughout the night. There is a lift to access all five floors of the building. The home is situated on the promenade overlooking Morecambe Bay. The home is organised into separate units over 4 floors. The Keswick unit provides the regulated activity personal care. Grasmere, Derwent, and Langdale provide nursing care to people. In addition, since the last inspection visit Derwent unit has been made into a unit specialising in supporting people who are living with dementia. At the time of inspection 96 people were residing at the home and the registered provider employed approximately 170 staff.

At the time of the inspection there was no 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. A new manager has been identified and we noted from our internal communication system they were currently completing the registration process with the Commission.

The service was last inspected in December 2016. We identified a breach to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014. We found systems for managing medicines were not consistently safe and risks were not always identified and addressed. In addition, the registered provider had failed in their duties to report statutory notifications as required to the 2009 Care Quality Commission (CQC) Registration Regulations. We used this inspection visit to ensure improvements had been made.

At this inspection visit in October 2017, we found improvements had been made. We reviewed care plans and risk assessments and found risk was suitably addressed and mitigated. When people were at risk of harm there were a number of risk assessments in place to manage risk. These were regularly reviewed and updated when people’s needs changed.

Following our inspection visit in December 2016, the registered provider had developed links with a pharmacist and had commissioned them to audit medicines and review systems for administering medicines. The pharmacist visited the home on a weekly basis. In addition, the registered provider had reviewed systems for administering medicines and had implemented a new electronic system. This had highlighted some concerns and the home was currently in process of implementing another new system to meet the needs of the service and to reduce risk. In the interim period, additional checks had been put in place to reduce any risk.

After the December 2016 inspection visit, one member of staff had been delegated responsibility for ensuring all statutory notifications were sent to the Commission. During this inspection in October 2017, we reviewed all accidents and incidents that had occurred at the home. We noted all statutory notifications had been submitted without delay.

People told us they were included in developing their plan of care when they started receiving a service. Care plans were reviewed and updated at regular intervals and information was sought from appropriate professionals when required. Although care plans were updated in a timely manner, people who lived at the home told us they were not always involved in reviewing their plan of care. We found the quality of person centred information held within care plans was variable. We have made a recommendation about this.

Staff we spoke with were aware of the principles should someone require being deprived of their liberty. Good pract

Inspection areas

Safe

Requires improvement

Updated 30 November 2017

The service was safe.

People who lived at the home told us they felt safe.

The registered provider was working proactively to ensure medicines were suitably managed at the home. Systems were not yet fully embedded but risk was being addressed in the interim period.

The senior management team were working proactively to address deployment of staffing at the home to ensure people�s needs were consistently met. Plans were in place to manage the deployment of staffing as an interim measure.

Recruitment procedures were in place to ensure people employed were of good character. Processes were in place to protect people from abuse. Staff were aware of what constituted abuse and how to report it.

Premises and equipment were suitably maintained to ensure they were fit for purpose.

Effective

Good

Updated 30 November 2017

The service was effective.

People�s needs were monitored and advice was sought from other health professionals, where appropriate.

Staff had understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and the relevance to their work.

People�s nutritional and health needs were met by the service.

Staff had access to on-going training to meet the individual needs of people they supported.

Caring

Good

Updated 30 November 2017

Staff were caring.

People who lived at the home were positive about the attitude and behaviours of staff who worked at the home.

People�s preferences, likes and dislikes had been discussed so staff could deliver personalised care.

Staff treated people with patience, warmth and compassion and respected people�s rights to privacy, dignity and independence.

Responsive

Good

Updated 30 November 2017

The service was responsive.

People�s care needs were kept under review and staff responded when people�s needs changed.

The service had a complaints system to ensure all complaints were addressed and investigated in a timely manner.

The service ensured there was a range of social activities on offer for people who lived at the home.

Well-led

Good

Updated 30 November 2017

The service was well led.

Processes had been implemented to ensure statutory notifications were submitted in line with legislation and in a timely manner.

The registered provider had worked proactively to fill the vacant registered manager�s post in a timely manner.

Regular communication took place between management, staff and people who lived at the home as a means to improve service delivery.

The manager had good working relationships with the staff team and staff commended the manager�s skills and abilities.

The manager was aware of their roles and responsibilities and displayed a commitment to developing and maintaining a high quality service.