Sandgate Manor

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

When incidents and accidents occurred, they were recorded. Action was now taken to reduce risk following incidents. However, records continued to need to be improved to ensure the actions taken were clear. Incidents were reviewed to ensure any patterns or trends were identified. For example, the registered manager had identified one person became upset more often at particular times, this meant staff were able to plan for this and be more aware an incident could occur. The service was working with partners to improve the support they provided to people where there were trends of incidents.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care when people moved between different services.

Feedback from health and social care partners was positive. Partners told us the referrals made for support were appropriate and people had access to external services and the equipment they needed. One partner told us, ‘All referrals were made in a timely manner.’

When people moved into the service there were opportunities for them to visit prior to moving in to see if they were happy with the service and meet the other people who lived there. One person told us they felt very welcomed by staff when they moved into the service.

When people went to hospital in an emergency they were supported by staff if there was no relative able to do so.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns appropriately.

Staff knew how to identify possible abuse and had undertaken training in safeguarding. When concerns had arisen, the local authority had been informed as appropriate. Incidents had been appropriately investigated and acted upon to reduce risk.

People told us they felt safe living at the service, one person said, “I feel very safe here.” Where people were restricted of their liberty the necessary legal authorisations were in place.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. However, some care plans continued to need to be improved in some areas. For example, one person’s care plan stated they needed to be turned at night. This was no longer the case and the care plan needed to be updated. However, staff knew not to turn the person and were not doing so.

Other care plans were complete and accurate. A number of people were supported to use a feeding tube for fluid and food or sometimes just for medication. Staff had the guidance they needed to support people with caring for the tube and stoma site. Staff knew how to provide support to people with feeding tubes and what to do if there was an emergency, such as the tube coming out. Staff also knew what to do if a service user was choking.

One relative told us, “[The staff] are very patient with [my relative] as they have difficulty eating so staff don’t rush them, use adapted cutlery and always ensure [their] softer diet is being followed.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Appropriate checks had been competed such as checks to the electrical wiring and gas safely. The lift and equipment used to support people to move had been checked to ensure they were safe and fit for purpose. Regular audits were undertaken to check no new environmental hazards had arisen. When concerns arose maintenance staff were alerted so they could plan for repairs or replacements to be made. The environment was free from hazards.

At the time of the inspection there was enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. There had recently been a period where permanent staffing levels had been lower. The provider had acted to recruit more staff, and some agency staff were used to increase staff levels again whilst the new staff came on board.

Staff had undertaken the training they needed to provide people with effective support. Training was a mixture of online learning and face to face training. Staff were positive about the training they now received. One staff said, “They provided us training before we could use the hoist. I have learnt how to hoist people and move people safely and feel confident now.” Staff competency checks had been completed for manual handling and medicines administration to ensure staff knew how to complete these tasks safely.

People and their relatives told us they were happy with the staff who supported them. One person told us, “I think that the care staffare very good, they make me feel safe and happy.” Staff were supervised and told us they felt supported. Staff were recruited safely and had undergone the necessary safety checks needed before commencing in the role.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The service was clean when we visited. One relative told us, “I would say it’s clean and hygienic, I have not had any concerns.”

Staff used personal protective equipment (PPE) appropriately. There were suitable bins to dispose of PPE as needed. Staff had completed infection control training and knew how to reduce risks to people.

Some relatives did raise they would like to see areas of décor updated and there were some areas where the walls and doorways had become scuffed as people moved about using wheelchairs. However, there was a plan in place to address this, and areas had improved. One relative said, “The environment looks better now, it used to be a bit run down but is better now.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People’s medicines were stored safely and there was an appropriate system in place to ensure medicines were also disposed of safely if they needed to be.

People’s needs had been assessed to understand what support they needed with their medicines. Staff were aware of the risks associated with over medicating people who had a learning disability or autism, and we did not identify any concerns regarding overuse of mood-altering medicines.

People’s medicines were administered as prescribed. One person’s ‘as and when’ PRN protocol was missing. However, the person told staff when they needed this medicine, and we saw the medicine had been administered when requested. The protocol was put back in place immediately after the inspection. Medicines stocks were regularly checked to ensure the number of medicines in stock matched records. Medicine administration records (MARs) were complete and accurate.