Sandpiper Care Home

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. This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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.
The service had a learning culture that supported safety and improvement and staff were encouraged to reflect and learn from events. Learning from accidents and incidents was shared through meetings and supervision and the registered manager reviewed events to identify patterns and areas for improvement. Lessons learned were documented and staff told us they had time in supervision to reflect on practice and make changes. However, records, approaches used and staff understanding of how to support people when they became distressed showed there was a significant gap in skill and knowledge. For example, incident records for one person showed repeated distress during personal care but this was not reviewed to find causes or change support. Other records described people as the cause of their distress rather than exploring triggers and reasons for how they felt. This meant people were at risk of not receiving consistent and appropriate support at times of distress. The provider responded promptly by arranging training and some staff had already attended and demonstrated improved understanding of distressed behaviour and the importance of positive language to reduce risk and improve safety.
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. The service had safe systems in place to support people to move between services and to maintain continuity of care. Clear processes were used at key points such as admission and discharge and these helped people experience smooth transitions. Information about people’s needs was shared promptly and effectively with other services involved in their care which reduced the risk of gaps or delays in support. These systems helped ensure people continued to receive care safely and in line with their assessed needs when transitions took place.

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. People told us they felt safe. One relative explained to us about a safeguarding event that had occurred and how impressed they were about how it was managed quickly and effectively with clear actions taken to reduce future risk and ensure the person remained safe.

The provider shared concerns quickly and appropriately. Safeguarding arrangements were effective and helped protect people from abuse and avoidable harm. Staff understood their safeguarding responsibilities, could describe what abuse looked like, and knew how to raise concerns within the organisation. Safeguarding training was up to date. Safeguarding referrals had been made when required and concerns were reviewed and followed up appropriately. Where people were unable to make decisions for themselves and restrictions were required to keep them safe, the principles of the Mental Capacity Act 2005 had been followed and Deprivation of Liberty Safeguards applications had been made.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. The service involved people in managing risks in a way that supported choice and safety. Risks were recorded in ways people could understand and care plans reflected individual needs and preferences. Risk assessments were regularly reviewed by staff and showed people’s views or those of their relatives had been included to guide safe and person-centred support. A relative said, “I trust the staff to take care of [my family member]. I have seen the staff watch [my family member] using their walker and they are alert to any issues."

The service provided a safe environment where risks were identified and managed effectively. Equipment was suitable for use and was checked and serviced regularly to ensure it remained safe and effective. Call bell systems were in place to enable people to summon support when needed. The premises were secure, well maintained, clean and free from obvious hazards which supported people and staff to stay safe. A relative said, “You sign in, there is an alarm in the main entrance, you can visit at any time. The staff go out of their way to help you in any way they can.” Another relative told us, “It is very welcoming upon arrival. Once you enter a member of staff meets and greets you with an update of your loved one. This makes it very personal. The security is excellent and everyone is safe.” CCTV was used in communal areas and people and their visitors were made aware of this which helped promote safety while respecting people’s privacy.

Recruitment checks were completed before staff started work and there were no concerns about staff suitability. However, staff told us there were not always enough staff to meet people’s needs, particularly when several people required support from 2 staff for personal care or when people became regularly distressed. We observed staff were very busy during our visits which increased the risk of delays in responding to people, although most care needs were met. Staff had received training in most core areas but required further development in specific areas such as dementia awareness, supervision skills, dealing with conflict, positive behaviour support and positive language awareness to ensure they were fully skilled to meet people’s complex needs safely. Regular supervision and appraisals were in place but development plans were not always detailed enough to clearly show measurable goals and how staff would be supported to achieve them. The provider had reflected on staffing levels and had just implemented an additional staff member on shift to help better meet the needs.

Infection prevention and control arrangements were effective and helped protect people from the risk of infection. Infection risks were assessed and managed in line with policies and procedures that reflected current guidance. The environment and equipment were kept clean and hygienic and cleaning schedules were followed and monitored to maintain good standards. Staff demonstrated good hand hygiene practices which reduced the risk of infection spreading and supported people to receive safe care. Staff knew people well and interacted daily. A relative told us how lovely they felt the interaction was from staff in all roles. They said, “Housekeeping staff also very caring and provide not just cleanliness but care for people. One day the head of housekeeping passed by [my family member] in the hallway and said “your [family member] has just smiled at me this morning when I popped my head round."

The service had clear systems in place to store, administer and record medicines safely. A relative told us, “They are very professional over the medication if they have any queries they raise them and ensure it is dealt with in a professional manner.” Managers and trained staff completed regular audits to make sure medicines procedures were followed. We found quantities and balances were accurate. Instructions for medicines given at specific times were available and staff had person specific guidance for medicines given as needed. This supported safe and consistent practice.

Records showed the use of creams, ointments and thickening agents was clearly documented, including where creams were applied using body maps. Fire risk assessments were in place for people prescribed paraffin-based products. Staff recorded the use of medicine patches and followed guidance to rotate application sites to help keep people safe. One person received medicines covertly. Appropriate assessments and documentation were in place to make sure this was done safely and in line with guidance. Liquid medicines were labelled with opening dates to prevent use beyond expiry.

Arrangements for controlled drugs were appropriate with regular balance checks completed. Medicine storage temperatures were monitored in line with national guidance. There was a system to record any medicine related incidents or errors. Staff told us they received medicines training as part of induction and their competency was checked regularly.