Sandon House is a large detached property in its own grounds, in the centre of Mossley. Accommodation is provided over two floors. The service provides accommodation and personal care for up to 42 older people, some of whom are living with dementia. At the time of our inspection there were 30 people living at the home. This was an unannounced inspection which took place on the 26 April and 2 May 2017. The inspection was undertaken by one adult social care inspector and an expert by experience.
The service was last inspected in November 2014 when it was rated as Good.
During this inspection we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because there was a lack of accurate records in relation to the care people who used the service received and the providers systems of checks and audits was not sufficiently robust. You can see what action we have told the provider to take at the back of the full version of the report.
We also made one recommendation that the provider reviews their procedures for ensuring and recording peoples consent and involvement in care planning.
The providers systems of checks and audits had not been sufficiently robust. They had not ensured the recommendations of the reports about the condition of the electrical and fire alarm systems had been requested or completed in a timely manner, that action was taken following none administration of one person’s medicines, that correct procedures were followed for gaining people's consent to the support they were receiving and had not identified that records of care and support were not accurate or complete. We found the new registered manager had improved the system of weekly and monthly quality monitoring and auditing in place to help improve the quality of the service provided.
Staff received training in administration of medicines and had their competency checked regularly. Medicines were stored safely and securely. However, we found one person had not received their medicine as prescribed for 14 days and action had not been taken to identity the cause and rectify the issue.
Care records were person centred and contained sufficient information to guide staff. However we found that records of the care, support and treatment given were not always accurate or complete. This meant we could not be sure people had always received appropriate care.
People and their relatives told us they been involved in planning and reviewing the care provided. However records did not always show if people had been consulted about their care or given their consent to how the care was provided. The provider was meeting the requirements for the Deprivation of Liberty Safeguards (DoLS).
People told us they felt safe living at Sandon House. Staff we spoke with were aware of how to protect vulnerable people and had safeguarding policies and procedures to guide them. Staff were confident the registered manager would deal with any issues they raised.
The service is required to have a 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. The service had a new registered manager, who had been at the home for eight weeks, who was present during this inspection.
People who used the service, their visitors and staff we spoke with were very positive about the new registered manager and the way the service was being managed. People told us the new registered manager was approachable, pleasant, very nice and listens to people. We spoke with the new registered manager throughout our inspection and found them to be open, confident, enthusiastic and committed to providing a person centred service.
Recruitment processes ensured that people were protected from the risk of unsuitable staff. Staff personnel files contained references and criminal convictions checks. There were sufficient staff to meet people’s needs. Staff received the training, support and supervision they needed to carry out their roles effectively.
Accidents and incidents were appropriately recorded. Risk assessments were in place for people who used the service, staff and the general environment. Appropriate health and safety checks had been carried out.
People had access to a range of health care professionals. People at risk of poor nutrition and hydration had their needs regularly assessed and monitored. Most people told us they liked the food, it was home cooked and they were always offered choices.
The service had an infection control policy. The home was clean and homely. Improvements had been made to the decoration, furnishings and fittings of the home.
All the people we spoke with were positive about the support they received and the caring attitude of the staff. People said, “I think staff are very kind and they do treat us with respect” and “From a caring point of view, it’s all good here. The staff are kind. They treat us with respect and they do listen to what we say.”
We found that the new registered manager and all the staff we spoke with knew people who used the service well and knew their likes and dislikes. We found staff were caring in their approach and were responsive to people’s needs and requests for support.
There were sufficient activities available for people if they wished to join in. People told us they were happy with the activities on offer.
We saw there was a system for gathering people’s views about the service. There was a system in place to record complaints and the service’s responses to them. People told us communication and the service response to complaints or concerns had improved.
Staff were positive about the new registered manager and the changes they had made at the home. They said, “I find the new manager is very approachable and will listen to any concerns. I think the home will continue to improve with better monitoring procedures and working practices” and “The new manager is making a difference and there have been noticeable improvements. I do feel much happier with this current situation. I love my work with the residents here.”
The service had notified CQC of any DoLS authorisations, accidents, serious incidents and safeguarding allegations as they are required to do.
The CQC rating and report from the last inspection was displayed in the entrance hall.