Sandwood 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

People and those important to them were supported to understand safeguarding and how to raise concerns when they didn’t feel safe. Staff understood their duty to protect people from abuse and knew how and when to report any concerns they had to managers. When concerns had been raised, managers reported these promptly to the relevant agencies and worked proactively with them, to make sure timely action was taken to safeguard people from further risk. Safety risks to people were managed well. Managers assessed and reviewed safety risks to people and made sure people, and those important to them, were involved in making decisions about how they wished to be supported to stay safe. There were enough staff to support people with their needs. Managers reviewed staffing levels regularly to make sure there were always enough suitably skilled and experienced staff on duty. Staff received relevant training to meet people’s needs. Staff received support through supervision. Managers made sure recruitment checks were undertaken on all staff to ensure only those individuals that were deemed suitable and fit, would be employed to support people at the service.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they felt safe living at Sandwood. One person said “I feel safe here, I have my call bell and staff come when I need them, I would report anything I needed to the office.” People told us that there were no unlawful restrictions imposed on them. They were free to complete their own routines and live their lives as they wished. Some people would be at risk if they did not have continuous supervision and control, where this was the case, we saw staff had applied the suitable Deprivation of Liberty Safeguards. These safeguards ensure people who cannot consent to their care arrangements in a care home or hospital are protected if those arrangements deprive them of their liberty.

Staff understood how to respond to allegations of abuse. Staff told us that they had no concerns, but if they did, they were confident the management team would act appropriately. The manager understood how to respond to allegations of abuse. They had a clear process of how to investigate and keep people safe. Staff knew where to find the safeguarding policy. Staff understood what they needed to report and how they should report any concerns of abuse.

We saw people and staff have positive relationships. There was an open culture of communication and we saw no evidence that people were at risk or fearful of the staff team. People appeared relaxed and happy in staff’s company. Observations were carried out in the living area there was no practice which caused concern. All people were spoken to respectfully and all care was given with consent or in their best interests. This was cross referenced with people's care plans. For example, we reviewed a care plan which demonstrated a clear MCA decision had been made to deliver kind and compassionate care in the person's best interest.

Safeguarding concerns were reported in a timely manner to the relevant authority, action was taken to reduce any ongoing risks to people whilst waiting for an outcome for the safeguarding team. Lessons learnt were shared with the staff team to reduce the risk of recurrence. If an allegation of abuse was made, there were appropriate policies in place to guide the staff team. Records showed that incidents were quickly investigated and referred to the local authority safeguarding team if needed. Staff received training in safeguarding and were supported to discuss any learning from safeguarding incidents in their preferred forum, such as individual supervisions or at regular team meetings.

People told us that staff understood their needs well and offered support to keep them safe. A person we spoke with told us, “I am well looked after, If I need anybody, I have a red button to press.” Another person we spoke with told us, “The staff do help, [name] is great, I am waiting to be seen for more specialist equipment so I can get out and about again.” A relative we spoke with told us, “I’m satisfied [relative] is safe, I think they give her independence and privacy.”

Staff told us they felt they were able to support people safely. Staff we spoke with told us, recent changes at the home had made things safer for people living at Sandwood. Staff told us, “We have had lots of changes recently which has been good for the home, it is safer now, we have a strong team.” Staff recognised the possible risk agency staff brought to the service, but they ensured they gave all agency staff a thorough induction. The manager told us, any risks were discussed at the daily flash meeting to ensure risk reduction measures were implemented without delay.

Risks were managed safely. We observed high risk areas such as rooms storing hazardous products to be locked. This protected people living with dementia from potential harm. We observed risk reduction measures in place, such as falls sensor mats and specialist moving and handling equipment in place for people. People were prompted to take positive risks; walking equipment, such as a walking frames were left within easy reach to ensure people were able to remain as independent as possible. People were supported safely during lunch, people who required physical support with their nutritional needs were supported according to their individual needs and consent was gained.

People had detailed person-centred care plans in place. Risks were assessed and risk reduction measures detailed. For example, a detailed skin integrity risk assessment and care plan was in place for a person who was at risk of skin damage. Records we reviewed demonstrated staff followed and implemented this guidance to reduce the risk of skin damage. People had detailed falls risk assessments in place and any mitigation clearly documented. Each person had an individual personal emergency evacuation plan in place. This meant staff and emergency services had accurate information in the event of an emergency. Specialist support had been sought when needed. For example, a referral had been made to the speech and language therapy team for a person who was at risk of choking, their guidance had been implemented and documented into care plans. A weekly check had been implemented to ensure all monitoring records such as repositioning records, fluid charts and continence records were checked by the management team to ensure support provided was in line with each person’s assessed need. Where gaps had been identified, action was taken and shared with staff to prevent re-occurrence.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they were supported by kind staff who supported them safely. We received mixed feedback regarding responsive to waiting times. Some people told us they did not wait long for staff to provide support whereas others told us, it was varied, sometimes they waited longer than others. A person we spoke with said, “I think staff come fairly quickly”, however another person said, “I don’t wait long but sometimes I have to remind them to come back”. People told us they felt staff supported them safely. A person we spoke with said “The staff are very good; they know what they are doing.” People told us the agency staff supported them safely and they knew people well. One person we spoke with said, “We have regular agency staff who know my routine.”

We spoke with 7 members of staff during the inspection and received feedback from one member of staff following our visit to Sandwood. Staff told us, at times they were short staffed but felt whilst it made shifts busy, they didn’t feel people’s safety had been compromised, staff did tell us this had improved recently. The manager feedback recruitment had been an issue, but they had overcome this. Staff told us the use of regular agency staff had eased staff shortages and felt confident in the agency staff they used. Staff told us where they had shared concerns regarding some agency staff the manager had listened and taken action. Staff told us, they felt the team was strong and felt the leadership was strong. We received a concern following our visit to Sandwood relating to staffing levels but found no evidence to support these concerns.

There were enough suitably trained staff providing care and support during our visit to Sandwood. We observed people to supported in a timely manner without any significant delay. Staff supported people using a kind and caring approach. Staff appeared to know people well and we observed people to be relaxed in the company of staff. We observed people to receive timely support during lunch time. People looked well-groomed and clean throughout the day. People were not left on their own in any of the communal areas. This protected people from the risk of harm as staff were present to anticipate any potential risks. Dining areas were busy with people who were sat taking part in activities with staff. We observed activity staff to display exceptional kindness and rapport with all people.

Processes in place ensured there were enough suitably trained staff on duty. There was a dependency tool in place taking into account people’s individual needs. This determined how many staff were required each day in order to support people safely. Staff were recruited safely. Processes ensured necessary checks were completed prior to staff starting at Sandwood. This included reference checks, proof of identity as well as Disclosure and Barring Service (DBS) checks. A DBS check is a way for employers to check an employee criminal record, to help decide whether they are a suitable person to work for them. This protected people from receiving support from unsuitable staff.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they were involved in the management of their prescribed medicines. However, people did tell us, they did not always receive their medicines on time which concerned them. A person we spoke with told us, “They do sometimes bring my medicines late.” And another person told us, “My nighttime tablet can be late sometimes.” People told us they received tablets for pain when needed and felt confident staff would contact their GP about their prescribed medicines if needed for advice.

Staff told us that they completed training to safely provide support to people with medicines. Staff were able to describe safe systems for medicine management. The manager was open and honest about recent medicine errors and described the action they had taken to reduce the risk of further medicines errors. Staff told us, “We have learnt from the mistakes we made around medicines, the manager is very passionate about getting things right.”

Processes in place meant people were protected from the risk of receiving their prescribed medicines unsafely. Following medicines errors, action was taken by the manager to reduce the risk of recurrence. For example, where human error was found to be a cause for concern, staff were supported to complete their training again and have their competency reassessed. A new process of ‘four checks a day’ was also introduced and completed to highlight any administration errors immediately. Specialist professional advice had been sought from a pharmacist who works with the service to ensure enough action had been taken to improve the management of medicines. People had medicine administration records in place which detailed how they like to take their medicines and what support they needed. This meant staff had accurate information in order to support people safely. We found medicine administration records to be completed legibly which meant they could be reviewed by other healthcare professionals if needed. Where people were prescribed time critical medicines such as medicine for Parkinson's disease, these were given on time. This meant people would not be subjected to any unnecessary symptoms associated with not receiving their medicines as prescribed. Controlled drugs were stored according to guidance. Staff completed regular checks for controlled drugs. Controlled drugs are subject to government restrictions due to the risk of harm and/or addiction. Completing regular stock checks of these medicines, provides assurances of management of these high-risk medicines.