Archived: Sandhall Park

We carried out an unannounced comprehensive inspection of this service on 26 January 2015. At which a total of 12 breaches of legal requirements were found. We took enforcement action with regard to three breaches in relation to Regulations 22 (Staffing) 17 (Respecting and involving people who use services) and 10 (Assessing and monitoring the quality of service provision) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The provider was given a fixed timescale for compliance with the enforcement notices.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to the three enforcement notices. We undertook a focused inspection on the 26 March 2015 to check that the registered provider had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to the three enforcement notices. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Sandhall Park’ on our website at www.cqc.org.uk

Sandhall Park provides accommodation for up to 50 people who require support with their personal care. The home provides support for older people and people living with dementia. There were 41 people living at the home at the time of our inspection.

The home’s registered manager has been in post since January 2015. 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 and associated Regulations about how the service is run.

At our focused inspection on the 26 March 2015, we found that the provider had followed their plan which they had told us would be completed by the 15 March 2015 and legal requirements had been met.

There were enough staff to meet people’s needs and staffing levels were monitored using a dependency level tool to ensure people’s needs were met. Staff had been employed following robust recruitment and selection processes.

Staff received a range of training opportunities and told us they were supported so they could deliver effective care; this included staff induction, supervision and staff meetings.

People we spoke with said staff were caring and they were happy with the care they received. Care records contained assessments, which identified risks and described the measures in place to ensure the risk of harm to people was minimised. The care records we viewed also showed us that people’s health and wellbeing was monitored and referrals were made to other health professionals as appropriate.

The registered manager monitored the quality of the service, supported the staff team and ensured that people who used the service were able to make suggestions and raise concerns. We saw from recent audits that the service was meeting their internal quality standards.

The inspection took place on the 26 January 2015. The inspection was unannounced. At the last inspection the service was fully compliant with the regulations we looked at.

Sandhall Park is registered to provide accommodation and care for up to 50 older people. The service is a purpose built, single storey care home with car parking to the side and rear of the property. There were 48 people living at the home at the time of our inspection, some of whom had dementia care needs.

The home has a registered manager. 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.

During our inspection we identified 13 breaches in the Health and Social Care Act. This included care and welfare, safety and suitability of premises, safeguarding people from abuse, cleanliness and infection control, management of medicines, meeting nutritional needs, respecting and involving service users, complaints, consent to care and treatment, staffing, requirements relating to workers, supporting workers and assessing and monitoring the quality of service provision. These ranged from minor to major concerns. You can see what action we have told the provider to take at the back of the full version of the report.

We found that people were not always kept safe. Staffing numbers were insufficient and this was impacting on the care and support which people received. Not all people felt safe or confident in raising issues around their safety.

Risks were not always appropriately managed. Although accidents and incidents were recorded they were not analysed to prevent re-occurrence. A high number of falls were happening and the registered manager had not taken action to try to prevent them.

Recruitment practices did not follow company procedures and appropriate checks were not always completed.

Medication systems required review. Medication was not appropriately recorded and it was not clear if medicines were being given as prescribed.

Some of the maintenance checks were not up to date and we found some unpleasant odours in parts of the home. A major programme of redecoration was underway.

Staff did not always receive induction, training or supervision to support them in their roles. Training was not up to date and from our observations the quality of the training needs to be considered.

There was no dementia care model and little evidence to suggest that current guidance or research was being considered or that staff had the knowledge, skills or experience to provide safe, effective care for people.

Consent was not always gained and staff demonstrated little or no understanding of the Mental Capacity Act 2005. There was little evidence to demonstrate that people were involved in discussions regarding their care or treatment.

Staff did not demonstrate appropriate skills or knowledge when supporting people with distressed or anxious behaviours. This meant that people’s safety could be compromised.

The dining experience for people was poor with little in terms of choice. Mealtimes were task based rather than social opportunities for people and staff failed to respond to people’s requests.

The adaptation and design of the premises was not suitable for people with dementia care needs.

A major programme of redecoration and refurbishment was taking place.

People did not always receive appropriate care which met their needs. Care was task based and we observed examples where staff failed to respond appropriately to people’s requests for help.

People’s privacy and dignity was not maintained and people were not treated with respect. There was little evidence to demonstrate that people were offered choice.

People had their needs assessed and care records were available. Some of these records were not up to date and did not reflect people’s individual needs.

Social activities did not take into account people’s likes, dislikes and preferences. There was very little in terms of meaningful activity or social stimulation available.

The complaints procedure was not displayed and people told us they were not clear of who to complain to. When people raised concerns they were not responded to appropriately.

Some people did not know who the registered manager was. The home was not well managed and staff were not displaying appropriate values and behaviours.

Quality monitoring systems were ineffective and did not bring about change and improvement.