Archived: Sandgate Manor

Updated 7 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 28 and 29 November 2017 and was unannounced. Inspection site visit activity started on 28 November and ended on 29 November 2017. It included direct observation of care and support, interviews with people, their relatives and staff employed by the service, and review of care records and policies and procedures.

Before the inspection we looked at information we held about the provider. On this occasion we did not send a Provider Information Return to be completed. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications we had received. Notifications are information we receive from the service when significant events happen, like a serious injury. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

The inspection team consisted of two inspectors and one expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. We spoke with the registered manager, deputy manager, trainee manager, two senior carers, five care staff, nine people and three people’s relatives. After the inspection we spoke with a health and social care professional who is in regular contact with the service. We looked at six people’s care plans and the associated risk assessments and guidance. We looked at a range of other records including three staff recruitment files, the staff induction records, training and supervision schedules, staff rotas, medicines records and quality assurance surveys and audits.

This is the first time the service had been inspected under their new registration.

Updated 7 April 2018

Sandgate Manor is a service for up to 25 people with learning disabilities and /or autistic spectrum disorder who may also have physical disabilities. The service comprises of a large main house that houses 19 people and three lodges that house three people. At the time of our inspection there were 22 people living at the service.

Sandgate Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager at the service. 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 also employed a ‘home manager’ and a ‘trainee manager’ as part of the management team working under the registered manager.

People received their medicines when they needed them from staff that had been trained and competency checked. However, there were no separate protocols in place for ‘as required’ medicines. You can see what action we told the provider to take at the back of the full version of the report.

Quality auditing systems had not been effective in highlighting issues we found at this inspection such as with ‘as required’ medicines not having the required paperwork and the lack of an accessible complaint policy. You can see what action we told the provider to take at the back of the full version of the report.

People were kept safe from abuse and harm Staff had received training and knew how to report suspicions around abuse. Risks to people were minimised through the use of effective control measures. There were sufficient numbers of staff deployed to meet people’s needs and ensure their safety.

Staff understood the best practice procedures for reducing the risk of infection and audits were carried out to ensure the environment was clean and safe. The service used incidents, accidents and near misses to learn from mistakes and drive improvements.

People had effective assessments prior to a service being offered. Care outcomes were planned and staff understood what support each person required. Staff were trained in key areas and had the skills and knowledge to carry out their roles. People were supported to receive enough to eat and drink; staff used food and fluid charts to record intake for people at risk or malnourishment or dehydration.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act were being complied with and any restrictions were assessed to ensure they were lawful and the least restrictive option.

The service worked in collaboration with other professionals such as district nursing and people’s GP’s to ensure care was effectively delivered. People maintained good health and had access to health and social care professionals. Environments were risk assessed to ensure people were safe in their homes and staff could work without the risk of danger.

Staff treated people with kindness and compassion in their day to day care. Staff knew people’s needs well and people told us they valued and liked their care staff. People and their relatives were consulted around their care and support and their views were acted upon. People’s dignity and privacy was respected and upheld and staff encouraged people to be as independent as safely possible.

People received a person centred service that was supportive of their needs. People’s needs were fully assessed and care plans ensured that personal details were carried through to care delivery. Staff were open to any complaints and understood that responding to people’s concerns was a part of good care. There was a complaints policy and form, though there was not an accessible format available to people. We have made a recommendation about this in our report.

End of life care had been planned for people who wished to do so. The service had end of life care plans but these did not make it clear how people would be supported to prepare for the end of life phase. We have made a recommendation about this in our report.

There was an open and inclusive culture that was implemented by effective leadership from the registered manager. People and staff spoke of a ‘family’ culture that was caring. People, their families and staff members were engaged in the running of the service. There was a culture of learning from best practice and of working collaboratively with other professionals and health providers and this was done in an open and honest way.

This is the first time the service has been rated as Requires Improvement.