13 December 2017
During a routine inspection
Sandhall Park provides accommodation for up to 50 people who require support with their personal care. The service provided personal care and support for older people and people living with dementia. The premises are on ground floor level and split into two separate areas. The Honeysuckle area supports people with residential needs and Jasmine area supports people living with dementia. On the first day of the inspection there were 46 people living at this service.
The provider is required to have a registered manager in post. There was a registered manager and they had been in post since August 2014. 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.
At our previous inspection in December 2016 we rated the service Good. During this inspection we found the provider to be ‘Requires Improvement’ in safe and well-led. We found evidence to support that the provider was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Quality assurance systems and audits were in place. However, these did not identify all the issues we raised during the inspection. In addition, where the internal audits had highlighted areas that required improvements, at the time of our visit these had not been fully actioned.
People received care and support from care workers that had good knowledge about their needs and preferences. However, risk assessments when reviewed did not always take into account deterioration in people’s health needs and some scores were incorrectly totalled. Records showed us that people’s consent to their care was sought and documented in care plans.
People’s health care needs were recorded and monitored so that appropriate referrals could be made to health professionals for advice and guidance.
Relatives told us they always felt welcomed when they visited the home and that they had no restrictions around visiting times within reasonable hours of the day. The majority of relatives felt the communication was good and that they knew what was going on, although some felt concerns were not always addressed effectively.
Care workers completed online and face to face training courses. Senior care workers checked that staff completed refresher training to ensure that skills and knowledge were current. The majority of care workers felt supported, although we received mixed feedback about whether they would feel comfortable raising concerns to the registered manager.
Care workers received monthly supervisions and annual appraisals. Recruitment checks were conducted but improvements were required to make recruitment practices more robust.
Safeguarding concerns were recorded in accidents and incidents, and individual’s care folders. The central safeguarding log did not contain all the concerns, or always show actions taken or the lessons learnt.
Overall medicines were administered and stored safely. People were supported if necessary to attend their annual medicine reviews. However, some labels for creams did not include sufficient information to guide staff on where they should be applied. Records for pain relief were not monitored for their effectiveness and when required medicines protocols were not in place.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.