Sandwood Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Effective governance, management and accountability arrangements were in place to promote service improvement. Staff understood their roles and responsibilities. Managers accounted for their actions, values and performance of staff. The manager had clear oversight of the service and systems in place highlighted risks and areas for improvement. The manager was aware of the regulatory requirements and submitted notifications as required. The manager demonstrated a person centred approach and was committed to drive service improvement. This assessment did not cover all parts of our Single Assessment Framework, therefore we have only updated scores and ratings for those areas which we have assessed which means at this visit we use the ratings from the previous inspection to rate the key questions.

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.

The manager and staff displayed the values of the organisation. People were empowered to be part of the community and treated as individuals. Staff told us there was a much more open and transparent culture since the new manager had been in post. The manager told us there had been lots of changes which had improved the culture of the service. Staff echoed this. Staff told us, whilst at times their work could be challenging, they felt the changes at the service had a positive impact on the culture at the home. Staff told us, they were a strong team which endeavoured to provide with the best possible care.

Processes in place meant there was an open and honest culture. The manager had an open-door policy and completed daily walk rounds to ensure staff displayed the cultures and values of the organisation. The provider’s representative completed an audit to ensure staff worked in line with the values. Where staff failed to work in line with the culture and values of the home, action was taken to address this. We observed performance improvement plans in place to ensure the needs of people were met safely. An equality and diversity policy was in place which included all protected characteristics.

The manager knew people and their needs. Staff told us since the new manager was in post the improve had improved significantly. Staff told us, “[name] is really good, they want the best for people, I am scared they will leave, it’s the strongest we’ve been in a long time, and I don’t want that to change.” The manager told us, they were committed to improving the quality of the service, they had made changes where needed and recognised the previous instability of the management team had on the team. The manager was continuing to work with the wider staff team to ensure all staff felt confident in their job roles. The manager told us they had good support from their direct line manager and a new deputy manager also offered experience and support. The manager and staff worked with the wider community including the GP and pharmacists to improve the safety and care people received. Staff were encouraged and supported by the manger to organise community events such as Christmas party for people and their families to enjoy.

The management team were experienced and capable which provided a well-led service. Processes in place ensured the quality of the service was monitored and maintained. The manager promoted high standards of care with a dedicated and committed attitude to drive service improvement. A provider audit was completed to assure the manager continued to carry out their role effectively.

There was an open culture at the home which encouraged staff to speak up when needed. Staff told us they felt the manager was approachable and that if they needed to raise concerns, their concerns would be acted on. The manager told us, meetings and supervisions were held to encourage staff to raise concerns and share ideas in a forum they felt confident. The provider’s representative visited the service regularly to allow staff to speak with them if needed. Staff were aware of how to raise concerns both internally and externally.

Policies in place supported staff to raise concerns both internally and externally. Regular meetings were held and recorded to allow for staff not able to attend to review the content. Actions of meetings were documented to ensure any action needed was completed. A range of advocacy services were displayed for people to utilise of needed. This meant both staff and people were equipped to speak up if needed. Residents and relatives’ meetings were held for people and their families to raise any concerns they may have in a safe environment. A dedicated email address which was held centrally by provider was in place for anyone to report concerns to. This information was easily accessible on the provider’s website.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff were clear about their roles and responsibilities. Staff felt there had been lots of changes but felt this was positive for both staff and the service. Staff felt supported by the manager and told us they would act on any concerns to protect people using the service. Staff recognised at times the manager had to make difficult and unpopular decisions to improve the service for people. The manager was aware of their regulatory requirements and responsibility under the duty of candour. Duty of candour is a professional responsibility to be honest with people when things go wrong. The manager had submitted an application to become registered with CQC. They were open and honest throughout the assessment process. The manager and deputy manager displayed positive attitudes to the assessment process and were responsive to feedback.

Governance systems in place were effective. Audits in place were detailed and detailed what action was needed. This meant processes in place promoted service improvement. A wide range of audits including safeguarding, medicines and care planning was in place to ensure the service learnt from any errors. Audits were share with staff during team meetings with clear action on what the team needed to do, to ensure the quality and safety of care improved. The provider had policies in place to ensure staff knew how to perform their duties in line with guidance, legislation, and the providers own ways of working. Emergency contingency plans were in place to ensure staff had guidance in the event of an emergency. High risk policies such as safeguarding, fire and health and safety was freely available on the providers own website to inform people, staff and the public.

People told us they were supported to maintain contact with those that were important to them. A person also told us, they were supported to attend a virtual church service. We also observed signage around the home promoting the local church service for people. The local church visited Sandwood monthly to lead prayers for those unable to leave the home. People were supported to undertake activities of their choosing, and these were discussed at meetings and feedback acted upon. People told us staff contacted their GP when needed for them.

Staff and managers gave us examples of working with other healthcare professionals to improve people’s outcomes. Staff discussed working with the dementia outreach team to seek support in managing the symptoms people display when living with dementia. Care plans we reviewed demonstrated this guidance had been followed and implemented into care plans. The manager discussed working with the local GP to improve partnership working.

A professional we spoke with spoke positively about Sandwood. Staff were praised for their approach and did not refer to specialist services unnecessarily. A professional said, “Staff make timely referrals and provide good information, they act on feedback we give them.” Acting on feedback improved people’s outcomes and quality of life.

Systems and process in place meant referrals were made to other professionals when needed. When professionals provided advice and guidance this was implemented into care plans. For example, one person required a specialist chair as assessed and implemented by the occupational therapist. Care plans detailed how the person should safely sit in the chair including images to guide staff. This meant staff had correct guidance to follow to ensure people received the right care and support.

The manager told us they acted upon feedback from the local authority, CQC and the provider led audits to improve the service. Staff echoed this and told us, “Lots of positive changes had been made since the new manager started.” The manager told us they had implemented robust monitoring system to ensure lessons were learnt from previous incidents. For example, stringent medicines audits were now in place to ensure any errors were picked up in a timely manner. The manager told us they worked well with other professionals and discussed working with the primary care network pharmacist to strengthen the medicines process at Sandwood. The manager had support from frequent visits from their manager to ensure they had the opportunity to discuss any issues and share best practice.

Processes in place promoted quality improvement and detailed lessons learnt. Audits and incidents were shared at staff meetings and daily flash meetings. This met staff were provided with information to learn and reduce the risk of recurrence. Best practice guidance was shared in the home and training such as RESTORE2 and nutritional guidance was shared and implemented in the home. This improved people’s quality of life and outcomes. For example, people told us their nutritional intake had improved since living at Sandwood, records we reviewed supported this statement.