Background to this inspection
Updated
27 August 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors, a specialist advisor who was a registered nurse and an 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.
Service and service type
Sanderstead Care Centre is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager who was in the process of registering with the Care Quality Commission. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service about their experience of the care provided. We spoke with the operations director who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the service improvement manager, three members of care staff, a nurse, a domestic worker and the laundry assistant. During the inspection we observed how staff interacted with people who used the service. We reviewed a range of records. This included five people’s care records. We looked at two staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including policies and procedures, accident and incident forms and audits were also reviewed.
After the inspection
We spoke with five relatives of people. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.
Updated
27 August 2022
About the service
Sanderstead Care Centre is a residential care home providing accommodation for persons who require nursing or personal care to 19 older people many of whom live with dementia. The service can support up to 44 people.
People’s experience of using this service and what we found
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
We found systems and processes used to ensure the service was safe and effective failed to meet the required standards. We observed a lack of leadership, direction and oversight. Governance arrangements and quality assurance auditing systems were in place but not used effectively. The service was not well-led.
While we did not identify any direct impact on people, however people were at risk of harm as risks were not adequately assessed and there was an absence of key care planning documentation.
Communal areas of the home were in need of redecoration, refurbishment and regular maintenance.
People were not supported to have maximum choice and control of their lives.
Incidents and accidents were reviewed and reported to ensure lessons were learnt to drive improvements. However, lessons were not cascaded to staff. This was confirmed by the provider and by staff.
We were assured people were protected from the risk and spread of infection.
Systems in place to safeguard people from abuse were effectively implemented.
People were supported by staff appropriately as far as it was possible during the COVID-19 pandemic restrictions.
For more details, please see the full report, which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 20 April 2021).
Why we inspected
The inspection was prompted because we received information of concern from visiting professionals about the environment and the care and support people were receiving. A decision was made for us to inspect and examine those risks. As a result, we undertook a comprehensive inspection.
The overall rating for the service has changed from requires improvement to inadequate. This is based on the findings at this inspection. We have found evidence the provider needs to make improvements.
Following on from this inspection the provider submitted a formal application to the Care Quality Commission to close the location.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so. We have identified breaches in relation to safe care and treatment, premises, consent, staffing and good governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Special Measures
The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within six months to check for significant improvements. If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration. For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.