CQC report explained · a nursing home
What the CQC found at Sandfields
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, with safeguarding procedures, risk assessments, safe recruitment and medicines systems in place. Infection prevention and control arrangements were also checked and found satisfactory.
- Effective?
- Good
- This area was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found positive leadership, open communication and effective quality checks. People, relatives and staff spoke positively about the management.
What inspectors found, February 2023
Sandfields rated Good; inspectors found safe care and strong leadership during a focused inspection after concerns about safeguarding and staffing.
The inspection took place without notice on 18, 19 and 20 January 2023. Two inspectors and an Expert by Experience spoke with people living there, relatives, staff and professionals. They also observed care and checked care records, medicines records and management records.
The inspection was prompted by concerns about safeguarding and staffing. Inspectors found no evidence that people were at risk of harm from these concerns. They rated Safe and Well-led as Good.
The home had safeguarding procedures, risk assessments, safe recruitment checks and systems for managing medicines and infection. Staff knew people's needs, and inspectors found positive leadership and systems for checking and improving care.
This was a focused inspection of Safe and Well-led. The other three areas were not inspected, so their previous ratings were used for the overall Good rating. The previous overall rating was also Good, published on 30 August 2017.
Safeguarding and risk management
Staff had safeguarding training and understood how to report concerns. Risks such as falls, pressure ulcers, fire and the environment were assessed and reviewed.
“Risk assessments in relation to these areas of risk were regularly reviewed and updated as required.” from the report
Medicines
Medicines were stored, given and disposed of safely. Electronic records showed that people received their medicines as prescribed.
“Medication administration records (MAR) were accurately completed electronically, and showed people received their medicines as prescribed.” from the report
Person-centred information
The home recorded people's histories, character and preferences. Inspectors also saw examples of people being supported to follow personal interests and goals.
“Life story books and memory boxes outside people's bedrooms had been filled with information about people's history, character and preferences.” from the report
Leadership and quality checks
Managers were open to feedback and used audits, meetings and reviews to identify and act on improvements.
“An effective and robust system of quality assurance checks, both at service and provider level helped ensure continuous development and improvement of people's care.” from the report
Sharing safeguarding lessons
minorThe manager was still strengthening how investigation findings and lessons learned were shared with relatives. Ask how this now works in practice.
“The registered manager was strengthening their systems around sharing investigation findings and any lessons learned with relatives.” from the report
Staff consistency
minorThe manager was working to improve consistency by reducing agency staff where possible. Ask what progress has been made since the inspection.
“The registered manager told us they were working to further improve staff consistency by minimising agency staff as far as practically possible.” from the report
- 01How do you now share safeguarding investigation findings and lessons learned with relatives?
- 02How many agency staff are currently being used, and what have you done to improve staff consistency?
- 03How often are people's falls and pressure ulcer risk assessments reviewed and updated?
- 04How do you check that medicines are given safely and that staff remain competent to administer them?
- 05How do you act on issues found through your daily audits and quality checks?
This was an unannounced focused inspection of Safe and Well-led, including infection prevention and control under Safe; the other ratings carried over from the previous inspection. This explanation was written from the published report of 8 February 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2017
Rated Good; inspectors found safe, kind and responsive care, but consent records for some sensor systems were not always complete.
Inspectors visited the home without warning on 4 and 5 July 2017. They spoke with people, relatives, staff and healthcare professionals. They observed care and reviewed care files, staff records and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People told inspectors they felt safe, cared for and happy. Inspectors found enough staff, safe medicines practice, suitable care plans, personalised activities and positive relationships between people and staff.
The inspection also followed up concerns from a March 2017 coroner's inquest about recognising medical concerns and seeking medical help. Inspectors found staff identified changes in people's health and took suitable action. The home had also improved its recording of risk plans since the previous inspection.
Inspectors found one recording shortfall. Consent or best-interest decisions were not always recorded for room sensor systems. This was raised during the inspection and the home took immediate action.
Clearer risk information
The home had improved its risk-management records since the previous inspection. Staff had clear guidance about how to support people safely.
“Following our previous inspection the provider had improved the recording of people's risk management plans.” from the report
Kind, personal care
Staff knew people's preferences and supported their dignity, independence and wellbeing. Inspectors saw respectful and friendly relationships.
“Care staff knew people well and what was important to them.” from the report
Activities and social life
People had activities based on their interests, with opportunities to go out and take part in meaningful tasks. Activities were provided throughout the week.
“The team ensured activities were provided seven days a week for people to enjoy.” from the report
Health and nutrition support
Staff supported people to access healthcare and responded when people became unwell. Dietary needs, preferences and risks such as choking were recorded and understood by staff.
“People were cared for and supported by staff who identified changes in their needs and took effective action.” from the report
Active quality checks
Management used meetings, surveys, audits and an improvement plan to identify and follow up actions.
“The service operates a detailed service improvement plan, which covers a range of areas including care, health and safety, learning and development and customer satisfaction.” from the report
Sensor consent records
needs fixingConsent or best-interest decisions for some room sensor systems had not always been recorded. The issue was raised with management and immediate action was taken.
“We found where people had sensor systems in their room that the consent of the person, or best interest decisions had not always been recorded.” from the report
- 01How do you record consent or best-interest decisions for room sensor systems, and how do you check these records remain up to date?
- 02What changes were made to risk-management and care records after the previous inspection, and how are these improvements checked now?
- 03How do you ensure staff recognise changes in a person's health and seek medical help promptly?
- 04How are activities matched to each person's interests, and how do you make sure people who use wheelchairs can take part in outings?
- 05How do you decide staffing levels across the home's units, including if the unused unit is brought back into use?
This was an unannounced inspection of the overall service and all five CQC questions, with additional follow-up of concerns raised after a March 2017 coroner's inquest. This explanation was written from the published report of 30 August 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Sandfields
3 rated inspections over 7 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: GoodWell-led: Good
- October 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- January 2014
Registered with the Care Quality Commission on 24 January 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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38 live-in carers within about an hour of Gloucestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,030 to £1,360 a week. 31 can care for a couple. 12 years' experience on average.
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