CQC report explained · a residential care home
What the CQC found at Sandiway Manor Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found robust safeguarding systems, accurate malnutrition risk assessments, regular weight checks, safe medicines management and enough staff. Recruitment checks had also improved.
- Effective?
- Good
- People's nutrition monitoring, staff training and induction had improved. Staff supported people to access healthcare, and the home followed the Mental Capacity Act principles described in the report.
- Caring?
- Good
- People and relatives described staff as kind, caring and respectful. Inspectors saw people being offered choices, supported to remain independent and treated with privacy and dignity.
- Responsive?
- Good
- Care plans were person-centred, regularly reviewed and up to date. People had access to daily activities, community activities and information in formats they could understand.
- Well-led?
- Requires improvement
- Governance, audits, supervision and management oversight had improved. However, inspectors judged that management and leadership were still inconsistent and needed to show good practice over a longer period.
What inspectors found, September 2019
Sandiway Manor Residential Home was rated Good overall; inspectors found safe, kind and responsive care, but rated well-led Requires Improvement.
Inspectors visited on 9 and 13 September 2019. The first visit was unannounced and the second was announced. They spoke with five people, five relatives and six staff, and reviewed care records, medicines records, recruitment files and management records.
The home was rated Good for safe, effective, caring and responsive care. People said they felt safe, received their medicines and had enough food and activities. Inspectors found better monitoring of weight, more consistent staff training, updated care plans and respectful support.
Well-led was rated Requires Improvement. Management and quality checks had improved, but inspectors said the leadership had not yet shown consistent good practice over time. The overall rating improved from Requires Improvement at the previous inspection, and the provider was no longer in breach of regulations.
People felt safe
People told inspectors they felt safe, and the home had improved its safeguarding systems and risk assessments. Weight monitoring had reduced the risks linked to malnutrition.
“Robust systems were now in place for the identifying and reporting of incidents of abuse.” from the report
Kind and respectful staff
Inspectors observed caring interactions. People were offered choices, supported to stay independent and treated with privacy and dignity.
“Without exception people and relatives told us that staff were "kind", "caring" and "respectful" towards people.” from the report
Improved activities
The home had increased the range of activities, including group sessions, one-to-one activities and events involving the local community.
“People now had access to regular daily activities in line with their wishes.” from the report
Better care records
Care plans were person-centred and regularly reviewed. They recorded people's preferences and how staff should support them.
“Care plans were person-centred and included how people were to be effectively supported.” from the report
Improved quality checks
Audits and checks were being completed more regularly and used to identify and address shortcomings.
“Quality assurance systems used now effectively monitored key aspects of the service.” from the report
Leadership needed more consistent evidence
needs fixingAlthough management and governance had improved, inspectors did not raise the well-led rating to Good because they needed to see consistent good practice over time.
“We could not improve the rating for Well-Led from Inadequate to Good because to do so requires consistent good practice over time.” from the report
- 01What evidence since this inspection shows that leadership and management have been consistently good over time?
- 02Which audits and checks are now used, and how do you make sure any problems are acted on promptly?
- 03How do you monitor people's weights and respond if someone is at risk of malnutrition?
- 04How are staff training, induction and supervision kept up to date?
- 05What daily and community activities are available for a person with my relative's interests and abilities?
This was a planned inspection based on the previous rating and considered the care provided, the premises and all five CQC questions. This explanation was written from the published report of 25 September 2019 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, January 2019
Sandiway Manor Residential Home was rated Requires Improvement, with kind care but inadequate leadership and ongoing safety concerns.
Inspectors made an unannounced visit on 21 and 22 November 2018. They spoke with 13 people, staff, the manager and the provider's representative. They checked four care records, four recruitment records and records about the home's day-to-day running.
The home was caring, clean and supplied medicines as prescribed. People spoke positively about staff, food and access to health professionals. However, nutritional checks, safeguarding investigations, staff training, care records and activities were not always managed properly.
Leadership was rated Inadequate. The provider had not acted on earlier concerns about quality checks and leadership. This was the fifth consecutive Requires Improvement rating, although a new manager and new chief executive had started making changes.
The overall Requires Improvement rating means inspectors found that the home was not consistently meeting the required standards. The report identified breaches of regulations about safe care, safeguarding and good governance.
Kind and respectful care
People described staff positively, and inspectors saw staff offering reassurance, respecting privacy and supporting people's choices.
“Throughout the inspection we overheard staff speaking kindly to people, offering gentle and supportive encouragement where needed, or reassurance where people were upset and distressed.” from the report
Medicines managed better
Inspectors found that medicines were being given as prescribed. Earlier problems with medicines management had been addressed, apart from one discrepancy that had already been found and corrected.
“At this inspection we found that these issues had been addressed.” from the report
Food and health support
People liked the food, which was freshly prepared and adapted for special dietary needs. People were supported to see health professionals when needed.
“Home-made food was served on a daily basis and were nutritionally balanced.” from the report
Clean and suitable environment
The home was clean and fresh-smelling. Inspectors found safe water temperatures, working safety equipment and suitable access around the building.
“The service was clean throughout and smelled fresh.” from the report
Safeguarding delays
seriousA safeguarding investigation had not been completed several months after an incident. Inspectors said this could leave people at risk of ongoing harm.
“This showed that safeguarding processes were not robust enough to investigate incidents and protect people from the risk of harm.” from the report
Missed nutrition checks
seriousTwo people did not have nutritional risk assessments. Weight checks were also missed, including for someone who had lost weight.
“Whilst we identified that people had not come to harm as a result of this, people were placed at the potential risk of harm because adequate monitoring was not in place to identify and address the risk of weight-loss.” from the report
Weak leadership and monitoring
seriousLeadership had been unstable and the provider's quality checks were not effective. Similar concerns had been raised at the previous inspection but had not been dealt with.
“The registered provider had quality monitoring processes in place however these were ineffective.” from the report
Staff training and recruitment gaps
needs fixingSome staff training was not up to date. Inspectors also found missing references, an absent risk assessment for a previous conviction and unclear timescales for renewing criminal record checks.
“Staff had not always received the training they needed to carry out their role.” from the report
Too few activities
needs fixingPeople said they were bored and spent much of the day sitting or sleeping in the lounge. Inspectors did not see activities taking place.
“During our inspection we did not observe any activities taking place.” from the report
Care records not always current
needs fixingSome records were detailed, but others were incomplete or out of date. This included records about weight monitoring and malnutrition risks.
“However, in other examples we observed that care records were not being kept up-to-date.” from the report
- 01What has changed since the inspection to make sure every person's nutritional risk assessment and weight checks are completed on time?
- 02How are safeguarding concerns now investigated, recorded and reported without delay?
- 03What staff training is currently overdue, and when will all staff complete it?
- 04What regular activities are now available, and how are they matched to each person's interests?
- 05How does the provider now check that care records are complete and up to date?
This was an unannounced inspection covering all five rating areas, including the care provided and the home's premises. This explanation was written from the published report of 18 January 2019 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 Sandiway Manor Residential Home
6 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Sandiway Manor Residential Home →
- January 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at Sandiway Manor Residential Home →
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- February 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 24 December 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
84 live-in carers within about an hour of Cheshire West and Chester
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 £980 to £1,260 a week. 76 can care for a couple. 10 years' experience on average.
“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.