CQC report explained · a residential care home
What the CQC found at Sandmar
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, staff understood their risks and there were enough staff to meet people's needs. Medicines records were complete, and inspectors were assured about infection prevention and control.
- Effective?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- People had detailed, individual support plans and were involved in reviewing them. They were supported with choices, activities, relationships and communication needs.
- Well-led?
- Good
- The management team used checks on care records, medicines, staff records and surveys to plan and review improvements. Relatives and health professionals said communication and partnership working were effective.
What inspectors found, July 2021
Sandmar rated Good; inspectors found safe, personalised care and effective management, with improvements since the previous inspection.
This was an announced focused inspection on 19 May 2021. The inspector spoke with people living at the home, managers, relatives, care staff and health professionals. Records about care, medicines, staffing and management were also checked.
The home was rated Good overall. Inspectors found that people felt safe, medicines were managed safely, infection control measures were in place and staff understood people's risks and support needs. Care plans were detailed and personalised, and people were supported with activities, relationships and independence.
The home had previously been rated Requires Improvement in 2019 and had breached Regulation 12. Inspectors found that improvements had been made and the home was no longer in breach. This inspection only assessed Safe, Responsive and Well-led. The other ratings were carried forward from the earlier comprehensive inspection.
Risk management
Risk assessments covered issues such as smoking, changes in mental health and going out independently. Staff understood the plans and the actions needed to keep people safe.
“Risk assessments and management plans had been reviewed and updated as people's needs changed.” from the report
Personalised support
Support plans gave staff detailed information about each person's needs, goals and preferences. People were involved in regular reviews and supported to make choices.
“People had clear support plans, which set out how their individual needs should be met.” from the report
Medicines
Medicines administration records were complete and recorded medicines given and held at the home. There were also clear instructions for medicines taken when needed.
“Medicines administration records had been fully completed.” from the report
Quality monitoring
The management team checked records, medicines, staff files and satisfaction surveys. They used the results to plan improvements and checked that actions were completed.
“The provider had effective quality assurance systems in place.” from the report
Activities and relationships
People were supported to take part in activities they enjoyed and to keep in touch with family and friends. Activities were adapted during COVID-19 restrictions.
“People were supported to take part in a range of activities they enjoyed.” from the report
Inspectors raised no specific concerns in this report.
- 01How often will my relative's risk assessments and management plans be reviewed when their needs change?
- 02How will you involve my relative and our family in reviewing their personalised support plan?
- 03What activities and opportunities for trips out are currently available?
- 04How will you keep families informed about visiting arrangements and any changes linked to infection control?
- 05What checks are carried out on medicines records and what happens if a problem is found?
This was a focused inspection of Safe, Responsive and Well-led only; the other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 2 July 2021 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, March 2019
Rated Requires Improvement; inspectors found kind and effective care, but risks, care plans and activities were not always managed well.
Inspectors visited on 9 and 14 January 2019 without giving notice. There were 11 people living in the home. They spoke with people, relatives, managers, staff and a care coordinator. They observed care and checked care plans, medicines, staffing, training and management records.
The home was rated Good for Effective, Caring and Well-led. People said staff were kind, approachable and available. Staff supported people with healthcare, training was in place, and people were involved in decisions about their care.
Safe and Responsive were rated Requires Improvement. Some risk assessments were not updated or followed. Medicine instructions for medicines taken when needed were not always clear. Some care plans lacked detail, and records showed people spent much of their time watching television.
The overall rating Requires Improvement means the home was not consistently meeting the standard expected by the CQC. The report identified a breach of Regulation 12 about safe care and treatment, and the provider was required to say what action it would take.
Kind staff
People and relatives praised the staff. Inspectors saw staff use a calm and compassionate approach when people were anxious or distressed.
“People we spoke with and relatives praised the staff for their caring manner.” from the report
Medicines records
Medicine administration records were completed consistently, and medicines no longer needed were disposed of appropriately.
“Medicine administration records (MAR) were consistently signed to show medicines administered.” from the report
Staffing and security
People said there were enough staff and that staff were available when support was needed. People said having staff on duty gave them a sense of security.
“Two people said having staff on duty at all times gave them a sense of security.” from the report
Staff training
New staff received an induction, and training records showed that staff had attended mandatory training. Regular supervision and annual appraisals were also in place.
“The training records confirmed that staff had attended mandatory training.” from the report
Approachable management
People and staff said managers were approachable. Inspectors observed good interaction between the provider and people living in the home.
“People told us senior managers were approachable and they knew the providers.” from the report
Risks were not always controlled
seriousRisk assessments were not always updated after people's needs or behaviour changed, and staff did not always follow the guidance. Smoking indoors continued despite an agreement, creating a risk to everyone in the home.
“The agreement not to smoke inside and to hand in cigarettes for safe keeping was not adhered to.” from the report
Unclear instructions for some medicines
seriousInstructions for medicines taken when needed did not always explain whether staff should offer them or how to choose between different medicines.
“PRN protocols did not always detail whether PRN medicines were to be offered or if the person was able to request them.” from the report
Care plans lacked detail
needs fixingSome care plans did not clearly explain people's preferences, needs or how staff should support them. Plans for community treatment orders also lacked clear instructions about what to do if conditions were broken.
“Some care plans lacked detail on how staff were to support people effectively.” from the report
Audits did not always find problems
needs fixingThe home's audits did not assess care plans against a clear standard. Inspectors also found that some records needed closer management monitoring.
“The quality of the care plans had not been assessed against a set standard instead the audit listed the care plans that were reviewed.” from the report
- 01How have you updated risk assessments when people's behaviour or other risks change, and how do you check that staff follow them?
- 02What has changed about the arrangements for preventing smoking indoors?
- 03How do your current instructions explain when and how each medicine taken when needed should be given?
- 04How will you make sure care plans clearly describe each person's needs, preferences and support?
- 05What meaningful activities are now available, and how do you record whether people take part and enjoy them?
This was an unannounced inspection covering all five CQC areas, including care, premises, records, staffing and management. This explanation was written from the published report of 27 March 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 Sandmar
3 rated inspections over 5 years: the service has held its Good rating throughout.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementdown from GoodSafe: Requires improvementResponsive: Requires improvementWell-led: Good
- September 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 15 January 2011.
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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