CQC report explained · a residential care home
What the CQC found at Sandstones
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, staffing, environmental checks and incident records were managed safely, and the home had improved its medicines processes since the last inspection.
- Effective?
- Good
- Care plans covered people's needs and preferences, staff had training and support, and people received fresh food and help to access healthcare. The home followed the principles of the Mental Capacity Act and had submitted Deprivation of Liberty Safeguards applications where needed.
- Caring?
- Outstanding
- People were treated with exceptional kindness, dignity and respect. They were involved in decisions, supported to stay independent and encouraged to continue their relationships, interests and community activities.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People chose their daily routines and activities, had information in different formats, and felt able to raise concerns that were dealt with promptly.
- Well-led?
- Good
- Managers and staff created an open, inclusive and person-centred culture. Audits, feedback, incident reviews and partnership working were used to monitor and improve the service.
What inspectors found, September 2019
Rated Good overall; inspectors found exceptionally caring, person-centred support and improved medicines management.
The inspection was unannounced and took place on 10 July 2019. One inspector reviewed care records, medicines, staff training, recruitment, incidents, accidents and quality checks. They spoke with people living in the home, staff, relatives and a local authority officer.
The home supported 35 older people. Inspectors found that people felt safe, had choice over their routines and were supported to remain active and involved in the community. Food was fresh and plentiful, records were well kept, and staff knew people very well.
Care was rated Outstanding. The other four areas were rated Good: Safe, Effective, Responsive and Well-led. The overall rating stayed Good, while Caring improved from Good at the previous inspection. Safe also improved from Requires Improvement to Good, including better medicines stock checks and eye-drop processes.
Exceptional kindness
Inspectors found a strong culture of compassion. Staff knew people well and went beyond basic care to support their emotional wellbeing and personal relationships.
“There was an exceptionally strong and visible person-centred culture with staff going out of their way to ensure that people were respected as individuals” from the report
Choice and independence
People had control over their routines, activities and care. Staff supported people to keep their skills, interests and community connections.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Safe medicines practice
The home had acted on the previous inspection's concerns about medicines stock and eye drops. Inspectors found medicines were stored, given and disposed of safely.
“Medicines were received, stored administered and disposed of safely. Regular audits of medication stock have improved practice in this area.” from the report
Good knowledge of people
Staff understood people's needs, preferences and health changes. This supported continuity of care and early access to healthcare.
“Healthcare records were kept to high standards and staff knowledge of individuals was extremely good.” from the report
Activities and community links
People helped shape the activities programme and were supported to take part in gardening, shopping, visits and other community activities.
“People were offered a stimulating range of social and recreational activities. They were encouraged and supported to continue their interests both within and outside their home.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you support my relative to keep control of their daily routine and make their own choices?
- 02How would you support my relative to continue their hobbies, relationships and activities outside the home?
- 03What support would my relative receive with medicines, including if they wanted to self-medicate?
- 04How would you identify and respond to changes in my relative's health?
- 05How would you involve my relative and our family in reviewing their care plan and raising concerns?
This was an unannounced planned inspection covering all five CQC questions, including the premises and care provided; the report says the inspection looked closely at two people's care records. This explanation was written from the published report of 18 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, February 2017
Rated Good overall; inspectors found kind, person-centred care, but medicines management still required improvement.
This was an unannounced comprehensive inspection on 5 and 6 January 2017. Inspectors spoke with people living at the home, relatives, staff, managers and a visiting health professional. They looked at care records, medicines, staff files, training records, policies and the building.
The overall rating was Good. Effective, Caring, Responsive and Well-led were rated Good. Safe was rated Requires Improvement because medicine stock records did not always match the medicines given, some eye drops had not been dated when opened, and some medicine competency checks were incomplete.
The home had improved since the previous inspection. Earlier legal problems about medicines and consent had been addressed. Inspectors found that care was kind and person-centred, people's risks were managed, staff were available, food and activities were good, and managers monitored the service. Some smaller improvements were still needed in complaint information, audit records and end-of-life care planning.
Kind and respectful care
Staff were patient, compassionate and attentive. Inspectors saw positive relationships and found that staff knew people well.
“We observed staff to be kind, caring and compassionate in the delivery of care.” from the report
Person-centred support
Care plans described people's needs, preferences, risks and ways of providing support. Care was reviewed with people and relatives.
“Care plans contained person centred information and the staff we spoke with knew what was important to the people they cared for.” from the report
Good food and activities
People had varied meals, regular snacks and drinks, and choices at mealtimes. They could take part in a broad range of activities and social sessions.
“People were offered a varied menu to choose from at mealtimes and offered snacks and drinks regularly throughout the day to promote their dietary intake.” from the report
Improved consent arrangements
The earlier problem with obtaining legal consent had been corrected. Capacity assessments and best-interest decisions were recorded when needed.
“During this inspection, we saw that the required improvements had been made and the provider was now compliant with Regulation 11 of the Health and Social Care Act and the MCA.” from the report
Visible management
Managers worked alongside staff and promoted good teamwork. People, relatives and staff told inspectors the home was well led.
“The manager and care manager were positive and visible role models and worked alongside staff in support of people's care.” from the report
Medicine stock records
seriousThe amount of some medicines in stock did not match the records of what had been given. A new checking system was started during the inspection.
“Whilst checking people's medication administration records we found that the balance of medication in stock did not always tally with what had been administered.” from the report
Opened eye drops
seriousSome eye drops had not been dated when opened, so it was unclear whether they were still safe to use.
“Eye drops in use had not been dated when opened so it was unclear whether they were still safe to use.” from the report
Incomplete medicine competency checks
needs fixingStaff giving medicines had been trained, but some checks of their practical competence had not been fully completed.
“Competency checks to ensure staff members administering medication were skilled and capable to do so had been undertaken but had not always been completed in full.” from the report
Missing complaint contacts
needs fixingThe complaints procedure did not give contact details for the manager, the provider's customer relations team or outside complaints bodies. This could make it unclear where to take a complaint.
“Contact details for who people could contact in the event of a complaint were however not provided.” from the report
End-of-life planning
minorSome care plans recorded end-of-life discussions, but inspectors said this needed more exploration for some people.
“This aspect of care planning for some people needed further exploration.” from the report
- 01How do you check that the amount of each medicine in stock matches the medicines recorded as given?
- 02How are opened eye drops dated and checked to make sure they remain safe to use?
- 03Have all staff who give medicines now completed their full competency checks?
- 04What contact details will families use if they want to make or escalate a complaint?
- 05How do you record and review each person's wishes about end-of-life care?
This was an unannounced comprehensive inspection covering all five questions and following up legal breaches found at the December 2015 inspection. This explanation was written from the published report of 21 February 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 Sandstones
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- February 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 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.
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Most charge £980 to £1,230 a week. 37 can care for a couple. 8 years' experience on average.
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