CQC report explained · a residential care home
What the CQC found at Sandwood Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2020
The Firs Nursing Home: targeted inspection found improvements, but the overall rating remained Requires Improvement and was not re-rated.
This was a targeted inspection on 21 October 2020. Inspectors checked whether the home had acted on a previous Warning Notice about its systems for managing quality and safety. They spoke with four people, staff and a visiting community nurse, observed care and reviewed care and management records.
Inspectors found better organisation, communication and leadership. Staff understood their roles and people spoke positively about the care. Audits, checks and records were described as detailed, current and effective.
The visit only looked at the specific concerns covered by the Warning Notice. It did not reassess the full set of CQC questions, so the overall rating was not changed and remained Requires Improvement. The well-led question was also inspected but not rated.
Improved monitoring
Audits and checks were up to date, and the manager had good oversight of performance and risks.
“Audits and checks were found to be detailed and up to date and the registered manager had good oversight of performance and risks.” from the report
Positive leadership
Staff said they felt supported, and inspectors found that communication and organisation had improved.
“Staff reported they felt well supported by the registered manager, and improvements had been made to communication and organisation.” from the report
Positive care experience
People were positive about the care and the approach of staff. Inspectors observed staff working effectively together in a welcoming atmosphere.
“People were positive and complimentary about the caring approach of staff and the leadership of the registered manager.” from the report
The full service was not rechecked
needs fixingThis was a limited follow-up inspection. The previous overall Requires Improvement rating stayed in place because other areas were not assessed.
“The overall rating for the service has not changed following this targeted inspection and remains Requires Improvement.” from the report
- 01What concerns from the previous inspection remain open, apart from the Regulation 17 governance issue?
- 02How often are audits and checks reviewed, and what happens when they identify a problem?
- 03How will you continue to monitor incidents, accidents, weights, wound care and call bell use?
- 04When is the next comprehensive inspection expected, and which areas will it reassess?
- 05How do you use the current improvement plan to check that changes are lasting?
This was a targeted inspection of specific concerns about Regulation 17 and did not assess the full key questions; the overall and well-led ratings were not changed. This explanation was written from the published report of 3 November 2020 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 2020
Rated Requires Improvement, with Well-led rated Inadequate; inspectors found unsafe and inconsistent care, poor dignity and nutrition support, and weak management systems.
This was an unannounced inspection on 02 and 03 December 2019. Inspectors spoke with people living in the home, relatives and staff, and reviewed care records, medicines records, recruitment files, complaints, training and quality checks.
The home did not provide consistently safe, effective, caring or responsive care. Inspectors found staffing pressures, gaps in care records, medicines shortfalls, dirty equipment, missed nutritional support, delays when people asked for help and too few meaningful activities.
Inspectors also found that some care was kind and patient. People were supported with health appointments, staff received training, and end of life care was described as good. However, management and quality systems had not brought about lasting improvement.
The overall rating remained Requires Improvement, the same as at the previous inspection. Well-led fell from Requires Improvement to Inadequate. This was the home's third consecutive Requires Improvement rating, and three regulations were breached.
Safeguarding
Staff understood how to recognise and report abuse or avoidable harm. Recruitment checks were completed before staff started work.
“People were protected from abuse and avoidable harm.” from the report
Staff training
Staff received induction, ongoing training and opportunities to discuss their work and development needs.
“Staff received an induction, ongoing training and opportunities to discuss their work.” from the report
Health care support
The home worked with health professionals and made referrals when people needed further assessment or advice.
“Referrals to external health care professionals for assessment or guidance were made in a timely manner.” from the report
End of life care
Inspectors found good end of life support, including involvement from palliative care nurses and records of people's treatment wishes.
“People received good end of life care.” from the report
Calming support
Staff used reassurance, distraction and communication to help people who were anxious or distressed.
“Staff used distraction techniques to support people during periods of high anxiety.” from the report
Staffing and delays
seriousStaffing levels were not consistently matched to people's needs. People could be left waiting for assistance, and staff said they were rushed.
“Several people and staff raised concerns how staff were rushed, and this impacted on people's needs being met in a timely manner.” from the report
Nutrition and hydration
seriousPeople at risk of malnutrition did not always receive the snacks and fortified drinks in their care plans. One person's continued weight loss was not followed by consistent recorded support.
“People did not receive support in line with their care plan and recommendations made by health care professionals.” from the report
Dignity and privacy
seriousInspectors saw care being provided in front of other people and found that some personal care and the surrounding area were not handled respectfully.
“This practice did not respect the person's privacy or dignity.” from the report
Activities and social contact
needs fixingPeople had few meaningful activities or opportunities to pursue interests. The activity coordinator was often used to provide care instead.
“People received limited social activities and opportunities to pursue interests and hobbies.” from the report
Medicines and equipment
needs fixingSome liquid medicines were not dated when opened, cream records were incomplete, and one person's medicine was left for them to take without being observed. Some equipment was dirty.
“Liquid medicines were not always labelled with the date of opening.” from the report
Weak management oversight
seriousAudits and checks had not driven lasting improvement. Care records were not consistently maintained, and the home did not have a registered manager at the time of inspection.
“Systems and processes were not effective to ensure compliance.” from the report
- 01What current staffing levels are provided on each shift, and how are they matched to residents' dependency needs?
- 02How do you make sure every resident at risk of malnutrition receives the snacks, fortified drinks and mealtime support in their care plan?
- 03What checks now ensure medicines are dated, topical cream applications are recorded, and people are observed taking medicines when required?
- 04How do staff protect residents' privacy and dignity when providing injections, personal care or assistance?
- 05What regular activities are now available for people, including those who spend much of their time in bed or have dementia?
This was an unannounced planned inspection based on the previous rating and covered all five CQC questions, including the home, care and management systems. This explanation was written from the published report of 8 January 2020 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 Sandwood Care Home
4 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- November 2020Inspected but not ratedcurrent ratingWell-led: Inspected but not rated
- January 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- November 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 11 March 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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