CQC report explained · a nursing home
What the CQC found at The Sands Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, risks were assessed and reviewed, staff were trained, and call bells were answered promptly. Staff did not always sign records after applying topical creams, but no harm was identified and this was addressed during the inspection.
- Effective?
- Good
- This key question was not directly inspected during this focused visit. The report says no areas of concern were identified in the information reviewed.
- Caring?
- Good
- This key question was not directly inspected during this focused visit. The report records that people praised the kindness and quality of the staff team.
- Responsive?
- Good
- This key question was not directly inspected during this focused visit. The report says people and relatives praised the responsiveness of the management team and staff to concerns.
- Well-led?
- Good
- Management systems, audits and action tracking had improved and were being used to monitor care and safety. People, relatives and staff felt the home was well managed.
What inspectors found, June 2022
The Sands Care Home is rated Good; inspectors found safe, kind care and better management, with minor gaps in medicine records and staffing pressure at times.
This was an unannounced focused inspection carried out on 24 and 25 May and 10 June 2022. Inspectors spoke with people living in the home, relatives and staff. They checked medicines, care records, recruitment and training records, and documents about safety, maintenance and management.
The home was rated Good for Safe and Well-led. People said they felt safe, staff were kind, call bells were answered promptly, and risks were assessed. The home was clean, staff were trained, and recruitment checks were completed.
There was one minor medicines recording issue. Staff had not always signed records after applying creams, although no harm was found and the manager dealt with this during the inspection. Some people and staff would have preferred more staff at busy times, but people did not say they felt unsafe.
The previous rating was Requires Improvement, published in December 2021. The inspection found enough improvement in medicines management and oversight for the service to no longer breach the regulations previously breached. The overall rating changed to Good, but this visit only directly inspected Safe and Well-led.
People felt safe
People told inspectors they felt safe. Staff understood how to recognise and report abuse, and incidents were reported when required.
“People living in the home told us they felt safe.” from the report
Prompt call bell responses
Everyone inspectors spoke with said call bells were answered quickly. Staffing levels were calculated using people's needs.
“Everyone we spoke with said staff always responded to their call bells quickly.” from the report
Kind and person-centred care
People and relatives praised the kindness of staff. Care records reflected people's wishes, cultural needs and personal goals.
“People told us they felt safe living in the home and praised the kindness and quality of the staff team.” from the report
Improved management oversight
Audits were being followed up and actions were completed in a timely way. The management team was described as approachable and supportive.
“The providers systems to monitor the quality and safety of the service were robust.” from the report
Clean and infection-aware home
The home was clean and tidy. Staff had infection control training and followed current guidance on protective equipment.
“The home was clean, tidy and well presented.” from the report
Cream records were not always signed
minorStaff did not consistently sign topical medicine records after applying creams. Inspectors found no harm, and the issue was addressed during the inspection.
“Staff had not consistently signed the topical MAR when they had applied topical creams.” from the report
Staffing pressure at some times
minorSome people and staff said they would prefer more staff, particularly at busy times or when there was sickness. They did not say this made them feel unsafe.
“There is enough staff except in the morning due to sickness. I have never been left in limbo.” from the report
- 01How do you now check that staff sign topical medicine records every time creams are applied?
- 02How many staff are normally on duty in the mornings, and what cover is arranged when staff are off sick?
- 03What actions from the previous inspection have been completed, and how are you checking that the improvements continue?
- 04How often are medicine, care record and safety audits completed, and what happens when an issue is found?
- 05Which current ratings come from the earlier comprehensive inspection rather than this focused inspection?
This was a focused inspection of Safe and Well-led; the other key question ratings were not directly inspected and previous ratings were used in calculating the overall rating. This explanation was written from the published report of 22 June 2022 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, December 2021
Rated Requires Improvement; inspectors found unsafe medicines management and weak oversight, although care was effective and people generally felt safe.
This was a focused inspection after concerns about care and treatment, including medicines. Inspectors visited on 15 July and 5 August 2021. They spoke with people, relatives, staff and a health professional, and reviewed care, medicine, staffing, recruitment and management records.
The main concerns were medicines not always being given as prescribed, missed doses, an out-of-date antibiotic and poor recording. Some people also lacked confidence in agency staff, and staffing levels varied. The systems checking the quality of the home had not found these problems.
Inspectors found good practice in care planning, staff training, food and drink support, healthcare access, infection control and safeguarding. People said they felt safe, knew the manager and could raise concerns.
The overall rating was Requires Improvement. Safe was Requires Improvement, effective was Good and well-led was Requires Improvement. The inspection was focused, so the other key questions were not inspected and earlier ratings were used.
People felt safe
People and relatives said they were confident that people were safe. Staff knew how to identify and report abuse.
“People were protected from the risk of abuse. Staff had been trained in how to identify abuse and how to report concerns.” from the report
Infection control
Inspectors were assured that infection prevention arrangements, including protective equipment, visiting and outbreak planning, were in place.
“We were assured staff were consistently using PPE effectively and safely.” from the report
Good care planning
People's needs were assessed and care plans described the support required. Staff and relatives said staff knew people well.
“The registered manager assessed people's needs and each person had a care plan detailing the support they required.” from the report
Healthcare support
Staff identified changes in people's health and made referrals to specialist services when needed. The home worked closely with the GP practice.
“The service worked closely with the GP practice to ensure people received the healthcare they needed.” from the report
Person-centred activities
People described care as personal and said staff organised activities and helped them make friends. Relatives also spoke positively about activities.
“They work at making us happy and they organise activities for us, exercises sometimes, a barbecue is planned, and we had a fete the other day, such fun!” from the report
Medicines were not always safe
seriousPeople missed doses, one person received an out-of-date antibiotic, and some medicines were given at the wrong time. Records did not always show that medicines or thickener had been given correctly.
“Medicines were not always managed safely, and people did not always receive their medicines as they had been prescribed.” from the report
Staffing and agency staff
needs fixingRotas showed changes in staffing numbers, and the home used agency staff to fill gaps. Some people lacked confidence in the skills of agency staff.
“However, despite training and induction two of the 12 people we spoke with told us they lacked confidence in the agency staff.” from the report
- 01What changes have been made to ensure every medicine is ordered, stored, given at the right time and recorded correctly?
- 02How do you check that missed or refused medicines are followed up and escalated?
- 03How do you assess the competence of agency staff before they support residents, and how do you keep staffing levels safe on each shift?
- 04What new checks are in place to make sure problems with medicines, staffing and agency staff are identified promptly?
- 05What action was taken after the incident that had not been notified to CQC?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and earlier ratings were used in calculating the overall rating. This explanation was written from the published report of 1 December 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.
Every inspection of The Sands Care Home
5 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- June 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodWell-led: Good
- January 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- December 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 31 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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Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
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