CQC report explained · a residential care home
What the CQC found at The Sands Meadows
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safe medicines management, regular risk reviews, safe recruitment and suitable infection control.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Managers had good oversight of care, records and quality checks. People, relatives and staff said managers were approachable and supportive.
What inspectors found, February 2023
Rated Good; inspectors found safe, kind care and improved medicines management after a previous Requires Improvement rating.
This was an unannounced, focused inspection on 18 January 2023. Inspectors spoke with people living in the home, relatives and staff. They also checked care records, medicines records, health and safety records, audits and meeting notes.
The home was rated Good for Safe and Well-led. Inspectors found that people were protected from harm, received medicines safely and had up-to-date risk assessments. Staff were trained, recruitment checks were completed and the home was clean.
Inspectors found approachable management and good oversight of care. Relatives said staff were friendly, caring and kept them informed. The overall rating changed from Requires Improvement to Good because improvements had been made and the previous legal breach had been resolved.
This was a focused inspection. The report only assessed Safe and Well-led. The other ratings used for the overall rating were carried over from the previous inspection.
Safer medicines
Medicines were given by trained staff whose skills had been checked. A new electronic medicines system helped staff identify late doses and doses given too close together.
“A new electronic medicine records system had been fully embedded.” from the report
Protection from harm
Staff understood safeguarding procedures and recorded incidents, including falls and injuries, so lessons could be identified and acted on.
“Safeguarding records were thorough and showed how lessons were learned to avoid reoccurrence.” from the report
Caring staff
People and relatives described staff as kind, friendly and caring. Bedrooms were personalised to reflect people's tastes and preferences.
“People received safe care from kind and caring staff.” from the report
Good management oversight
Managers checked the quality of care and records, followed up issues and kept policies up to date. Relatives said the management team was approachable.
“Managers were clear about quality and ensured they had good oversight of the service, care practice and care records.” from the report
Weekend staffing may look lower
minorSome relatives said staffing could sometimes appear a little low at weekends. They still told inspectors they believed staffing levels were safe.
“Relatives said staffing could sometimes appear a little low at weekends however they were confident staffing levels were safe.” from the report
- 01How do you make sure staffing remains safe at weekends?
- 02How is the new electronic medicines system checked, and what happens if it flags a late dose?
- 03Who is managing the home while the registered manager is on extended leave?
- 04How are falls, injuries and other incidents reviewed, and what changes have been made as a result?
- 05How will you keep relatives informed if someone becomes unwell or has an accident?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection. This explanation was written from the published report of 21 February 2023 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 2022
Rated Requires Improvement; inspectors found enough staff and kind, person-centred care, but unsafe medicines management and weak audits.
This was a focused inspection on 9 and 18 November 2021. Inspectors looked at Safe and Well-led because concerns had been raised about safety. They spoke with people, relatives and staff, observed care, and checked care, medicines, recruitment and management records.
The main problem was medicines. Some out-of-date medicines had been given, fridge temperatures were outside the recommended range, and records did not always show that creams or thickener had been used correctly. The provider acted during and after the inspection, including removing the out-of-date medicines.
There were enough staff, recruitment checks were robust, risks were generally managed, and infection control arrangements were suitable. People received kind and person-centred care. However, the overall rating was Requires Improvement because Safe and Well-led were both rated Requires Improvement. The other three key questions were not inspected, so their earlier ratings were used.
Enough staff
Inspectors found enough staff to meet people's needs. Staffing was assessed using people's level of dependency and feedback from staff.
“There were enough staff to meet people's needs.” from the report
Safe recruitment
The provider carried out checks on new staff, including criminal-record checks and references from previous employers.
“The provider carried out robust checks on new staff before they were employed.” from the report
Kind and respectful care
Inspectors found that care was person-centred and that staff treated people patiently, kindly and respectfully.
“People received person-centred care which met their needs. Staff were patient and kind to people and spoke to them with respect.” from the report
Family involvement
Relatives said managers asked for their views, listened to them and responded to suggestions about care and activities.
“Communication is brilliant, they always have time to listen and answer any questions we have.” from the report
Learning from incidents
The provider analysed incidents and shared lessons with staff to improve safety.
“The provider and management team analysed incidents to learn and share lessons with the staff team when incidents occurred.” from the report
Medicines were not always safe
seriousFive people were given out-of-date medicines. Other medicines were not always given according to the manufacturer's instructions, and records for creams and thickener were not always accurate.
“We found no evidence that people had been harmed however, we found medicines were not managed safely.” from the report
Checks did not find the problems
seriousThe provider had medicine audits, but these did not identify the unsafe storage and administration issues. This led to a breach of Regulation 12.
“Although the provider had systems to audit the service, these had not identified issues around the management of medicines and ensured the provider was meeting regulations.” from the report
- 01What specific changes have been made to prevent out-of-date medicines being given, and how are these checks recorded?
- 02How are fridge temperatures for medicines checked each day, and what happens when they are outside the recommended range?
- 03How do you check that medicines are given at the correct time and separately from food when the manufacturer's instructions require this?
- 04How are records for creams and thickener checked for accuracy?
- 05What evidence can you show that your medicines audits now identify and correct problems promptly?
This was a focused inspection of Safe and Well-led only; the other key questions were not inspected and their previous ratings carried over. This explanation was written from the published report of 21 January 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.
Every inspection of The Sands Meadows
3 rated inspections over 3 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- August 2019GoodSafe: Requires improvementWell-led: Good
- August 2018
Registered with the Care Quality Commission on 31 August 2018.
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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85 live-in carers within about an hour of Lancashire
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. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.