About the service:

Sandycroft provides nursing care and support for a maximum of 26 people who live with dementia and/or a physical disability or sensory impairment. At the time of our inspection there were 17 people living at the home. Sandycroft is situated in a residential area of Blackpool close to local amenities. There are three floors offering single room accommodation for people who live at the home. There are ample toilet and bathing facilities and a large communal area for people's use.

People’s experience of using this service:

We found the management team were keen to complete lessons learnt following recent concerns raised to maintain everyone’s safety. People, staff and visitors said they felt the management team were making improvements at the home. A staff member stated, “I know it has only just happened, but the new manager is going to be really good news for the home. It already feels safer here.”

We found care planning and recordkeeping was not always personalised or detailed to assist staff responsiveness to people’s needs. For example, there were gaps in records and monitoring charts.

We have made a recommendation about recordkeeping.

The management team had safe systems to mitigate accidents and incidents. Care records held risk assessments intended to reduce the risk of harm or inappropriate care. The new manager assured us they were focused on developing these further to maintain people’s safety.

People and relatives said they felt safe and secure at Sandycroft. One person commented, “Staff are caring, compassionate and competent.” A relative added, “We've never had any concerns, [our relative] is well-looked after and safe.” Staff demonstrated a good understanding of their responsibilities to protect people from abuse and poor care.

The provider was improving the deployment of consistent, regular staff and the number of personnel on each shift to meet people’s needs. Those who lived at Sandycroft told us staffing levels were sufficient to ensure they were supported with a timely approach.

We observed staff followed national guidance in the safe management of people’s medicines. Those who lived at the home confirmed they received their medication as prescribed.

People told us they enjoyed their meals and were offered options about what to eat. Staff completed support plans and various assessments to monitor and meet their nutritional needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. We saw staff supported people to make their day-to-day decisions.

Records showed the management team provided staff induction training and a programme of courses to support them in their roles.

Staff demonstrated genuine affection and compassion whenever they interacted with people. One person told us, “All the girls are lovely with me.” People commented staff respected their human rights to be self-sufficient and live meaningful lives.

We found the provider and new manager was working transparently with other organisations following recent concerns raised to the local authority. They were engaging with staff, people and relatives to gain their feedback about the improvement of the home.

People and relatives confirmed the new management structure at Sandycroft had improved the home’s atmosphere and their comfort. Staff told us the management team worked closely with them and were accessible. One staff member stated, “[The manager] has been very supportive.”

Rating at last inspection: Good (date published 07 August 2018).

Why we inspected: We undertook an unannounced focused inspection due to information of risk and concern reported to the local authority. We completed a full inspection, due to the nature and level of concerns received, to check people were safe and the service was effective, caring, responsive and well-led.

Follow up: We have asked

The inspection visit at Sandycroft took place on 13 and 14 June 2018 and was unannounced.

Sandycroft provides nursing care and support for a maximum of 26 people who live with dementia and/or a physical disability or sensory impairment. At the time of our inspection there were 22 people living at the home. Sandycroft is situated in a residential area of Blackpool close to local amenities. There are three floors offering single room accommodation for people who live at the home. There are ample toilet and bathing facilities and a large communal area for people's use.

Sandycroft is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, both of which we looked at during this inspection.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Sandycroft registered under a new provider on 26 May 2017. Consequently, this was their first inspection.

During this inspection, we found suitable staffing levels provided a calm and unhurried atmosphere throughout our inspection. Call bells and requests were responded to with a timely approach. One person who lived at Sandycroft said, “There is always someone around.” Staff files we looked at showed personnel did not start in post until the management team received relevant checks. Everyone we spoke told us they found staff were skilled and knowledgeable.

Care files we saw held risk assessments to guide staff to manage any underlying or medical risks to people’s safety. Accidents were analysed to look at any potential themes and reduce the potential for their occurrence. Personal protective equipment was available around the home to maintain good levels of infection control.

Staff files we looked at demonstrated staff received safeguarding training to protect people against harm or abuse.

Each person’s care file held medication care plans, which provided good guidance for staff about their specific needs. The management team completed competency-testing to assess staff skills and safe practice.

People told us they had sufficient meal portions and choice of meals. One person said, “The staff will make something different if you don’t like what is on offer”. The management team completed risk assessments to reduce the risk of malnutrition or obesity.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Recorded consent was held in people’s care files.

Staff demonstrated a good level of understanding about valuing each person’s right to dignified support. One person who lived at Sandycroft told us, “When they take me for a shower they always ask if I want them to stay. They always protect my privacy and dignity.” We observed staff made every effort to value the uniqueness of those who lived at the home. They achieved this by discussing and recording people’s needs with them and their relatives. One person told us, “We did a care plan in the beginning and we review it regularly.”

The management team and staff had achieved the Gold Standards Framework highest award of ‘Beacon’ status because of excellence in end of life care. They used new technology to better and more immediately assess people’s health needs. The registered manager’s excellent end of life approach was strengthened by a compassionate, experienced and skilled staff team.

We found care was planned and delivered within a person-centred model. The review and update of people’s care was undertaken regularly with the person and