Archived: Sandy Lane Hotel

Updated 12 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by 2 inspectors on the first day and 1 inspector on the second day.

Service and service type

Sandy Lane Hotel is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Sandy Lane Hotel is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection a manager was in post and they had applied to register.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority contracts and safeguarding teams. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 members of staff including care staff, senior staff, the deputy manager and the manager. We also spoke with 3 people who used the service, 4 relatives and observed staff interactions.

We looked around the home to review the facilities available for people and the infection prevention and control procedures in place. We also looked at a range of documentation including care files, daily records and medication administration records for 4 people. We looked at 3 staff recruitment files and reviewed documentation relating to the management and running of the service such as staff rotas, training and audits.

Updated 12 October 2023

About the service

Sandy Lane Hotel is a residential care home providing personal care for up to 31 people. At the time of the inspection, 23 people were using the service. The service has 3 floors which can be accessed by a lift.

People’s experience of using this service and what we found

The provider had failed to make the required improvements to the safety and quality of the service. Governance systems in place were ineffective at identifying shortfalls and failed to support sufficient improvements.

People did not always receive their medicines as prescribed and processes were not followed to ensure people’s medicines were in date and safe to administer. Risks to people’s safety and wellbeing were not effectively assessed and mitigated and there was a lack of oversight to ensure people’s care was delivered in line with their care plans. Some equipment and areas of the service could not be appropriately cleaned and were not clean during the inspection.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic. Staff did not have relevant training to meet the needs of people with a learning disability or autistic people.

People received appropriate support to eat and drink and specialised diets were catered for. Though records did not show regular monitoring and oversight of the support people received with meals and drinks to manage risks of malnutrition and dehydration.

People and their relatives were positive about the staff and the care provided. Communication with people’s relatives and relevant healthcare professionals had improved whilst the new management team were in post. Feedback about the delivery of the service had started to be gathered and used to make some changes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 12 August 2022). The service remains rated inadequate. This service has been rated inadequate for the last 3 consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider had addressed the breach of regulation regarding staff recruitment, but they remained in breach of regulations 9 (Person-centred care), 12 (Safe care and treatment) and 17 (Good governance).

At our last inspection we recommended that the provider reviewed their training procedures to ensure staff had the appropriate training to support people. At this inspection we found the provider had not acted on the recommendation and was in breach of regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Why we inspected

We carried out an unannounced focused inspection of this service on 15 June 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person-centred care, safe care and treatment and good governance.

This focused inspection was carried out to follow up on action we told the provider to take at the last inspection regarding fit and proper persons employed, to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has not changed and remains inadequate. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sandy Lane Hotel on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to medicines, risk management, infection prevention and control, mental capacity, staff training, person-centred care and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Since the last inspection we recognised that the provider had failed to notify CQC of all notifiable incidents. This was a breach of regulation 18(2) of the Care Quality Commission (Registration) Regulations 2009.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.