Archived: Revitalise Sandpipers

Revitalise Sandpipers is a specialist residential service which provides respite holidays for people living with a disability. The service offers breaks in a relaxed, holiday style environment, and offers a variety of trips, entertainment and activities. People who use the service are supported by a team of staff and volunteers. The service can accommodate up to 38 people. At the time of our inspection 23 people were using the service.

Although the service was a holiday destination and predominantly offered short term breaks, five of its beds were commissioned by the NHS for people who had acquired a spinal injury. People stayed on the spinal unit for an average period of 6 weeks. Although the NHS supplied its own staff, staff employed by Revitalise Sandpipers also provided some support. We took this into consideration during our inspection.

People using the services of Revitalise Sandpipers benefited from a service that was safe and well-led.

Regular health and safety checks were carried out to ensure the service offered a safe environment for people. Risks to people were managed in a pro-active way. Staff supported people to manage risk in way which kept them safe and respected their individual choice.

Staff had been trained in how to report and manage any safeguarding incidents. The service adopted an open and learning approach, to help minimise the risk of incidents recurring.

People received their medicines as prescribed and by staff who were trained and competent.

Staff recruitment processes ensured staff were safe to work with people. People told us there were enough staff to meet their needs in a timely way.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The manager was described by staff as being hands on, knowledgeable and approachable. The manager helped instil a positive culture which was committed to delivering high-quality support to people. People thought highly of the service and many were repeat guests. Staff were keen to share with us how much they enjoyed supporting people at the service, to help make their holiday experience memorable.

The service worked in collaboration and partnership with other relevant organisations to help achieve positive outcomes for people.

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

Rating at last inspection

The last rating for this service was good (report published 24 May 2018).

Why we inspected

The inspection was prompted in part due to concerns received about management of risk, including the use of bed rails. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe section of this full report.

We also 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.

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 remained good based on the findings of this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Revitalise Sandpipers provides short breaks for people living with a disability and their supporters / carers. The service offers short breaks in a relaxed, holiday style environment with a variety of trips, entertainment and activities. People who use the service are supported by a team of staff and volunteers. The service can accommodate up to 38 people. At the time of our inspection 28 people were using the service.

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

People were protected against the risk of abuse by staff who understood their responsibilities and knew how to keep people safe. The provider had robust processes to make sure staff and contractors were suitable to work with people who may be vulnerable.

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

Rating at last inspection

The last rating for this service was good (published 24 May 2018).

Why we inspected

We carried out this targeted inspection to check on a specific concern we had about how the provider ensured staff and contractors were of suitable character to work with people who may be vulnerable. The overall rating for the service has not changed following this targeted inspection and remains good.

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

There were 13 people being supported at the time of the visit.

We found the following examples of good practice.

•The service had responded well to the changing threat of COVID-19. Good liaison with statutory bodies had equipped the manager and staff with the latest knowledge so that people were receiving appropriate support.

•The home continued to have positive liaisons with the local spinal injuries unit and provided ongoing support and rehabilitation for up to five people. Appropriate cohorting was in place in line with best practice. Health care professionals were engaged with the support that people received at the service.

The service provides short breaks for people with a disability and their supporters / carers. The service offers short breaks in a relaxed, holiday style environment with a variety of trips, entertainment and activities. People who use the service are supported by a team of staff and volunteers. The service can accommodate up to 38 people. At the time of the inspection 32 people were accommodated.

This was an unannounced inspection and it took place on 16 and 17 April 2018.

At the last comprehensive inspection in October 2016 we found a breach of regulations with in respect to, maintaining appropriate records for the care and treatment delivered to people and to demonstrate that effective systems where in place to identify and assess risks to individuals. The service was rated as ‘Requires improvement’.

On this inspection we found improvements had been made and the breach of regulations had been met. It was clear the improvements had been in place over a sustained period and the service continued to develop. On this inspection we rated the service as ‘Good’.

A registered manager was in post. 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.

We found improvements had been made so that any potential risks to people using the service were better identified. More effective care plans had been agreed with people so that potential risks could be reduced. This was evident with medicines management where people were now fully assessed on admission and clear strategies where in place for each person to manage medicines safely.

Key documentation included attention to ensuring people’s consent to any care and treatment was recorded and operated in accordance with the principles of the Mental Capacity Act 2005 (MCA).

Revitalise Sandpipers had improved much of their key assessment and care planning documentation. The service had continued to develop quality monitoring processes and the registered manager had support from senior managers.

Policies and procedures provided guidance to staff regarding expectations and performance. These included policies regarding people’s diversity. Staff were clear about the need to support people’s rights and needs regarding equality and diversity.

People using the service and staff were involved in discussions about the service and were asked to share their views. This was achieved through daily contact by the managers and staff and regular surveys. These provided very positive responses regarding people’s stay.

The service maintained effective systems to safeguard people from abuse and the service had worked effectively with the local safeguarding team when needed.

Medicines were safely stored and administered in accordance with best- practice and people’s individual preferences. The records we saw indicated that medicines were administered correctly and were subject to regular audit.

We saw evidence that the service learned from incidents and issues identified during audits.

People’s needs were assessed and recorded by suitably qualified and experienced staff. Care and support were delivered in line with current legislation and best-practice.

The service ensured that staff were trained to a high standard in appropriate subjects. There was clear demarcation between regular staff and volunteers so that roles were clear.

We saw clear evidence of staff working effectively to deliver positive outcomes for people. People reviewed were receiving effective care and gave positive feedback regarding staff support and their holiday experience.

We saw evidence that the service worked effectively with other health and social care agencies to achieve better outcomes for people and improve quality and safety. Visiting professionals told us that Revitalise Sandpipers offered an effective service which clearly met specific rehabilitation needs.

People told us that staff treated them with kindness and respect. It was clear from care and incident records that staff were vigilant in monitoring people’s moods and behaviours and provided care in accordance with people’s needs.

We checked the records in relation to concerns and complaints. The complaints’ process was understood by the people that we spoke with. We saw evidence that complaints had been responded to in a professional and timely manner by the registered manager or a senior manager.

People spoke positively about the management of the service and the approachability of senior staff. There was clear management structure that supported staff and people understood.

Revitalise Sandpipers is registered to provide accommodation with nursing and personal care to people with a disability and their carers. The service offers short breaks in a relaxed, holiday style environment with a variety of trips, entertainment and activities. People who use the service are supported by a team of staff and volunteers. The service can accommodate up to 38 people. At the time of this inspection 23 people were using the service.

A registered manager was in post. 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.

During this inspection we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Records relating to people’s care planning and the assessment of risk were not always robust. This was because records failed to fully demonstrate how risks to people had been determined and how their care needed to be delivered. Records relating to people’s care contained wording such as prompting, encouraging and assistance but failed to demonstrate how a person needed to be prompted, encouraged or assisted. Failure to have detailed information about how a person needed to be supported may result in individuals’ not receiving the care and support they required.

Records relating to complaints made about the service required improvement. The details complaints was recorded, however there were no records to demonstrate the process and investigations that had taken plan into the complaints. This meant that there was not clear audit trail in relation the recording of people’s concerns.

People told us that they felt safe at the service. Procedures were in place to protect people from harm. Safeguarding procedures were available at the service. Staff demonstrated a good awareness of how to respond to any safeguarding concerns. People told us that they felt safe at the service.

Effective staff recruitment procedures were in place. The process involved carrying out a number of checks to help ensure that only staff suitable to work with vulnerable people were employed.

People told us that staff always asked for their consent prior to carrying out any care and support. People told us that they were always given a choice of what they wanted to do with their time and what they wanted to eat.

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

We have made a recommendation that the registered provider ensures at all times up to date information is sought in relation to people’s status under the Mental Capacity Act 2005. This is to ensure that people’s rights are maintained and protected under the Act at all times

People were happy with the choice of food available to them and felt that their nutritional needs and choices were met.

Staff received regular updated training for their role. They felt well support by the senior staff, received regular supervision and attended regular staff meetings to keep them up to date with their role.

People told us that staff were caring and respected their privacy. The environment was relaxed, calm and friendly. Lots of laughter was seen to take place between people and the staff supporting them.

People’s needs relating their cultural and spiritual choices were sought and people were supported to attend local religious services of their choice. This helped ensure that people were able to practice and maintain their faith pathway during their stay at the service.

During their stay people had the opportunity to go on planned trips, carry out activities within the service and access the local community with the support of staff and volunteers. Having access to various pastimes helps people maintain their physical and psychological health.

Policies and procedures were in place to offer guidance and support to staff. This enabled staff to deliver safe care and support. The registered provider was in the process of reviewing the services policies and procedures to ensure that contain current best practice.

We considered all the evidence we gathered under the outcome we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found '

Is the service safe?

We enquired about the staffing levels and people who used the service told us there was sufficient staff on duty to meet their needs. The staffing levels described by staff were reflected in staff duty rotas we looked at.

Because the service supported different people each week, the needs of people varied and staff said it could be very busy some weeks. The registered manager was aware of this and planned in January 2015 to increase staff support at key times in the morning and evening.

We found that people who required the use of equipment to move were supported with hoisting in accordance with their plan of care.

Is the service effective?

This was a responsive inspection based on specific concerning information CQC received about the safety of the service. We did not look specifically at this area.

Is the service caring?

This was a responsive inspection based on specific concerning information CQC received about the safety of the service. We did not look specifically at this area.

Is the service responsive?

This was a responsive inspection based on specific concerning information CQC received about the safety of the service. We did not look specifically at this area.

Is the service well-led?

This was a responsive inspection based on specific concerning information CQC received about the safety of the service. We did not look specifically at this area.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found:

Is the service safe?

People staying at the centre told us they received a good standard of care and support. Some people told us they had visited before and that they continued to come to Sandpipers as they really enjoyed their visits. A person told us they felt safe as there were staff around to help at all times.

Is the service effective?

People who were staying at the centre told us the staff had a professional attitude and that they were attentive to their needs. People's comments included, 'What the staff do is wonderful' and 'Staff deal with guests [people staying at the centre] really well - ten out of ten." People told us the staff and volunteers worked well together and that collectively the staff team were really good. Staff and volunteers received training and support to help them carry out their role effectively and safely.

Is the service caring?

People said the staff and volunteers were caring and helpful in their approach and no one raised a concern about the attitude of the staff or a lack of dignity when receiving personal care. People's comments included, 'The staff are absolutely marvellous' and 'Everyone really cares about making the week enjoyable." During our inspection we saw very positive interaction between the staff, volunteers and guests. There was a relaxed atmosphere and people were able to choose what they wanted to do and at a time that suited them.

Is the service responsive?

People told us when they needed assistance this was provide promptly by the staff. People told us when they rang their buzzer the staff came as quickly as they could. We did not look at care files on this occasion. People said however they had been contacted prior to their stay to discuss their care needs and requirements. They told us that on arrival the staff discussed with them the care and support they needed. People at the centre had access to a wide range of activities that were important to them. People said the trips out were very good.

Is the service well led?

The service had a quality assurance system which included audits [checks] by the centre manager and senior management. Staff and volunteers told us they were clear about their roles, responsibilities and ethos of the home. People told us they were able to provide verbal feedback about their stay at the centre and also given satisfaction questionnaires to complete. We saw that the service was monitored to ensure it operated safely and effectively.

"The staff are very helpful.'

'The staff are fantastic, there are plenty to help at all times.'

'We have had a great time this week staying here and we are looking forward to the party night tonight before we go home tomorrow.'

We found people were treated respectfully and was given information before their arrival at the centre and had a welcome greeting on their arrival. Individuals could choose how they spent their stay at the centre. This included participating in the daily trips, staying locally around Southport amenities or staying at the centre.

We reviewed four electronic care files and found them to be person centred in their approach with good quality data being recorded by staff as they delivered care. There was a process in place to manage a guest's care and support during the stay at the centre.

The organisation had effective human resource policies and procedures in place to support all aspects of managing and recruiting staff.

The centre had effective infection prevention and control policies and procedures in place to ensure guests and staff employed were protected against identifiable risks. Systems were in place to prevent and control the spread of infections.

One guest who stayed at the centre told us 'Staff treat me as a person and did not look at me as having a disability.'

We spoke to another guest at the centre, they told us 'The food is excellent and so are the staff. I will be back later in the year for another break.'

Throughout our visit we observed staff being attentive to the needs of the people staying at the centre and their tone and manner was respectful and caring.

The centre had a guest relationship manager who told us the quality assurance feedback from the guests was very important to ensure the centre continued to meet the changing needs of the guests.

At the time of our inspection it was party night; the guests were served a three course silver service evening meal, with choices from a selected menu. Following the meal a live entertainer had been planned. We observed staff and volunteers supporting guests to eat their meals and socialising with them. There was good interaction and communication between the guests and staff. We observed a relaxed party atmosphere with laughter and chatter.