Sanderstead Care Centre is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 42 people over three floors in one adapted building. At the time of our visit there were 28 people using the service, some of whom were living with dementia. There was a registered manager 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. This was the service's first inspection since being taken over by a new provider in February 2018.

We found the provider was in breach of the regulation in relation to safe care and treatment. This was because medicines were not always managed safely and some risk assessments were missing information. Stocks of medicines did not always correspond with what was recorded. We found some risk management plans did not contain important information about how to respond to people presenting aggressive or threatening behaviour.

The provider was also in breach of the regulation in relation to notifying the Care Quality Commission of any outcome of an application to deprive a person of their liberty and to notify us of any abuse or allegation of abuse. Since the inspection, the provider has submitted notifications to us. However, the provider remains in breach of this regulation because they need to demonstrate compliance with this regulation over a period of time.

You can see what action we told the provider to take at the back of the full version of the report.

People felt safe using the service and staff were aware of the service’s policy and procedures on safeguarding people from abuse. Risks to people’s safety were mostly managed appropriately, including risk of falling, developing pressure ulcers and risks relating to use of mobility equipment. The service had appropriate measures in place to deal with emergencies including fire and medical emergencies. Maintenance staff made sure the premises were safe by carrying out regular checks and minor repairs. The home was clean and there were systems to prevent the spread of infection.

The provider had systems to monitor accidents and incidents. We found evidence the registered manager took appropriate action in response to accidents and incidents.

Medicines were stored safely. There was appropriate guidance for staff about using medicines that did not require prescriptions. People who had medicines to take only when required had instructions for staff about when to give it, although these sometimes lacked details such as how to tell if a person was in pain.

The provider was in the process of refurbishing the home. Some areas looked fresh and pleasant but others still needed to be refurbished. The service was fully wheelchair accessible but did not have dementia-friendly features such as signage or contrasting colours. We recommend that the provider incorporates best practice guidance about providing a dementia-friendly environment into their ongoing plans for refurbishing the premises.

The registered manager made sure they kept up to date with current research and best practice and passed this on to staff. Some staff were qualified to train their colleagues and staff received a variety of training and supervision to ensure they had the support, skills and knowledge to carry out their roles effectively.

People had their needs assessed in line with current guidance and staff involved healthcare professionals in developing care plans to meet people’s healthcare needs. People were able to access healthcare services when they needed to. People’s nutritional needs