Sandford House is registered to provide accommodation and personal care for up to 18 people with a diagnosis of mental health related issues. Accommodation is based in two adjacent properties, over three floors and accessed by stairs. There are four double and ten single rooms. The home is in the Nether Edge area of Sheffield, on local bus routes and close to amenities. Sandford House 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.

Whilst the service is registered with us as Sandford House, the service is also known as Sandford Grove. The registered provider has applied to change the services name to Sandford Grove.

The registered provider/ nominated individual is responsible for two other services in Sheffield. The registered manager of Sandford House is also registered manager for one other service. The registered provider and registered manager share time at Sandford House to manage the service. 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.

At the last inspection, the service was rated Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

People who lived at Sandford House told us they felt safe and they were provided with the support they needed.

Staff were aware of their responsibilities in keeping people safe.

Policies and procedures for the safe management of medicines were in place.

There were robust recruitment procedures in operation to promote people’s safety.

Staff were provided with relevant training and supervision so they had the skills they needed to undertake their role.

People receiving support felt staff had the right skills to do their job. They said staff were respectful and caring in their approach.

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.

People’s support plans contained relevant person-centred information to inform staff. The support plans had been reviewed to ensure they were up to date.

People were confident in reporting concerns to the registered manager or registered provider and felt they would be listened to.

There were quality assurance and audit processes in place to make sure the service was running well.

The service had a full range of policies and procedures available to staff.

Further information is in the detailed findings below.

Sandford House is registered to provide accommodation and personal care for up to 18 people with a diagnosis of mental health related issues. Accommodation is based in two adjacent properties, over three floors and accessed by stairs. There are four double and ten single bedrooms. The home is in the Nether Edge area of Sheffield. At the time of our inspection there were 18 people living at the home.

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.

People told us they felt safe with staff. A relative we spoke to had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.

Potential risks to people had been identified and assessed appropriately. There were sufficient numbers of staff to support people and safe recruitment practices were followed. Medicines were managed safely.

Staff had received all essential training and there were opportunities for them to study for additional qualifications. All staff training was up-to-date. Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found the registered manager understood when an

application should be made and how to submit one. We found the provider to be meeting the requirements of DoLS. The registered manager and staff were guided by

the principles of the Mental Capacity Act 2005 (MCA) regarding best interests decisions should anyone be deemed to lack capacity.

People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated

in line with their personal preferences.

Staff knew people well and positive, caring relationships had been developed and people were encouraged to express their views. People were involved in decisions about their care as much as they were able. Their privacy and dignity were respected and promoted. Staff understood how to care for people in a sensitive way.

There were suitable numbers of trained staff on duty to meet people’s care needs. People considered staff to be caring and available when they needed them.

There was clear leadership within the home. The provider and registered manager carried out regular checks on the quality of care and services to identify any areas that required improvement.

Care plans provided information about people in a person-centred way. People’s personal histories had been recorded and their preferences, likes and dislikes were

documented so that staff knew how people wished to be supported.

Complaints were dealt with in line with the provider’s policy and there had been no formal complaints logged in the previous year.

At the time of this inspection seventeen people lived at Sandford House. We spoke with ten people living at the home, in small groups and individually, to obtain their views of the support provided. In addition, we spoke with the registered provider, the registered manager and all of the staff on duty which included the senior carer, a carer and the domestic staff about their roles and responsibilities.

We gathered evidence against the outcomes we inspected to help answer our five key questions; 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. The summary is based on speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People supported by the service, or their representatives told us they felt safe.

People told us they felt their rights and dignity were respected.

Systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We found that risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant people would be safeguarded as required.

The service was safe, clean and hygienic.

Is the service effective?

People’s health and care needs were assessed with them and their representatives, and they were involved in writing their plans of care. Specialist needs had been identified in care plans where required.

Staff were provided with training to ensure they had the skills to meet people’s needs. Staff were provided with formal individual supervision and appraisals at an appropriate frequency to ensure they were adequately supported and their performance was appraised. The manager was accessible to staff for advice and support.

Is the service caring?

We asked people using the service for their opinions about the support provided. Feedback from people was positive, for example; “they (staff) are all right, very good”, “they (staff) give me the help I need, they know what I am like” and “it’s all right here. I am much healthier now. They (staff) have helped to sort me out, get me better”.

When speaking with staff it was clear that they genuinely cared for the people they supported and had a detailed knowledge of the person’s interests, personality and support needs.

People using the service and their relatives completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People’s preferences and interests had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People’s individual choices regarding how they spent their day were supported by staff.

People’s dietary preferences were known and supported by staff. People told us, “they (staff) know what we like, there’s always an alternative (to the menu). They are very good like that” and “the food is good. We’ve no complaints at all”.

People spoken with said they had never had to make a complaint but knew how to make a complaint if they were unhappy. We found appropriate procedures were in place to respond to and record any complaints received. People could be assured that systems were in place to investigate complaints and take action as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system. Records seen by us showed that if shortfalls were identified they were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

Records checked showed that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

People told us that they were happy living at the home and satisfied with the care and support they were receiving. Their comments included; "this is a good place. I’m better off here and it’s helped me a lot", "it's good", "I'm happy" and "the staff are very kind to me."

During the inspection we spent time sitting with people in the communal areas of the home. This meant we were able to observe people's experiences of living in the home. The interactions between people living at the home and staff appeared positive. Staff spoken with knew the people living at the home very well. We found that care and support was offered appropriately to people.

Each person living at the home had a care plan. We found that the information in these was detailed and up to date. This meant that the delivery of care to people was safe, effective and appropriate.

We found that medicines were being obtained, recorded, handled, dispensed and disposed of in a safe way.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed. Staff were provided with relevant training to maintain and update their skills and knowledge.

The home had an effective complaints system available. A system was in place to respond appropriately to any complaints received.

We spoke to eight people that lived at Sandford House. They told us that they liked living at the home, and the staff knew them well and supported them in the way they needed. Comments included; “We all know the staff and can talk to them about anything.” “The staff are kind, it’s great.” If I have any worries staff will help me.” “I am safe here; I get the support I need.”

One relative told us that the home was “Very good.” Staff knew their relative very well and they received the help needed. They told us “Staff are marvellous, very considerate. I can talk to them at any time and I am always made to feel welcome. I have no concerns at all.”