This was an unannounced inspection carried out on 22 December 2016.

Sandpiper Care Home can provide accommodation and personal care for 30 older people and people who have a physical disability. It can also provide care for people who live with dementia. The service is on two floors with the first floor being mainly reserved for up to 18 people who live with dementia. There were 27 people living in the service at the time of our inspection.

The service was operated by a company who was the registered provider. There was a registered manager. 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. In this report when we speak both about both the company and the registered manager we refer to them as being, ‘the registered persons’

Staff knew how to respond to any concerns that might arise so that people were kept safe from abuse including the risk of financial mistreatment. People had been helped to avoid the risk of accidents and medicines were safely managed. There were enough staff on duty and background checks had been completed before new staff were appointed.

Staff had received training and guidance and they knew how to care for people in the right way. People had been assisted to eat and drink enough and had been supported to receive all of the healthcare assistance they needed.

The registered persons had ensured that people’s rights were respected by helping them to make decisions for themselves. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered persons had taken the necessary steps to ensure that people only received lawful care that respected their rights.

People were treated with kindness and compassion. Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

People had been consulted about the care they wanted to receive and they had been given all of the assistance they needed. People who lived with dementia were given the special assistance and reassurance they needed to reduce the risk of them becoming distressed. People had been helped to pursue their hobbies and interests and there was a system for quickly and fairly resolving complaints.

People had been consulted about the development of the service and quality checks had been completed. The service was run in an open and inclusive way, good team work was promoted and staff were supported to speak out if they had any concerns. People had benefited from staff acting upon good practice guidance.

The service provides care to up to 30 older people or people living with a dementia. The service is a purpose built two storey building with a secure unit for people living with dementia on the upper floor.

At lunchtime we undertook a Short Observational Framework for Inspection (SOFI) in the upstairs lounge/dining room. SOFI helps us to understand people’s perceptions of the care and treatment they receive when they are unable to tell us themselves. We used this to find out about the lunchtime experience of people living with dementia.

We considered the findings of our inspection to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our discussions with people using the service and the staff supporting them. We spoke with six people, three relatives and a visiting health professional. We also looked at six care records.

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

Is the service safe?

The home had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA states that every adult has the right to make their own decisions about their care and treatment and must be assumed to have capacity to make them unless it is proved otherwise. The Deprivation of Liberty Safeguards are part of the MCA. DoLS supports people in care homes and hospitals to be looked after in a way that does not unlawfully restrict their right to freedom.

We saw the service had policies and procedures in relation to safeguarding vulnerable adults and whistle blowing. We spoke with care staff who understood what was meant by abuse and knew how to report their concerns.

Care staff told us they ensured equipment was in good working and reported any faults in order to keep people safe.

Is the service effective?

We found staff attended training courses to meet the individual needs of people in their care such as the care of a person living with dementia.

We saw that before people received care and treatment staff sought their consent or agreement.

The registered nurses told us they attended regular meetings. One told us, “We have regular meetings, but if we have a problem we get together and discuss and resolve the problem.”

Is the service caring?

We observed staff interact with people. People were enabled to maintain their independence.

At lunchtime we saw one person who did not want to sit at the table to eat their meal supported to walk about the dining room with their meal.

We asked people if they felt well cared for. One person told us, “All lovely this morning, very happy, very content.”

Is the service responsive?

We saw when care workers raised had concerns about people's health and social care needs, that the provider had contacted appropriate health and social care professionals. The individual care files identified this and a record of actions taken were recorded.

We saw the provider had contingency plans in place in event of an emergency situation.

Is the service well led?

Satisfaction surveys had been undertaken by people, their relatives and visiting health professionals. We saw most responses were positive. We read responses from people and their families, “Looked after very well, and “Noise level at night time due to shouting.”

Nursing and care staff told us leadership in the service was very good. One staff member said, “Leadership – I couldn’t ask for better.”

At our previous inspection on 7 June 2013 we identified a number of concerns regarding the reviews of people's care plans and general health assessments. We had found people's support plans, risk assessments and weights had not been reviewed for some months; the home's own policy is that reviews should be carried out monthly.

At this inspection we found all care plans, risk assessments and general health assessments had been carried our monthly since the time of our visit.

We looked at four people's care records which included their care plans, risk assessments and health plans. These were clear, person-centred, detailed and provided information on how their diverse needs should be met. However, when we reviewed the care plans we found that although they contained risk assessments, weight charts, and other documents, these had not been reviewed monthly as stated in the provider's own policy.

The home had three members of staff responsible for activities throughout the week.

We were present whilst lunch was taken. We saw appetising food was served. One relative told us, "I think the food is very good." One person who lived at the home told us, "I like the food very much."

We looked around the home and observed a good overall standard of cleanliness. We saw people's rooms were clean and communal areas were clean and tidy. The home was free from mal odour.

We observed that staff were attentive to people's needs and that people who lived at the home were at ease with the members of staff.

We saw staff interacted with people with confidence. One person said who lived at the home said, "The staff are very, very good; they look after me so well."

Everyone we spoke with talked positively about the staff and felt they fully supported their care needs. People told us the staff spoke with them in a calm and respectful manner. One person said, "Staff are always nice."

People told us their care was personalised to their needs. They told us they knew staff kept records on them and had seen those records and discussed the content. One person said, "Staff show me my care plan."

People told us they felt safe and if they were concerned about anything they would discuss it with a family member, a friend or a staff member. One person said, "I've never had a need to complain." Another said, "I know any personal concerns would be looked into thoroughly."

The people who used the service told us staff were knowledgeable about a lot of illnesses. They said if the staff needed to seek advice from other health or social care professionals they did so promptly. One person said, "When I have needed my equipment changing they phoned the firm immediately. There is never a delay."