The inspection took place on the 3 July 2017. The inspection was unannounced and was carried out by two adult social care inspectors and two experts by experience.

We last inspected the service on 8 November 2016 and rated the service as good for the Safe and Well-led domains. This was a focussed inspection in response to information received by CQC. We also carried out a comprehensive inspection in February 2015 and rated the service as good overall. At this inspection we found the service remained good and met all the fundamental standards we inspected against.

Sandringham Care Home is registered to accommodate up to 92 people. It offers personal care and support to people who have dementia, people who have general nursing care needs and older people who require residential care. The home is located in the town centre of Bishop Auckland.

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The registered manager was on leave at the time of our inspection and we met with an acting manager who had been overseeing the service since April 2017.

There were safeguarding procedures in place. Staff were knowledgeable about what action they should take if abuse was suspected. The local authority safeguarding team informed us that were no current safeguarding concerns regarding the service.

The premises were clean. Checks and tests had been carried out to ensure that the premises were safe.

There were safe systems in place to receive, administer and dispose of medicines.

We found that recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people.

Staffing levels were provided to meet the needs of people using the service. Some staff we spoke with stated they felt there could be more staff on duty and people generally told us they were attended to reasonably quickly. Records confirmed that training was available to ensure staff were suitably skilled. Staff were supported through an appraisal and supervision system.

The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS). We saw the service identified where an authorisation may be required and followed the correct procedures to apply and maintain a DoLS.

People's nutritional needs were met and they were supported to access healthcare services when required.

We observed positive interactions between staff and people who lived at the service. Staff promoted people's privacy and dignity. There were systems in place to ensure people were involved in their care and support and treatment.

Care plans were in place which detailed the care and support to be provided for people. These were reviewed regularly or when needed and were held electronically.

There was an activities coordinator employed to help meet the social needs of people. Some people told us that more activities would be appreciated; others said there were sufficient activities at the home. People were supported to access the local community.

There was a complaints procedure in place. Feedback systems were in place to obtain people’s views.

The provider was meeting t

The inspection took place on 8 November and was unannounced.

Sandringham Care home is a care home with nursing which is registered to provide care for up to 92 older people and young adults who may have mental health, physical disabilities and dementia needs. The home has four separate units over three floors and it adapted for people with dementia.

The home has 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.

People who used the service told us they felt safe and well supported by staff. Staff had received training in safeguarding. We found staff understood what actions to take if they thought people were unsafe.

Appropriate systems were in place for the management of medicines so that people received their

medicines safely. Medicines were stored in a safe manner. We witnessed staff administering medicines in a safe and correct way.

The premises were clean and well maintained. We saw that equipment was in place to maintain the health and safety of people and staff, and were checked both by the service and approved contractors when required.

There was a process for managing accidents and incidents to ensure the risks of any accidents re-occurring would be reduced.

Staff employed by the registered provider had undergone a number of recruitment checks to ensure they were suitable to work in the service. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Staff told us they felt well supported by the registered manager and had received support through supervision and appraisal to enable them to care for people.

Individual support plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm.

We found people who used the service and their representatives were regularly asked for their views about the service.

There were quality assurance systems in place to ensure the effective running of the service; however these were in the process of being updated to provide greater clarity to staff about their roles and responsibilities.