This inspection took place on 24 April 2018 and was unannounced. At the last inspection in February 2017 we found breaches of Regulations 12 Safe Care and Treatment and 17 Good Governance of the Health and Social Care Act 2008 (Regulated Activities) 2014. At this inspection we found that sufficient improvements had been made and the provider was no longer in breach of regulations.

Sandy Lane Hotel 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 service accommodates up to 31 older people who may be living with dementia. There were 24 people living at the service on the day of the inspection.

There was a registered manager employed at 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.

Medicines were managed safely and in line with the company policy. Staff had received training and we saw checks had been completed to ensure staff were competent.

People told us they felt safe at the service. The service followed local safeguarding authority procedures in order to protect people and staff were trained accordingly.

Risks to people's health, safety and well being had been assessed. There were some minor issues around infection control which the registered manager addressed immediately. Where needed people were referred to healthcare professionals for support.

Accidents and Incidents had been recorded and analysed. Actions plans were in place where it had been identified that improvements or changes were needed to prevent reoccurrence of incidents.

There was sufficient staff on duty to meet people's needs. The recruitment process was robust. Staff were trained in subjects that enabled them to meet people's needs. Staff were supported through supervision, attended meetings with the management team and told us they enjoyed working at the service.

The environment was suitable for the needs of the people living there and had some positive dementia friendly areas. Communal areas displayed items for reminiscence and people's bedrooms had been personalised.

The provider had developed policies and procedures around equality and diversity to ensure a fair and equal service for all service users.

We observed some positive interactions between staff and people who used the service. Staff treated people with dignity and respect.

People had person centred care plans which reflected individual needs. We saw an activities programme displayed but people told us they would like to do more. People's sensory needs had been identified although this area could be developed further in line with the Accessible Information Standard.

People were aware of who they should talk to if they had a complaint.

There was a quality monitoring system in place with audits and checks of the service completed. The service had notified us of important events in a timely way.

Sandy Lane Hotel is registered to provide accommodation and personal care for up to 31 older people, some of whom may be living with dementia. The service is situated in Bridlington, in the East Riding of Yorkshire, close to the beach, local amenities and public transport routes. Accommodation is located over three floors and there are 30 bedrooms, one of which is a twin room; all have en-suite toilet facilities. There are three communal lounges and two dining rooms throughout the service and bathrooms on each floor. At the time of this inspection there were 27 people using the service.

The service is required to and did have a registered manager. 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 2008 and associated Regulations about how the service is run. The registered manager is responsible for the day to day management of the home and was available throughout this inspection.

This inspection was unannounced and was carried out on 23 February 2017. The inspection was to check that the registered provider was now meeting legal requirements we had identified at the last inspection.

At the last inspection on 21 December 2015 we found the registered provider was in breach of five of the regulations we assessed. These were in relation to safe care and treatment, premises and equipment, staffing, good governance and non-notification of incidents. The registered provider sent us an action plan that contained information on how they intended to meet those regulations and achieve compliance, which was checked during this inspection. We found improvements had been made and this action had been completed for three of these breaches.

We found that the service had not taken sufficient actions in relation to infection control practices, medicine practices and monitoring and improving the quality of the service and continued to be in breach of Regulations 12, safe care and treatment and 17, good governance.

We found that people's medicines were not always managed safely, we saw gaps in the recording of some people’s medicine records and one person’s controlled drug had not been booked into the service. In one bathroom cupboard we found used hairbrushes and razors, soap and topical creams.

Staff were aware of people's care needs but people's records did not always clearly reflect these. Some documentation was old and had not been reviewed or updated consistently, this included risk assessments, fluid charts, moving and handling assessments and personal emergency evacuation plans (PEEPs). Although there were some audits in place these had not picked up the shortfalls and the inconstancies of the recordings in the care plans, infection control and medicine practices, therefore they were ineffective at driving improvements.

There had been many improvements to the environment since the last inspection. All the accommodation on the ground floor had been damp proofed, communal rooms and some bedrooms had been re-decorated and new carpets had been laid. On the first floor some bedrooms had been re-decorated and new vinyl flooring and carpets had been laid. We noted that particular attention had been paid to people living with dementia and the flooring on the first floor was plain in line with dementia best practice.

Improvements had been made to staff training and we found staff received supervision and an on-going training programme was provided to assist staff to increase their knowledge and skills.

The registered manager understood their responsibilities to report accidents, incidents and other notifiable incidents to the CQC as required and we found this had improved since the last inspection.

Staff had been recruited safely and appropriate checks were completed prior to them starting work at Sandy Lane. Staff had a knowledge

We carried out this inspection on 21 December 2015. This inspection was planned to check whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection was unannounced; which meant that the staff and registered provider did not know that we would be visiting.

The last inspection was carried out 4 November 2014; at that inspection Sandy Lane Hotel was found to be compliant with the regulations we looked at.

Sandy Lane Hotel is a care home in Bridlington in the East Riding of Yorkshire. The home is registered to provide accommodation and personal care for 31 people, some of whom may be living with dementia. Accommodation is provided over three floors. A passenger lift provides access between floors. There are 30 bedrooms, one of which is a twin room and all have en-suite toilet facilities. There are three lounges and two dining rooms throughout the home and bathrooms on each floor.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager who was not registered with the Care Quality Commission (CQC). However, they had submitted an application for registration. 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.

The home had a system in place for ordering, administering and disposing of medicines. However we found that people did not always receive their medication as prescribed, medicines were not safely stored and the procedure for disposing of medicines had not always been followed. This was a breach of a regulation. You can see what action we told the provider to take at the back of the full version of the report.

We found that the homes premises were not always clean and well maintained. This was a breach of a regulation. You can see what action we told the provider to take at the back of the full version of the report.

We saw that staff had received an induction a prior to starting work within the home. However, we found that a high number of staff had not completed refresher training in a variety of topics. This was a breach of a regulation. You can see what action we told the provider to take at the back of the full version of the report.

The manager understood the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act (MCA) (2005) guidelines had been fully followed. However we found that the manager and registered provider had failed to notify the CQC of an application to deprive a service user of their liberty. This was a breach of a regulation. You can see what action we told the provider to take at the back of the full version of the report.

We found the provider did not have an effective process of auditing in place to check that the systems at the home were being followed and people were receiving appropriate care and support. This was a breach of a regulation. You can see what action we told the provider to take at the back of the full version of the report.

We saw that there were sufficient numbers of staff on duty and people’s needs were being met. However we made a recommendation regarding the deployment of staff during busy periods of the day.

We found that people were protected from the risks of harm or abuse because the registered provider had effective systems in place to manage any safeguarding issues. Staff understood their responsibilities in respect of protecting people from the risk of harm; however they required refresher training in safeguarding adults from abuse.

Assessments of risk had been completed for each person and plans had been put in place to manage identified risks. Incidents and accidents in the home were accurately recorded and monitored monthly.

We found that effective recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work so that only people considered suitable to work with vulnerable people had been employed.

Staff told us they felt well supported by the manager .They told us they received formal supervision, but could also approach the manager with any concerns at any time. However we found that supervisions and appraisals were not always effective at developing the staff team and we made a recommendation regarding this.

People’s nutritional needs were met. However, we found the lunchtime experience for people was inconsistent due the deployment of staff. We made a recommendation regarding this.

People were supported to maintain good health and had access to healthcare professionals and services. People were encouraged to have regular health checks and were accompanied by staff or relatives to hospital appointments when necessary.

We observed good interactions between people who used the service and the care staff throughout the inspection. We saw that people were treated with respect and that they were supported to make choices about how their care was provided.

We saw that people’s independence was promoted by the homes staff and that where possible people were encouraged to do things for themselves.

People had their health and social care needs assessed and care and support was planned and delivered in line with their individual care needs. The care plans were individualised to include preferences, likes and dislikes and contained detailed information about how each person should be supported.

The home employed an activity coordinator and offered activities for people to be involved in. People were also supported to go out of the home on day trips or to access facilities in the local community. However, people told us they would like more activities to be offered.

People’s comments and complaints were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided. However we did not see how this feedback was used to improve the service.

From what people told us, what we observed and noted as part of the inspection, staff provided appropriate care for the people who used the service. Food and drinks were specially prepared to ensure that people had a nutritious and balanced diet. One person said “Staff are very good, they are kind and helpful”. Another person said “I like the food here”.

People were protected from harm and the risk of harm through staff training and risk assessments. Staff could tell us what they would do if they saw abuse happening or someone reported abuse to them.

During our visit we saw that the home looked clean and tidy and there were infection control procedures in place.

The quality of the service was regularly assessed and people who used the service and staff were asked for their views about care and treatment and their feedback was acted on. There was a complaints procedure in place at the home. The people we spoke with knew what to do if they had any concerns.

Staff had received appropriate professional development and training to ensure they could meet the needs of the people who used the service.

In our previous inspection we found the premises were of suitable design but we had concerns regarding the maintenance of the premises that could impact on the health, safety and wellbeing of the people that lived there, the staff and visitors.

In response the provider had sent us an improvement plan telling us how they would ensure the above standard was met. We visited Sandy Lane Hotel and spoke with the registered manager and the owner about the improvements made. We reviewed their improvement plan and inspected the premises to check the improvements had been made. We also checked the overall safety, suitability and maintenance of the building and looked at other relevant documentation.

At this visit we saw the provider had taken steps to provide care in an environment that was suitably designed and adequately maintained.

From what people told us, what we observed and noted as part of the inspection, staff cared for the people who used the service appropriately and medicines were safely administered. We saw that care needs were discussed with people and that before people received care their consent was asked for. One person said “People have sat down with me and gone through the care I need. I think it was with social services as well”. Another person said “I think it’s fantastic here”.

We saw that there were appropriate recruitment procedures in place and sufficient numbers of staff on duty. People were protected from harm and the risk of harm through staff training and risk assessments. Staff could tell us what they would do if they saw abuse happening or someone reported abuse to them.

The quality of the service was regularly assessed and people who used the service and staff were asked for their views about care and treatment and their feedback was acted on. We saw that records were kept appropriately and securely.

During our visit we noted a number of areas of concern regarding the maintenance of the premises that might harm staff and people that lived there. Following the inspection we referred these matters to the East Riding of Yorkshire’s environmental health department and asked them to confirm the home met their specific requirements.

People told us they were able to make choices about aspects of their lives such as when to rise and retire to bed, where to sit during the day and what meals to have. Comments were, “I like to get up about 7.30am – they don’t wake you up. I go to bed when I want”.

People told us they could see a range of health professionals and that staff contacted the GP for them when required. Comments were, “I see my GP when necessary and my chiropodist every ten weeks”.

People spoken with said that staff were friendly, caring and respected their privacy by knocking on doors prior to entering. Comments were, “The staff are very nice”.