The inspection took place on 4 September 2018 and was unannounced. The last comprehensive inspection took place in February 2018. The service was rated Requires Improvement overall. We found the service was in breach of four of the regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014. People did not always receive care and treatment which was person-centred and met their needs. The registered provider was not always doing all that was reasonably practicable to mitigate risks associated with people’s care and treatment. People’s medicines were not always managed safely. Systems and processes in place to monitor and improve the quality of the service, were not effective and needed embedding into practice. The registered provider did not always act in accordance with the Mental Capacity Act 2005.

Following the last inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve the key questions asking if the service was safe, effective, caring, responsive and well led, to at least good. The registered provider sent us an action plan detailing how they were going to make improvements. At this inspection we checked the improvements the registered provider had made. We found sufficient improvements had been made to meet the requirements of the Regulations.

At this inspection we checked if improvements had been made. We found that the registered provider had addressed all the concerns raised at our last inspection and the rating of the service improved to Good. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Sandygate Residential Care Home’ on our website at www.cqc.org.uk.

Sandygate Residential Care Home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Sandygate Residential Care Home is a purpose built care home located on the outskirts of Wath upon Dearne. The home provides accommodation for up to 54 people on two floors. The care provided is for people who have needs associated with those of older people, this includes a dedicated unit for people living with dementia. At the time of our inspection 49 people were using the service.

At the time of our inspection the service had 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.

Systems were in place to safeguard people from abuse. Staff confirmed they had received training in this subject and knew what action to take if they suspected abuse.

Risks associated with people’s care were identified and managed effectively. Risk assessments were in place which detailed how risks could be minimised.

We observed staff interacting with people who used the service and we found there were enough staff to meet the needs of people in a timely way. However, during our inspection some people told us that there were occasions where there were not enough staff available to meet people’s needs.

We looked at systems in place to manage medicines and found they were stored and administered in a safe way.

The service was clean and well maintained. Some areas identified on inspection required attention and we discussed them with the registered manager. We were told that these issues were already in the process of being addressed.

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. The service was compliant with the Mental Capacity Act

The inspection took place on 6 and 13 February 2018 and was unannounced on the first day. The last comprehensive inspection took place in January 2017, when we identified a breach in the well led domain and the service was rated requires improvement. At this inspection we checked if improvements had been made. We found that the provider had failed to make or sustain sufficient improvements in this area. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Sandygate’ on our website at www.cqc.org.uk.

Sandygate is a care home. People living 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.

Sandygate can accommodate up to 54 people. At the time of our inspection 49 people were using the service.

At the time of our inspection the service did not have 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. At the time of our inspection the home had a manager in post who had commenced their employment at the service in November 2017. The manager was not registered with Care Quality Commission, but had commenced the registration process.

We found risks had been identified and measures put in pace to manage the risk. However, we found the risks were not always managed so people were at risk of harm. We found risk assessments did not always contain enough detail to help prevent the risk occurring. This showed the registered provider was not doing all that was reasonably practicable to mitigate risks associated with people’s care and treatment.

The registered provider did not always ensure that safe arrangements were in place for managing medicines. We found people were prescribed medication to be taken as and when required known as PRN (as required) medicine. However, whilst protocols were in place to guide staff in how these should be administered, they lacked detail of what signs to be aware of prior to administering them. The temperature of the room upstairs, which was used to store medicines was not monitored or recorded to determine that they maintained the required temperatures. We also saw that eye creams and ointments were not always dated when opened. These medicines required disposal after four weeks of being opened.

We found some areas of the home were not kept clean and infection prevention and control policies were not adhered to. For example, store rooms were not always well organised. Some had items stored on the floor, which meant they were difficult to clean. One sluice area had shelves which were showing bare wood and therefore making them difficult to clean.

We observed staff interaction with people who used the service and found there was enough staff available to meet people’s needs in a timely manner. Staff we spoke with felt they worked well as a team and had enough staff working with them to support people appropriately.

Staff had received training to give them the knowledge and skills to carry out their roles and responsibilities. However, some staff had not received appropriate support, supervision and appraisal in line with the registered provider’s policy.

Staff were aware of how to report safeguarding concerns and use the whistle blowing policy if required.

Decisions made where people lacked capacity did not always follow best practice and did not evidence decisions were made in a person’s best interest. This did not meet the requirements of the Mental Capacity Act 2005.

People who used the service received appropriate support to eat and drink sufficient amounts to maintain a healthy and bal

This unannounced inspection took place on 17 and 18 January 2017. The home was previously inspected in May 2015 when we checked the service was meeting the regulation it had been in breach of in December 2014, which was regarding staffing levels. At that inspection we found action had been taken to address the breach.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Sandygate Residential Home’ on our website at www.cqc.org.uk’

Sandygate Residential Home is a purpose built care home located on the outskirts of Wath Upon Dearne. The home provides accommodation for up to 54 people on two floors, a lift is available to access the first floor and all rooms have en-suite facilities. The care provided is for people who have needs associated with those of older people, this includes a dedicated unit for people living with dementia.

The service did not have a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run. However, a registered manager from one of the company’s other homes was overseeing the home and a new manager had been appointed the week before our visit.

We found people were cared for by a stable staff team who knew them well. We saw staff encouraged people to be as independent as they were able to be and spoke with them in a friendly and respectful way.

People who used the service, and the visitors we spoke with, told us that overall they were happy with how care and support was provided at the home. They spoke positively about how staff delivered their care, but the majority of the people we spoke with raised concerns regarding the number of staff on duty, especially on the upstairs unit. They told us they felt this sometimes affected the timeliness of the care provision. We saw action was being taken to address this.

Systems were in place to make sure people received their medications safely, which included key staff receiving medication training. However, new monitoring checks needed embedding to ensure medication was administered correctly.

People we spoke with felt the home was a safe place for people to live and work. We saw there were systems in place to protect people from the risk of harm. Staff we spoke with were knowledgeable about safeguarding people and were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified any potential risks to people and plans were in place to ensure people’s safety.

The recruitment system helped the employer make safer recruitment decisions when employing new staff. Staff had received a structured induction into how the home operated, and their job role, at the beginning of their employment. Following this they had access to a varied training programme that met the needs of the people using the service.

People were provided with a choice of healthy food and drink ensuring their nutritional needs were met. The people we spoke with said they were happy with the meals provided, but we saw the overall dining experience could be better.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People’s needs had been assessed before they went to stay at the home and we found they, and their relatives, had been involved in planning their care. Care files checked reflected people’s needs and preferences so staff had clear guidance on how to care for them.

People had access to activities which provided regular in-house stimulation, as well

We carried out an unannounced comprehensive inspection of this service on 15 and 16 December 2014 in which a breach of the legal requirements was found in relation to staffing. This report relates to that breach. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Sandygate’ on our website at www.cqc.org.uk.

We carried out this focused inspection on 6 May 2015 to ensure improvements planned by the provider had been implemented to address this breach of Regulation. We found that action had been taken to improve the safety of the service provision.

Sandygate Residential Home is a purpose built care home located on the outskirts of Wath upon Dearne. The home provides accommodation for up to 54 people on two floors. The care provided is for people who have needs associated with those of older people, this includes a dedicated unit on the ground floor for people living with dementia. The home does not provide nursing care.

The service had not had a registered manager in post since October 2014. However, an acting manager had been appointed in February 2014. The acting manager told us they were planning to submit their application to become the registered manager for the service shortly. 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 and associated Regulations about how the service is run.

At this focused inspection we found that overall there was enough skilled and experienced staff on duty to meet people’s needs. Since our last inspection people’s levels of dependency had been reviewed to help the provider assess the number of staff required to meet people’s individual needs. The provider had also taken other action to help make sure there were enough staff available to support people. For example, we saw more staff had been recruited and changes were being made to working practices to enable senior staff to spend more time supporting people.

People who used the service, and the relatives we spoke with, told us that most of the time there was enough staff available to meet people’s needs.

We will review our rating for this service at our next comprehensive inspection to ensure the improvements made and planned continue to be implemented and have been embedded into practice.

We were unable to gain the views of all the people who were living at the home due to their complex needs. Therefore we also observed how support was provided and spoke with visitors and staff to help us understand their experiences.

People's needs were assessed and care and treatment had been planned and delivered as they preferred. A relative told us, “They put my mind at ease straight away. If you ask for anything it is done straight away.”

People were provided with a choice of suitable and nutritious food and drink. They told us they enjoyed the meals they received and said they provided variety and choice.

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to become knowledgeable about abuse and how concerns should be handled.

We saw there were effective systems in place to reduce the risk and spread of infection.

The premise was in a good state of repair. People said they were very happy with their rooms and the home’s general facilities.

We found there was enough qualified, skilled and experienced staff to meet people's needs. People said they received the care and support they needed in a timely manner. One person told us, “I am very happy here, the staff are excellent.”

We saw records were accurate and fit for purpose. They were kept securely and could be located promptly when needed.

We were unable to gain the verbal views of some people but other people spoke to us about their experiences living at the home. We also watched how staff provided care and support to people.

The people we spoke with said they were happy with the care and support they had received and felt the home was a safe place to live. They told us the staff were good at their job and we received only positive comments about how they provided care.

No-one raised any concerns with us about the way they were cared for. When we asked them if there was something they would like to change at the home to make things better none of the people who lived at the home could think of anything.

We spoke with relatives and people who used the service. Everyone who spoke with us was very positive about the service and the care provided by the staff.

One relative told us that her family member had put on weight since coming into the home and was well looked after. Another relative said “The home is very good, staff are very friendly and they look after my family member very well”.

We spoke with seven people who used the service. They told us that “The staff are lovely, care is good and things could not be better”. One person said “I enjoy living in the home, there are plenty of activities and the staff are nice”. Three people told us that “We are doing okay. Staff helped us get up today and we have had a lovely breakfast”.

The inspection took place on 15 and 16 December 2014 and was unannounced on the first day. The care home was previously inspected in September 2013, when no breaches of legal requirements were identified.

Sandygate Residential Home is a purpose built care home located on the outskirts of Wath upon Dearne. The home provides accommodation for up to 54 people on two floors. The care provided is for people who have needs associated with those of older people, this includes a dedicated unit on the ground floor for people living with dementia. The home does not provide nursing care.

The service had not had a registered manager in post since October 2014. However the service manager told us a new manager had been appointed and would be commencing employment in approximately eight weeks’ time. 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 and associated Regulations about how the service is run.

Throughout our inspection we saw staff supported people in a friendly and inclusive manner. They encouraged people to be as independent as possible while taking into consideration any risks associated with their care. At the time of our inspection there were 49 people using the service. We spoke with 12 people who used the service and 12 regular visitors to the home. The majority of people we spoke with told us that overall they were happy with the service provided. However, five people raised concerns regarding the number of staff on duty, especially in relation to the upstairs unit. They told us they felt this sometimes affected the standard of care provided.

People received their medications in a timely way from senior staff who had been trained to carry out this role.

Overall we found on most days there had been enough skilled and experienced staff on duty to meet people’s needs. However, the planned staffing numbers had not always been maintained and information collated about people’s individual dependency needs had not been effectively used to evaluate if the planned staffing numbers were adequate.

This was a breach of Regulation 22 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to tak at the back of the full version of the report.

There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. We saw new staff had received a structured induction and essential training at the beginning of their employment. This had been followed by regular refresher training to update their knowledge and skills.

People received a well-balanced diet and were involved in choosing what they ate. The people we spoke with said they were very happy with the meals provided. We saw specialist dietary needs had been assessed and catered for.

People’s needs had been assessed before they moved into the service and they had been involved in formulating and updating their support plans. The four care files we checked were individualised regarding people’s needs and preferences, but two files had not been updated in a timely manner to reflect changes in the person’s care needs.

A varied programme was in place to enable people to join in regular activities and stimulation both in-house and in the community. People told us they enjoyed the activities they took part in.

We saw the complaints policy was available to people using or visiting the service. When concerns had been raised we saw the correct procedure had been used to investigate and resolve issues.

The provider had a system in place to enable people to share their opinion of the service provided and the general facilities at the home. We also saw an audit system had been used to check if company policies had been followed and the premise was safe and well maintained. Where improvements were needed we saw the provider had put action plans in place to address these.