Sambhana Care Ltd

At this inspection, we found that the service had made meaningful progress across most areas, particularly in culture, communication, training, care planning and staff supervision. People and families consistently told us they experienced kinder, more reliable care, and staff described clearer expectations under the new registered manager and nominated individual.

Despite this progress, improvements had not been yet fully embedded due to time. Governance systems—introduced only recently—had not consistently identified issues, and in some cases, inspectors identified concerns that internal audits had missed. This meant leaders could not yet fully assure themselves, at time of inspection, that care was safe and consistently managed.
Medicines management and risk assessment remained an area of concern. Although the registered manager had taken steps to improve practice, there were still gaps in MAR charts, incomplete audits and insufficiently detailed risk assessments. Some risks, such as the use of flammable creams, had not been appropriately assessed until raised during inspection. Once raised, these were remedied immediately.

Overall, the service is moving in the right direction, and many improvements have had a positive impact on people’s experiences. The registered manager and nominated individual had created a more open, supportive and responsive culture. Governance, medicines and risk management require further time to fully demonstrate appropriate oversight and consistency.
Feedback given to the registered manager and the nominated individual was accepted and acted upon immediately.

This service has been in Special Measures since 16 April 2025. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a time frame within which providers must improve the quality of the care they provide.
The registered manager demonstrated improvements that have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.