Seabourne House Care Home

Updated 14 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was prompted in part by allegations of insufficient staffing, oversight concerns and poor care practices that put people at risk. Whilst incidents were subject to further investigation by the local authority safeguarding team, the information shared with CQC about care practices indicated potential concerns about how people’s needs were met and how well the service was led. This inspection examined those areas. Early evidence indicated that the oversight of the service was not as robust as it had been when we last inspected. We opened the inspection up to check if this had had an impact on people’s care.

The inspection site visits took place on the 3 and 10 January 2019. Our first visit was unannounced. The inspection team on the first day was made up of two inspectors. On the second day the team was made up of two inspectors, an assistant inspector and a Specialist Advisor. The specialist advisor provided clinical knowledge. We received information from relatives up until the 16 January 2019.

During our inspection we observed care practices and used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with seven people living in the home and spoke with or received feedback from relatives and friends of ten people. We spoke with 11 members of staff, a member of agency staff, the manager and three representatives of the provider organisation. We also looked at records, including medicines’ administration records related to nine people’s care, and reviewed records relating to the running of the service. This included four staff records, quality monitoring audits, the minutes of meetings and accident and incident records. We received requested information throughout the inspection. Following the inspection, we received further information as agreed with the inspection team.

We also spoke with social care professionals and health professionals who had worked with the service.

Updated 14 February 2019

The inspection visits took place on 3 and 10 January 2019 and the inspection was unannounced. We continued to receive information until the 16 January 2019. This inspection was carried out due to concerns that were raised with us. The provider was responsive to these concerns and worked transparently with CQC and statutory agencies to address issues raised.

Seabourne House Care Home 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.

Seabourne House Care Home is registered for 48 people. There were 37 older people living in the home at the start of our inspection. People had a variety of care and support needs related to their physical and mental health. The majority of the people living in the home had needs associated with the impact of dementia on their health and well-being.

There was not a registered manager in post, which is a requirement of the service’s 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 provider had acted to recruit to this role. The last registered manager had left the service in November 2018. An interim manager was in post and a new manager had been appointed.

We received concerns and allegations in relation to whether people’s needs were being effectively met and how well-led the home was. We reviewed this information and planned to carry out an inspection focusing on the questions, is the service safe? and is the service well led? During the inspection, we also identified that there were some issues related to oversight so we looked at all the domains to check the experience of care people were receiving.

Overall people’s rights were protected, however staff had mixed understanding of the application of consent and best interests decisions. The provider acknowledged this and had put measures in place to support staff.

Recording relating to some risks was not always robust. This meant the monitoring of people’s wellbeing and the risks they faced could not be achieved. This was addressed during our inspection.

People were supported to eat enough to obtain a balanced diet. People’s dietary needs were met although preferences were not always respected.

There were sufficient staff to meet people’s needs. Feedback from people and observations indicated that deployment needed to be reviewed and the provider committed to undertake this work.

Overall, people and relative’s complaints were taken seriously and used as an opportunity for learning and improvement. However, one complaint had not been fully responded to and one person’s concerns had not been fully addressed. The provider acted on this.

People’s needs were assessed and their needs planned for. Care plans had not all been updated to reflect changes to people’s needs and this impacted on meeting DoLS conditions. This had not impacted on care and staff were consistent in their understanding of people’s needs.

People were supported by staff who felt supported and valued their training. Staff had the support and training they needed to meet people’s identified needs.

People were supported by staff who promoted their independence and respected their dignity. People's independence and wellbeing was also enhanced by the design and environment of the home.

People received the care and support they needed and in the ways they preferred. Staff took the time to get to know people and their life and social histories. They used this information to help them understand the person and to provide appropriate care and support.

People were engaged with, and enjoyed, activities including individual and group activities. Most people and relatives felt that they were listened to and their views were considered and acted upon.

The environment was clean and well maintained.

There was a programme of quality checks and audits to monitor and improve the quality and safety of the service. The provider reviewed their processes in light of concerns identified and were transparent in their acknowledgement of learning. The registered provider took immediate action in response to the shortfalls identified.