We inspected the service on 27 November 2017. The inspection was unannounced. Seathorne Court Residential 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. Seathorne Court Residential Home is registered to provide accommodation and care for 18 older people. There were 15 people living in the service at the time of our inspection.
The service was run by a company who was the registered provider. There was a registered manager in post. 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.
At our last inspection on 8 December 2015 the service was rated, ‘Good’.
At the present inspection the overall rating of the service remained, ‘Good’. However, we rated our domain ‘effective’ as, ‘Requires Improvement’. This was because we found that improvements were needed to ensure that all parts of the accommodation were designed, adapted and decorated to meet people’s needs and expectations.
Our other findings were as follows. There were systems, processes and practices to safeguard people from situations in which they may experience abuse including financial mistreatment. Most risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. In addition, most of the necessary arrangements had been made to ensure that medicines were managed safely. Suitable arrangements had been made to ensure that sufficient numbers of suitable staff were deployed in the service and background checks had been completed before new care staff had been appointed. People had benefited from most of the necessary steps being taken to prevent and control infection and lessons had been learnt when things had gone wrong.
Suitable provision had been made to assess people’s needs and choices so that care was provided to achieve effective outcomes. Although some care staff had not received all of the training the registered persons said they needed, in practice they knew how to care for people in the right way. This included supporting people if they became distressed.
People received the individual assistance they needed to enjoy their meals and they were helped to eat and drink enough to maintain a balanced diet. In addition, suitable steps had been taken to ensure that people received coordinated and person-centred care when they used or moved between different services. Furthermore, people had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support.
People were supported to have maximum choice and control of their lives and nurses and care staff supported them in the least restrictive ways possible. The policies and systems in the service supported this practice.
People were treated with kindness, respect and compassion and they were given emotional support when needed. They had also been supported to express their views and be actively involved in making decisions about their care as far as possible. This included them having access to lay advocates if necessary. In addition, confidential information was kept private.
People received personalised care that was responsive to their needs. As part of this people had been offered opportunities to pursue their hobbies and interests. People’s concerns and complaints were listened and responded to in order to improve the quality of care. In addition, suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.
There was a positive culture in the service that was open, inclusive and focused upon achieving good outcomes for people. People benefited from there being a robust management framework that helped care staff to understand their responsibilities so that risks and regulatory requirements were met. In addition, the registered persons had taken suitable steps to ensure the financial sustainability of the service. In addition, the views of people who lived in the service, relatives and staff had been gathered and acted on to shape any improvements that were made.
Although quality checks had been completed some of them had not been sufficiently robust to quickly address shortfalls in the running of the service. However, good team work was promoted and care staff were supported to speak out if they had any concerns about people not being treated in the right way. In addition, the registered persons were actively working in partnership with other agencies to support the development of joined-up care.