Archived: Seagulls

Updated 24 April 2018

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.

This inspection took place on 11 and 12 January 2018 and was unannounced. The inspection was undertaken by one inspector and an inspection manager.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed previous inspection reports and notifications we had been sent by the provider. A notification is information about important events, which the service is required to send us by law.

We spoke to one person living at Seagulls. Other people who live at the home were unable to verbally communicate with us due to their learning disabilities. We observed care and support being delivered in communal areas of the home.

We spoke with four family members and three external professionals. We looked at care plans and associated records for three people, staff duty records, staffing records, records of accidents and incidents, policies and procedures and quality assurance records.

The home was last inspected in October 2015 when it was rated as Good.

Updated 24 April 2018

This inspection took place on 11 and 12 January 2018 and was unannounced. One inspector and an inspection manager carried out the inspection.

Seagulls 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.

Seagulls is a local authority run care home which provides accommodation for up to six people with learning disabilities and Autism who need support with their personal care. At the time of our inspection there were five people living in the home.

The home was arranged over two floors with most of the bedroom accommodation on the first floor. There were bathrooms available to people on each floor. There were 2 communal areas in the home, which were a kitchen/dining room and a lounge.

The home 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.

The last comprehensive inspection of this service was in October 2015 when the service was rated Good. At this comprehensive inspection we found the service was not meeting legal requirements and required improvements in the service which was delivered.

Failures to provide safe and care and treatment, person centred care, good governance and failing to act in accordance with the Mental Capacity Act 2005 were common themes.

Quality assurance systems were not robust to monitor and review the quality of the service which was provided. These had not been used effectively to identify concerns we found or drive improvement in the service.

Records of the assessment of people's ability to make some informed decisions had been undertaken. However, the principles of the Mental Capacity Act 2005 were not being applied in respect of best interest decisions to provide care or use restrictive practices. Staff we spoke with had a variable understanding of the Mental Capacity Act 2005.

Care plans were not consistently person centred and lacked detailed guidance for staff to ensure people received care in a safe way. Risk assessments that related to people’s health and safety did not ensure that all risks were effectively assessed. Action had not always been taken to reduce identified risks to ensure the safety of people. This exposed people to a risk of neglect and unsafe or inappropriate care or treatment. Risk assessments were not being developed to promote independence and we saw that people were being unlawfully restricted from areas of the home in order to manage risks.

People and their relatives were not regularly involved in the assessment and the on-going reviews of their care. Care plans were not written in a way that would enable people to understand and be involved in decision-making.

The premises were not always well maintained. The registered manager had requested that the landlord carry out some works but this had not been done. One area of the home was not clean and did not provide adequate personal hygiene equipment for people. Following our inspection action was taken to address this.

Staff had not received the appropriate training, professional development and supervision to be able to support people safely.

Staff were task orientated and there were not enough staff to meet people’s needs and to enable them to engage with people and support them to be involved in the tasks of daily life.

People received their medicines as prescribed. However, we identified some areas where improvements could be made to ensure the safe administration of topical creams.

Staff received training; however, some training to meet specific needs had not been provided. Staff had not always received regular and meaningful supervision. The provider had not ensured that staff performance and progress was monitored effectively and that staff had an opportunity to voice their individual views.

Recruitment procedures were not always safe. We saw that not all of the appropriate checks, such as references had been completed before staff started working with people.

People and their families told us they felt safe living at the home. Staff understood their roles and responsibilities to safeguard people from the risk of harm. Staff knew how to identify, prevent and report abuse.

Plans were in place to deal with foreseeable emergencies such as fire risk; staff we spoke with said they had had received training to manage such situations safely.

People were supported to maintain their health and well-being. Staff supported people to attend appointments with healthcare professionals. People were encouraged to eat healthily and staff made sure people had enough to eat and drink. However, people were not consistently being supported to be involved in choosing and preparing food and drinks.

Staff ensured people’s privacy was maintained. People were not always encouraged to make decisions about how their care was provided. Staff’s understanding of people's needs and preferences was based on familiarity.

We received some positive feedback about the care staff and their approach with people using the service. People were supported to take part in some activities within the local community. However, we observed occasions when staff had little time to spend with people and the care provided was task orientated.

Relatives and external health professionals we spoke with were positive about the service people received and people's visitors were welcomed.

There was a complaints procedure in place to enable people to raise complaints about the service. However, complaints were not being captured and information was not presented to people in a way they could understand.

People, their relatives felt confident to approach the staff or registered manager and felt they would be listened to.

We identified that the provider was in breach of six of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Registration Regulations 2009. You can see at the end of this report the action we have asked to provider to take.