Sea Gables Residential Home

The provider was not always following current guidance for testing in adult social care or managing risks related to the use of PPE. The provider has acted to address this.

We found the following examples of good practice.

People were supported to have visitors in line with government guidance.

People were supported to access the community safely and enjoy a range of activities.

People were supported to take responsibility for their own safety and the safety of others.

About the service

Sea Gables Residential Home is a care home. Sea Gables is registered to provide accommodation and personal care for up to seven people and predominantly supports people living with a learning disability and mental health needs. At the time of the inspection there were five people living at the service. The service was a large family style home, which had been adapted to suit the needs of the people living there.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People and their relatives gave us positive feedback about their safety and told us that staff treated them well. One person told us, “I feel very safe here.”

Staff were recruited safely, and sufficient numbers were employed to ensure people's care and social needs were met. Staff knew how to keep people safe from harm. The provider had a policy and procedure for safeguarding adults and the registered manager and staff understood the signs to look for. Risk assessments and management plans were completed for people and the home environment to ensure safety. There was a system to manage accidents and incidents and to reduce them happening again.

People received their medicines safely and as prescribed. Appropriate arrangements were in place for obtaining, recording, administering and disposing of prescribed medicines.

Staff had received appropriate training and support to enable them to carry out their role safely.

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

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People told us they were happy living at Sea Gables and felt supported to live their lives. One person said, “It’s a good place to live.” Staff were observed to treat people with kindness and compassion.

People's needs were assessed to ensure these could be met by the service. The registered manager and staff worked with other external professionals to ensure people received effective care.

Staff supported people and showed an understanding of equality and diversity and people were treated with dignity, and their privacy was respected. People and their relatives were involved in the planning and review of their care and people were supported to be as independent as possible.

There was a clearly defined management structure and regular oversight and input from the provider. Staff were positive about the management of the service and told us the registered manager and provider were very supportive and approachable. Any concerns or worries were listened to, addressed and used as opportunities to make continuous improvements to the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 14 December 2018).

Why we inspected

This was a planned inspection based on the previous rating.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Sea Gables is registered to provide accommodation and personal care for up to seven people and seven people were being accommodated at the time of the inspection. The home is based on two floors and is situated close to local facilities and shops. All bedrooms had en-suite bathrooms and there was a choice of communal areas where people could choose to spend their time.

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.

At our last inspection, in May 2016, we identified no concerns and rated the service as good. At this inspection, however, we identified some areas for improvement.

CQC were not always notified of significant events. There was a quality assurance process in place, but this was not always used effectively to identifying concerns and bring about improvement.

Best practice guidance was not always followed to ensure medicines were consistently recorded, stored and disposed of safely.

There were clear recruitment procedures in place; however, these were not always followed fully to help ensure only suitable staff were employed.

Arrangements were in place to deal with foreseeable emergencies, although some staff were not clear about the action to take in the event of a fire.

Staff protected people’s rights and acted in their best interests, although they were not always clear about the extent of their role under the Mental Capacity Act 2005. Procedures to use low-level interventions, to support people who could behave in a way that put themselves or others at risk, were not robust.

Most staff had received sufficient training to enable them to support people effectively, although a night support worker had not completed some essential training.

Individual risks to people were usually managed effectively and people were involved in risk-taking decisions. Infection risks were managed appropriately for the size and type of service.

People felt safe living at Sea Gables. Staff used innovative techniques to help people understand safeguarding and protect them from the risk of abuse.

There were enough staff available to meet people’s care needs and support them with activities. Staff were appropriately supported in their role by managers.

People’s nutritional and dietary needs were met consistently. The home had been adapted to meet people’s needs.

Staff supported people to access healthcare services when needed and helped ensure they experienced a smooth transition when they moved into or out of the service.

People were supported by kind, caring and compassionate staff who knew them well. They interacted positively with people and helped boost people’s morale and feelings of self-worth through a ‘Housemate of the month’ scheme.

Staff encouraged people to be as independent as possible, used appropriate techniques to communicate with them and involved them in planning the care and support they received.

Staff respected people’s sexuality, privacy and dignity. They supported people to build and maintain relationships with people important to them.

People received personalised care and support from staff who demonstrated a strong commitment to treating them as individuals and putting people at the heart of the service.

People were supported to access the community, take part in a wide range of activities and to lead happy, fulfilled lives. They were encouraged to develop independent living skills by setting personal goals.

Staff promoted choice and were responsive to people’s wishes. People felt able to raise concerns and there was an accessible complaints procedure in place.

There was a clear management structure in place and staff were motivated, happy in their work and felt supported by the management.

Staff demonstrated a commitment to the ethos of the service by supporting people in a personalised way to the best of their abilities.

The views of people, staff and professionals were sought and acted on.

Community links had been developed which benefited people and reduced the risk of them becoming socially isolated.

A registered manager was not in place at the time of the inspection, although the manager had applied to be registered with CQC and their application was being processed. 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 providers operated an innovative project called “The Land” to provide meaningful outdoor activities for people within a safe environment. This had proved beneficial for people living at Sea Gables by providing opportunities for them to care for animals, grow produce and develop likns with people and organisations in the community.

People were happy living at the home and were supported to work towards individual goals. These were detailed in people’s care plans, together with information about staff should help people achieve them. For one person, working at The Land had acted as a catalyst to developing their independent living skills and achieving their goal of moving to a supported living setting.

People felt safe living at Sea Gables and were protected from the risk of abuse. Individual risks were managed in a way that protected people from harm while promoting their independence.

Staff worked in a flexible way to enable people to lead happy and fulfilled lives. Recruitment practices were safe, people’s medicines were managed safely and there were plans in place to deal with foreseeable emergencies.

Staff were suitably trained and supported in their work and knew how to care for people effectively. They received appropriate induction and supervision.

People received enough to eat and drink and were supported to prepare meals. They had appropriate access to healthcare services when needed. Staff sought consent from people before providing support and followed legislation designed to protect people’s rights and freedom.

People were cared for with kindness and compassion. All interactions we observed between people and staff were positive and it was clear that staff knew people very well. Staff supported people to build and maintain relationships and protected their privacy at all times.

People were involved in developing and reviewing the care and support they received. They could access their care plans on request at any time and staff were responsive to people’s views when they requested changes to the way they were supported.

Sea Gables was well-led. The providers operated their services in a joined up way that complimented one another. There was a positive, open culture. The manager acted in a consultative way. Staff were happy in their work and worked well together.

There was a suitable quality assurance system in place. The manager was aware of the key strengths and areas for improvement at the home and had developed a plan to manage these.

We spoke with three members of staff and the manager, who were all able to demonstrate a clear understanding of peoples' care and welfare needs. They told us they felt they had enough time to meet people's needs. We observed care being provided in the communal areas of the home and saw staff were not rushed and had time to interact effectively with people. There was a duty roster system in place, which detailed planned cover and the arrangements to manage short term absence.

We spoke with two families of the people who used the service and a visiting health professional. They all told us they did not have any concerns regarding the quality of the care provided by the home. One family member said 'staff are great, they really understand [their relative's] needs'. They added 'I am very, very pleased with how they look after my [relative]'. The visiting health professional said 'when I visit, it feels like it is their [the people who used the service's] home'. They added 'My client has grown in confidence since they have been there'.

We observed that staff were friendly and courteous, and respected people's wishes. For example, people told us that staff always knocked before entering their rooms.

We found that care plans were comprehensive, and showed that people had been involved in decisions about their care. Staff received appropriate training and were supported to deliver care safely. They had a good understanding of how to protect people from abuse, and worked to a policy of non-restraint. One member of staff told us they were 'really happy with the way people were treated'.

The provider had an effective system to assess and monitor the quality of service provision, and demonstrated changes that had been made as a result.