Seaton Hall Residential Home

We found the following examples of good practice.

The home had good supplies of personal protective equipment (PPE) that were readily available in stations throughout the home. Clinical waste bins were positioned so that staff could access them when required.

The management promoted social distancing and made changes to the environment to reduce the risk of the spread of infections. For example, furniture had been repositioned, people were regularly reminded of social distancing and there was clear signage about this.

Visitors completed temperature checks and a health questionnaire on arrival. The home had a purposed built room, with protective screens, to allow safer visiting. The manager also planned to make an area where relatives could be tested and wait for results.

A senior member of staff observed staff were competent with hand hygiene and PPE use. The local infection prevention and control nurse had visited the home to provide training and observed staff were following PPE guidance.

Staff felt supported by the registered manager and the provider. Staff told us the manager offered them daily support if they had to isolate and they were supported to return to work safely. The manager praised staff for working together and the commitment they had shown to the home.

The home had identified staff to be infection prevention and control champions. These staff were responsible for sharing best practice with other staff.

Further information is in the detailed findings below.

Seaton Hall 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.

Seaton Hall Residential Home accommodates up to 29 older people who require personal care in one adapted building. At the time of our inspection, there were 23 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

Seaton Hall was last inspected by CQC in January 2017 and was rated Requires improvement overall. At the inspection in January 2017 we identified the following breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 17 (Good governance). This was because the provider's governance system had not always been effective in identifying or addressing improvements to the service. At this inspection we found improvements had been made in all the areas identified at the previous inspection.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and described potential risks and the safeguards in place to mitigate these risks.

The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed.

The home was clean and suitable for the people who used the service, and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. Staff were suitably trained and received regular supervisions and appraisals.

The provider carried out relevant vetting checks when they employed staff. However, there was no record of what documents had been checked to confirm the proof of identity of new staff. We have made a recommendation about this.

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

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Seaton Hall Residential Home. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

Activities were arranged for people who used the service based on their likes and interests, and to help meet their social needs. The service had good links with the local community.

People who used the service and family members were aware of how to make a complaint however there had been no formal complaints recorded at the service.

The provider had an effective quality assurance process in place. Staff said they felt supported by the registered manager and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service via meetings and surveys. People and family members told us the registered manager was approachable and visible.

The registered manager completed a monthly audit of the service. The provider visited monthly however these visits were not recorded. We have made a recommendation about this.

The last inspection of this service was carried out in June 2015. That inspection was to check whether the provider had made necessary improvements to assessing and recording the needs of people who stayed at the home for short periods. At that time we found there had been improvements to the way the service set out the support needs of people who were staying for short breaks.

Seaton Hall Residential Home is registered to provide accommodation and personal care for up to 29 older people who have personal or dementia care needs. There were 22 people living at the home when we visited, including four people who were staying for a short period. Seaton Hall Residential Home had been registered as a care home for over 20 years.

At the time of this inspection a former manager was still registered with the Care Quality Commission but was no longer in post. A new manager had commenced the process of applying for 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.

During this inspection we found the provider had breached a regulation about good governance. This was because the provider had not always notified us of events that are required to be sent to us by law. People, relatives and staff said the home's decoration and furnishings was in need of improvement. We found people’s care records did not always include current assessments about potential risks, such as falls, as these had been archived. This meant staff did not have immediate access to information about how to minimise those risks. You can see what action we have told the provider to take at the back of the full version of the report.

We found there were no adaptations to help people who were living with dementia to find their way around. We have made a recommendation about this.

People told us they felt safe and secure in the home. Staff were clear about how to recognise and report any suspicions of abuse. Staff told us they were confident any concerns would be listened to and investigated to make sure people were protected. The provider made sure only suitable staff were employed and used a dependency tool to decide the level of staffing.

People and relatives felt staff were trained and experienced. Staff understood the Mental Capacity Act 2005 for people who lacked capacity to make a decision and asked people’s permission before providing care.

Health and social care professionals said staff cared for people in a competent way and responded appropriately to any changes in people’s well-being. People were supported to eat and drink enough and they said they had choices about their meals.

Staff understood what was important to each person and were familiar with their preferences. There was a friendly atmosphere in the home and there were cheerful interactions between people and staff. People had opportunities to join in activities if they wanted and this was improving with a new activity staff member.

People were asked for their views about the home and felt their views were listened to. People had information about how to make a complaint or comment and these were acted upon. People, relatives and staff felt the manager was approachable and supportive.

One relative told us, 'The staff are superb and I have always found the care to be of a high standard'.' People also said, 'I find that the owner and the staff care a great deal about us,' and 'Staff know what they are doing and it is a good place to live in.'

We found that people's care was planned and delivered in line with their needs. The staff were very knowledgeable about people's care needs and how to meet them. We noted that the staff team had been very stable and all of the staff had been in post for a number of years. We found that the manager made sure the home provided effective care and encouraged staff development.

The home was well-maintained and the provider had an on-going programme of redecoration which ensured it was kept to a high standard,

We found that effective procedures were in place should people wish to complain.