Seacliff Care Home

Seacliff Care Home is a residential care home registered to provide care and support to up to 24 people. The service provides support to older people some of whom were living with dementia. At the time of our inspection there were 21 people using the service.

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

Improvements had been made to the quality assurance and oversight processes within the home. A variety of audits and checks meant there was consideration to continual improvement. Medicines procedures were strengthened, and good practice guidance was key to the improvements made.

People, their relatives and staff told us Seacliff Care Home was a safe place to be. There were enough staff on duty, and they had been recruited using robust, safe processes. Staff knew how to identify, and report concerns about people, they were confident matters would be followed up.

People had risk assessments in place for all their care and support. Assessments were reviewed regularly and supported people to live their life the way they wanted to. 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.

People were protected from avoidable infections; the home was clean and hygiene processes were in place. Accidents and incidents were recorded and reviewed to ensure lessons were learned within the home.

Staff felt appreciated and proud to work at Seacliff Care Home. They were complimentary about the leadership of the home and their colleagues. The registered manager understood their regulatory responsibilities.

Staff knew and understood their job role and tasks were defined. The home sought to work in partnership with a range of external professionals including making links within their local community. Seacliff Care Home actively sought feedback on the quality of the care provided and used the information to continually improve.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 3 February 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the provider follow good practice guidelines for the safe management of medicines. At this inspection we found the provider had acted on the recommendation and were operating safe practices.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Seacliff Care Home is a 'care home' registered to accommodate up to 24 people. At the time of our inspection there were 17 older people living in one adapted building in a residential area of Bournemouth.

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

Improvements were needed to the governance systems within the home. Improvements that had been introduced following our last inspection were not robust and had not been sustained. The systems for monitoring and checking the home operates in a safe way were not effective.

Medicines were not always managed in a safe way, records of medicines that required stricter controls were not completed in accordance with the providers policy. Risk assessments were in place for people and detailed. However, they had not been updated and reviewed as planned.

Staffing levels were not always stable. Although no impact on people was identified staff shortages due to sickness had an effect on staff morale and the registered manager and provider was working to improve this. Staff understood how to recognise the signs of abuse and who to report to. People, relatives and staff felt confident any concerns would be followed up. Staff were recruited safely.

Infection prevention and control measures in place were robust and this contributed to keeping people from avoidable harm. One relative told us they follow all safety procedures within the home and said, “There has never been a drop in cleanliness.”

Staff were proud to work for Seacliff Care Home and external professionals were complimentary about their working relationship with the home.

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.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 17 December 2020) and there were two breaches of regulation. We had since followed up through targeted inspections and found the provider was no longer in breach of the regulations. At this inspection we found the improvements made had not been sustained and this has resulted in a new breach of regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to the management and providers oversight at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan and meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Seacliff Care Home is a 'care home' registered to accommodate up to 24 people. At the time of our inspection there were 12 older people living in one adapted building in a residential area of Bournemouth.

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

Improvements have been made to the governance systems since our last inspection. Quality audits were completed and analysed to identify patterns, learning and changes to the ways of working. Audits included infection prevention and control, medicines and fire safety.

People and staff were positive about the changes within the home. Staff understood their roles and responsibilities. The manager and deputy manager told us they worked well together and were supported by the provider. The provider told us they were committed to maintaining and continuing the improvements within the home.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 December 2020) and there were multiple breaches of regulation. Following the last inspection, we told the provider when they must be compliant and meet the regulations. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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.

Seacliff Care 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.

Seacliff Care Home is registered to accommodate up to 24 people. At the time of our inspection there were 15 older people living in one adapted building in a residential area of Bournemouth.

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

Improvements had been made within the home since our last inspection. Infection control procedures had been reviewed and improved. There was a clear procedure for welcoming visitors to the home safely. Staff had enough personal protective equipment (PPE) to keep them safe and we observed this was worn correctly. Cleaning within the home had visibly improved.

Improvements had been made in regard to managing the Coronavirus pandemic within the home. A dedicated testing room had been created so the home could participate in testing of staff and the people living at Seacliff Care Home. The room was organised, private and clean. People and visitors said it was a nice environment which enabled them to have privacy.

Medicines were managed safely. There was a dedicated medicines room which was clean, well- stocked and organised. Managers and staff felt proud of the improvements made, they told us they were committed to continuing the improvements within the home.

People’s risks were assessed, and the home continued to organise people’s care files to make them easier to use and refer to. The home had undergone internal redecoration and organising which had improved the cleanliness, environment and safety for people as they move around the home.

People and staff told us they were happy at Seacliff Care Home and felt that improvements had been made. Staff were proud to work at the home and told us there was a sense of teamwork in the home, working together for the people they provide care for.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 December 2020) and there were multiple breaches of regulation. Following the last inspection we told the provider when they must be compliant and meet the regulations. At this inspection we found improvements had been made and the provider was no longer in breach of regulation 12.

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

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.

Seacliff 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.

Seacliff Care Home is registered to accommodate up to 24 people. At the time of our inspection there were 17 older people living in one adapted building in a residential area of Bournemouth.

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

People told us they were happy living at Seacliff Care Home. However, we identified several shortfalls and governance systems were not robust enough to keep people and staff safe. Infection control procedures were either not in place or robust enough to fully protect people. Fire safety concerns had been identified but actions were not taken.

Potential risks to people's health and welfare had not been consistently assessed. There was not always guidance for staff to mitigate the risks. Records of the care people received were not always accurate or complete. Medicines were not always managed safely. Testing had indicated a risk of Legionella in the water system. The home was working in partnership with the environmental health office and an external water specialist to mitigate the risk.

There were enough staff on duty and people told us they attended to their needs promptly. Staff told us they were happy working at Seacliff and had confidence in the newly appointed management of the home. Staff were recruited safely, and the necessary checks had been made. Safeguarding procedures were in place and followed, staff told us they were confident the manager would follow up on concerns raised.

Staff, people and their relatives felt involved in the home. However, this was reduced during the pandemic and alternative arrangements had been made for contact and visiting. The home had links with various organisations but the manager said this had reduced during the year but was hoping to build on these in the future.

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 good (published 26 July 2018).

Why we inspected

We received concerns in relation to fire safety, infection control, medicines and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the safe care and treatment of people and the management of the service at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Seacliff Care Home is registered to accommodate up to 24 people. At the time of our 20 older people were living in the home in one adapted building in a residential area of Bournemouth.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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At this inspection we found the service remained Good.

People were supported by staff who understood the risks they faced and the support they needed to reduce these risks. Staff understood how to identify and report abuse. Staff also supported people to take their medicines safely.

People all liked the food and there were systems in place to ensure they ate and drank safely.

People were supported by caring staff who had the skills and knowledge they needed. The majority of the staff team had worked in the home for a long time and they all knew people well. This ensured people were supported to live their life the way they chose. People had access to activities they enjoyed and helped to plan.

Communication needs were considered and staff supported people to understand the choices available to them. This meant people were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the systems in the service supported this practice. Paperwork reflecting the MCA was being reviewed when we inspected. Where people needed to be deprived of their liberty to receive care this had been identified and responded to appropriately.

People and relatives told us they could raise any concerns and these were addressed quickly. They told us that the manager, provider and the whole staff team were approachable.

Quality assurance systems involved people and was being developed to support the provision of a safe and good quality service.

People experienced care, treatment and support that met their needs and protected their rights. They were cared for by, suitably qualified, skilled and experienced staff that were safely recruited.

The provider had suitable quality assurance procedures in place to manage the health and welfare of people living in the home. People were able to comment on the service provided.

At the time of this inspection Seacliff was caring for two individuals who lived at the home. We spoke with one person, one care worker and the manager.

People living at Seacliff were not able to fully discuss their experience of living at Seacliff as they had cognitive impairments. We therefore spent time observing people and looking at records.

We observed care workers interacted politely and respectfully with the people they were supporting.

We found that care plans reflected people's needs and were person centred. The individual we spoke with said 'staff are very good' and also complimented the homes meal provision stating 'I can't complain about the food at all'.

People who use the service were protected against the risks of unsafe or unsuitable premises.

We found there were effective recruitment and selection processes in place, and people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

There were systems in place that ensured the quality of the service people received was maintained and improved.

People's personal records were accurate and fit for purpose.

People living at the home were not able to tell us about their experiences owing to dementia. Because people with dementia and/ or complex needs are not always able to reliably tell us about their experiences, we spent a majority of the visit observing people and looking at some records.

We found that people's privacy, dignity and independence were not always respected.

We examined records for five people living at the home and found that there were significant issues in the delivery of their care.

People were generally protected against the unsafe use and management of medicines. However there were some gaps in the recording of prescribed creams.

We examined staff records and found that suitable checks had not been completed. In addition, training records evidenced some staff had not received appropriate training or support.

At this inspection we found errors in record keeping which meant the provider could not be sure people's needs were fully met in line with their assessed need and care plan.

The provider had some systems to ensure the quality of service people received, however the system was not robust and did not ensure that people were protected against the risks associated with unsafe or inappropriate care.