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Archived: Seabrooke Manor Care Home Requires improvement

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Inspection Summary


Overall summary & rating

Requires improvement

Updated 14 April 2016

This inspection took place on 2 and 8 February 2016 and was unannounced. At the last comprehensive inspection in October 2015 this service was placed into special measures by CQC as it was rated inadequate in the “safe” and “well-led” domains. This inspection found that there was enough improvement to take the service out of special measures. However, we will continue to monitor to ensure that improvements made are sustained as there were still some regulation breaches.

Seabrooke Manor is a 120 bed care home providing residential and nursing care. The service is divided into four units. Norman House and Belgae House provide nursing and residential care. Saxon House provides residential dementia care and Roman House provides nursing dementia care. On the day of our visit there were 90 people living at Seabrooke Manor.

On the days of our inspection 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 and associated Regulations about how the service is run.

During this inspection we found that improvements had been made. Although continence risk assessments had improved, risk assessments for behaviours that challenged were still not specific enough to enable staff to manage the risks appropriately. Care records we looked at were up to date with the exception of one aspect of care. Future decisions care planning was in progress but was still falling short as most plans were either not completed properly or just said, “not willing to discuss.” We recommend further guidance is sought on having difficult conversations.

Staffing levels were reviewed regularly. On the day of our visit call bells were answered in a timely manner. However prior and after our inspection we were told of incidents on Belgae Unit where non- permanent staff were not responding to people in a timely manner. We recommend that action be taken to ensure consistent skills mix is achieved on Belgae unit in order to deliver consistent, safe care delivery.

Improvements had also been made to the activities provided to ensure that people cared for in their rooms and people living with dementia had appropriate activities. Although significant progress had been made with further training for the staff on dementia care, time was needed to ensure all staff had attended the training, and were confident in effectively managing certain behaviours. Staff also needed further training to use the various resources available within the service to engage with people.

Improvements had been made to ensure equipment such as pressure relieving mattresses, hoists and slings were checked regularly to ensure they were safe to use. Topical medicines were now managed safely and there were completed “as required” medicines protocols on three of the four units. In addition units audited each other’s medicine management monthly using a generic audit tool to ensure that safe medicine management guidelines were followed.

People told us they were treated with dignity and respect and that they could receive visitors at any time. They told us most staff listened to their wishes and respected them as individuals by delivering care where possible according to their preferences. Staff had attended equality and diversity training and were able to explain how they applied this in their daily practice by promoting people’s individual choice.

Before care was delivered consent was sought. Staff understood how the MCA applied to their practice and were aware of the people with a current deprivation of liberty authorisation.

People were supported to eat sufficient amounts that met their needs. Where required input from other healthcare professionals was sought and acted upon to ensure people’s health was maintained.

There were appropriat

Inspection areas

Safe

Requires improvement

Updated 14 April 2016

The service was not always safe. Risk assessments were not always completed correctly and monitoring procedures following a fall were not always completed. Staffing levels were reviewed regularly.

We found improvements had been made to ensure safe management of medicines and administration of topical medicines. However on one of the four units “as required medicine protocols” were not always completed in order to ensure to ensure safe medicine administration.

Safer recruitment practices were in place including appropriate checks to ensure staff were suitable to work in a social care environment.

Staff had been trained to use equipment safely. Equipment including slings, sliding sheets, hoists and mattresses were checked regularly and were clean.

Effective

Requires improvement

Updated 14 April 2016

The service was not always effective. Significant improvements had been made to ensure capacity assessments were completed and communication care plans explained how people’s communication difficulties were assessed. However this had not been sustained for a long enough period to review the rating of the service in this key area.

Staff had attended appropriate training and were still learning how to manage behaviours that challenged. People were supported to eat according to their preferences. The menu ensured that a varied balanced diet was available.

Regular supervision including group supervision and annual appraisals were completed in order to ensure that staff were supported to deliver safe care to people using the service.

Caring

Requires improvement

Updated 14 April 2016

The service was mostly caring. People were treated with dignity and respect. People told us that staff listened and usually answered the call bell promptly. However end of life care planning needed to be improved to ensure people’s wishes were respected.

Staff demonstrated knowledge on how they promoted equality and diversity by respecting people’s religious, cultural and educational backgrounds.

Responsive

Requires improvement

Updated 14 April 2016

The service was not responsive to people’s needs. Although improvements in how care was assessed, planned and reviewed were evident, aspects of care plans such as future decisions and consistent recording of weights were lacking.

Complaints were acknowledged, responded to and resolved where possible. Staff told us that any learning from complaints was discussed during handovers.

People’s relatives could visit at any time. Activities were arranged where possible to suit people’s preferences.

Well-led

Requires improvement

Updated 14 April 2016

The service was not always well led. Although significant improvements had been made to address shortfalls in record keeping, training, activities and care planning, these improvements were yet to be sustained. Aspects of record keeping including recording and updating dependency scores and future decisions were still to improve.

People thought the leadership was visible and attempted to rectify any of their concerns in a timely manner.

Regular “residents meetings” were held to keep people and their families involved and informed. Monthly quality assurance checks were completed by the regional manager and night checks were completed monthly jointly by the registered manager and their deputy.