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Inspection carried out on 20 September 2017

During a routine inspection

This inspection took place on the 20 September 2017 and was unannounced. Seabourne House provides accommodation and support for up to five people who may have a learning disability, autistic spectrum disorder or physical disabilities. At the time of the inspection four people were living at the service. All people had access to a communal lounge/dining area, kitchen, a shared bathroom and well maintained garden. Two people had bedrooms on the ground floor; two people had bedrooms on the first floor.

The service had a registered manager in post. The registered manager also had oversight of two other services. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 registered manager was present throughout the inspection.

The previous inspection on 21 and 22 June 2016 found five breaches of our regulations, an overall rating of requires improvement was given at that inspection. The provider had resolved the issues raised at the previous inspection which were no longer a concern at this inspection.

There were safe processes for storing, administering and returning medicines. People received their medicines in a person-centred and appropriate way.

Staffing was sufficient and flexible to meet people’s needs. Staff demonstrated they understood people and had good knowledge about their personal histories, interests and preferences. Staff had received sufficient training to help them complete their roles effectively.

Appropriate checks were made to keep people safe and safety checks were made regularly on equipment and the environment. People had individual personal emergency evacuation plans (PEEPs) that staff could follow to ensure people were supported to leave the service in the most appropriate way in the event of a fire.

Employment checks had been made to ensure staff were of good character and suitable for their roles.

Robust safeguarding guidance and contact information was available for staff to refer to should they need to raise concerns about people’s safety. Staff had good understanding about their responsibilities in relation to this. The provider audited safeguarding processes to ensure they remained robust.

The registered manager demonstrated a clear understanding of the process that must be followed if people were deemed to lack capacity to make their own decisions and the Mental Capacity Act (MCA) 2005. They ensured people’s rights were protected by meeting the requirements of the Act.

Regular monitoring and review of people’s health took place so action could be taken if further professional healthcare input was required.

People were supported to eat and drink and had choice around their meals.

Staff demonstrated caring attitudes towards people and spoke to them in a dignified and respectful way. Staff communicated with people in a person-centred and individual way to meet their own specific needs. There was a relaxed and open atmosphere; people were kept involved in all aspects of the service.

Care plans were meaningful and contained specific detail so staff could understand people better, care plans were a reflection of what happened in practice. People chose to participate in a variety of recreational activities inside and outside of the service.

Complaints were recorded and responded to effectively. There were systems in place outlining timescales of the complaints process and details of what actions the complainant should expect throughout the investigation process.

Robust systems for monitoring the service and identifying areas in need of improvement had been established since out last visit. The provider listened to people and their representatives and acted on feedback.

Inspection carried out on 21 June 2016

During a routine inspection

This inspection took place on the 21 and 22 June 2016 and was unannounced. Seabourne House provides accommodation and support for up to five people who may have a learning disability, autistic spectrum disorder or physical disabilities. At the time of the inspection five people were living at the service. All people had access to a communal lounge/dining area, kitchen, a shared bathroom and well maintained garden. Two people had bedrooms on the ground floor; three people had bedrooms on the first floor.

The service did not have 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 2008 and associated Regulations about how the service is run. The registered manager had left the service in January 2016 and was in the process of de-registering with The Commission. The provider had appointed a manager to manage the service. They had submitted an application to register with the Care Quality Commission (CQC) at the time of our inspection. The new manager was present throughout the inspection.

Staffing was insufficient to meet peoples need. There had been numerous occasions when insufficient numbers of staff had been allocated to shifts to ensure people’s assessed needs were met.

Although risk assessments had been completed to support people to remain safe, documentation lacked enough guidance for staff to put safe processes into action.

Recording and auditing of accidents and incidents were not managed well. Reoccurring patterns were not identified and learning from previous events was limited.

People were not supported well to manage their healthcare and referrals had not been made in a prompt or timely way to outside health professionals.

Mental Capacity assessments and best interest decisions had not been completed for less complex decisions to meet the requirements of the Act. One person’s authorisation to deprive them of their liberty had lapsed and an application to renew this had not been submitted which meant they were being restricted in an unlawful way.

Some of the language used in people’s records were not dignified or respectful.

Care plans and other documentation lacked important information and were conflicting. Although staff demonstrated they understood and knew people well, new staff would be unable to support people in the correct way if they relied on the care plans to inform their practice.

The service lacked oversight. The new manager could not demonstrate a good understanding of the needs of the people at the service.

There were safe processes for storing, administering and returning medicines. People had individual assessments around how they liked their medicines to be administered. Some improvements to documentation were required when people required prescribed creams and occasional use medicines.

Appropriate checks were made to keep people safe. Safety checks had been made regularly on equipment and the environment.

Recruitment processes were in place to protect people. People were protected from abuse and staff understood the processes for raising concerns about people’s safety.

People had choice around their food and drink and were encouraged to help staff prepare and cook meals. People could choose alternative meal options when they wished.

Staff demonstrated they understood people well and supported them with their interests. Staff were responsive to people’s requests to communicate with them.

People were helped to complain and staff would support people who were unable to use the easy read complaints policy by understanding what their body language meant if they were unhappy.

The new manager was aware of the key challenges of the service and had made some improvement to the service. People were encouraged to express their views and pr

Inspection carried out on 13 December 2013

During a routine inspection

There were five people living at Seabourne House at the time of our inspection. They told us they were happy living there and did not have any concerns. They said they felt safe and that the staff were kind. One person told us �I am very happy at Seabourne House�.

People told us they were pleased with the care and support provided. They said that the staff knew how to look after them and that they trusted the staff who supported them. One person told us �The staff are good, I like all of the staff�.

We looked at people�s care plans and found most had been reviewed when needed, but we saw that some key worker reviews had not taken place when they were supposed to. Where people could, they had consented to the care and treatment they received. We saw that processes were in place to protect people where they could not give consent.

We looked around Seabourne House and saw that it was well maintained and that people lived in a safe and comfortable environment.

Staff told us that they felt satisfied by the support provided by the manager. However, staff commented that the manager was unable to spend much time onsite because of their commitments at the two other services they managed for the same provider.

We saw that there was an effective and accessible complaints process in place. People told us they did not want to complain, but knew what to do if they felt they needed to complain.

Inspection carried out on 15 March 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences.

We observed that people, who used the service, were comfortable in the company of the staff team. We saw that there was a relaxed rapport between staff and people who lived in the home.

Staff demonstrated that they understood people�s care needs as identified in their plans of care.

People were supported to make choices and to develop and maintain their independent living skills.

Staff received regular training and attended formal meetings, which gave them the skills and support that they needed to meet people�s care needs.

There were systems in place to monitor the quality of the service. People who lived in the home were able to make their needs known through regular �Your voice� meetings.