Seahaven

Updated 21 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by 2 inspectors.

Service and service type

Seahaven is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Seahaven is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The provider was in the process of recruiting a new manager who was going to apply for registration.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We communicated verbally and nonverbally with 4 people. We spoke with 7 members of staff including, the deputy managers, locality manager, managing director and 3 support workers. We looked at 3 people's care plans and risk assessments. We looked at a range of other records including accidents and incidents, 3 staff recruitment files, medicines records, and audits. We looked staff rotas, minutes of staff and residents’ meetings and quality assurance.

After the inspection we spoke with 2 relatives and sought feedback from visiting professionals.

Updated 21 June 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Seahaven is a residential care home providing personal care to up to 19 people who have a learning disability and or autism. The service was delivered in 2 adjoining houses, registered as a single location. At the time of our inspection, one house accommodated 11 people and 6 people lived in the other. Most people who used the service received support with personal care. This is help with tasks related to personal hygiene and eating. Where people receive this support, we also consider any wider social care provided.

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

Right Support:

Risks to people were identified and there was full guidance in place to mitigate the risks. However, staff did not always follow the guidance and failed to report to management when incidents occurred. This meant that appropriate actions were not taken to mitigate the risks.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. However, when people were prescribed 'as and when' medicines for when they were distressed there was no guidance in place to make sure these medicines were given consistently and safely. At night there were times when people might have to wait to receive their ‘as and when’ medicines as not all staff were trained to administer medicines.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. 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.

Staff were recruited safely and there was enough staff deployed to ensure people received the care and support they needed when they needed it.

People were assisted to achieve their aspirations and goals. Staff focused on people's strengths and abilities to learn and develop new skills. People pursued their chosen interests.

Right Culture:

Quality assurance systems were in place to monitor the service people received. However, they had not identified the shortfalls we found at this inspection regarding risk assessments and medicines.

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Staff placed people's wishes, needs and rights at the heart of everything they did. The stable management and core staff team supported people to receive consistent care from staff who knew them well. People received compassionate and empowering care which was tailored to their needs. People and those important to them, were involved in planning their care. People's relatives felt that there was good communication, and they were kept informed of any changes to people's wellbeing.

Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. All the relative we had contact with were complimentary and positive about the service and the care and support their loved ones received.

Right Care

People were treated with kindness and care. Staff showed genuine affection in their approach. Staff knew people well. Day to day choices were offered to people and staff demonstrated a good understanding of people. Some people were not always encouraged to take an active role with tasks such as making meals and helping around the service. At times staff did things for people and not with them. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs.

Staff understood how to protect people from poor care and abuse. People indicated and said they felt safe living at Seahaven. We observed people to be relaxed in the company of staff. Safeguarding concerns had been responded to promptly. Staff had training on how to recognise and report abuse and they knew how to apply it.

Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

People's care, treatment and support promoted their wellbeing and enjoyment of life.

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 21 May 2021) and there were breaches of regulation. We served the provider with 3 Warning Notice under Section 29 of the Health and Social Care Act and 2 breaches of the regulations.

We undertook a targeted inspection (published 10 January 2022) to check the provider had taken action against the Warning Notices. The provider had taken action and the warning notices had been met. This did not change the previous rating of requires improvement because we only looked at part of the key questions. There were still 2 outstanding breaches of the regulations.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 11 March 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve fit and proper persons employed, and notifications of other incidents.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

This inspection was prompted by a review of the information we held about this service and to follow up on action we told the provider to take at the last inspection.

The inspection was also prompted in part due to concerns received about safeguarding incidents. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

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.

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

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 remains the same. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. 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 Seahaven on our website at www.cqc.org.uk.

Enforcement

We will continue to monitor the service and will take further action if needed. We have identified a breach in relation to safe care and treatment and in relation to governance and oversight.

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