Seaford Family Care

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. Before people moved into the home, the registered manager, deputy or senior staff member carried out a pre-assessment process to make sure that people’s needs could be met. These were carried out face to face with the person but it was unclear whether relatives or advocates were always a part of this process. We received mixed responses from people’s loved ones about their involvement in this process. One said, “I was not really part of the pre-assessment.” Another added, “I don’t think I’ve been involved in any reviews.” The registered manager told us that care plans and people’s support needs were only reviewed if something happened, an accident, a stay in hospital or following being unwell. Otherwise care plans remained unchanged. Although a new member of staff had recently been employed to review and update all care plans and risk assessments, there had been no regular reviews taking place with some not updated for 2 years.

The registered manager did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People’s preferences about the way they wanted to receive support, their likes, dislikes and daily routines, were only briefly mentioned within care plans. There was no detail about preferences to male or female care staff supporting them. Personal histories were sometimes only 2 or 3 lines of commentary with one concluding, ‘Nothing known after this point,’ which referred to the person’s last employment. The lack of care plan reviews resulted in any changes to people’s preferences not being recorded. The care plans were now under review but only a few had been completed at the time of this assessment and many had not been updated for 2 years. Immediate health needs were addressed, however. A relative told us that their parent needed to attend hospital recently and that they arranged an ambulance for them quickly and kept them informed as to what was happening.

The registered manager did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. The registered manager did not always respond in a timely way to enquiries and requests e-mailed in by other professionals. A professional told us that they usually had to wait a few days and then phone to follow up on messages that had sent a few days before. A professional also told us that they had offered ongoing support relating to medicine administration and managing people with complex medicine regimes but that this had not been taken up by the service. However, the registered manager reported positive relationships with other professionals in particular the district nursing team who often attended to support people with, for example, dressing changes. Relatives told us that appointments were made by the service in a timely way including chiropodists, hairdressers and GPs.

The registered manager did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.The cook was knowledgeable about people and their dietary needs. They were aware of preferences, allergies and those that required a diabetic diet. They told us that people were given a choice each mealtime of what they wanted and if they changed their mind that an alternative could be provided. However, feedback from people and relatives was negative with comments including, “Food not great. Seems cheap, no choices given. Could be much better. When we’re paying as much as we do, expect better” and “Food, it’s not great here.” People’s weights were taken monthly and staff told us that they would call the GP if there were any concerns. Some care plans lacked detail about people’s nutritional needs. A person with diabetes who needed regular insulin to manage their needs was marked as ‘low risk’ and there was no diabetic risk assessment in place.

The registered manager did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Recognised clinical measurements were recorded for some people. These included people’s weights and the use of the malnutrition universal screening tool (MUST) which measured the risk of people becoming under or overweight. Similarly, the Waterlow tool was used for some people to provide an indication of people who were susceptible to developing pressure sores. However, although these processes were being used, not all staff were able to tell us about their use and what they measured. There was no indication that the results of these measurements were monitored by staff to detect and highlight any concerns. Some people lived with dementia and did not have the capacity to make some day-to-day decisions. Regular reviews of people’s capacity were not in place and some staff told us that some people’s dementia had advanced and that additional support was now needed.

The registered manager told people about their rights around consent and respected these when delivering person-centred care and treatment. People were treated respectfully by a staffing team that understood the importance of gaining consent from people before carrying out any task or activity. Comments from staff included, “If they say no and they can’t to do it themselves, I’ll leave and go back later” and “I will still ask them but will try and help them make the decision.” Care plans provided some detail about least restrictive options for people, describing the importance of consent and the steps staff needed to take if support is refused. Relatives told us that staff supported their loved ones with decision making and that they were confident that they were never forced to do anything they did not want to do. A relative said, “They ask and encourage them now but his understanding of consent is not easy. I’ve said to them to ask and if he says yes that’s good but if he says no then just leave it. Staff have worked on this and now some people he likes and listens to.”