Ocean Breeze Residential Care Home

Ocean Breeze is a residential care home providing personal care to 20 people, some who may be living with dementia, aged 65 and over at the time of the inspection. The service can support up to 24 people.

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

Overall, improvements had been made to the systems in place to monitor the quality and safety of the service provided. However, further improvement was required to fully embed these systems into practice to ensure that people were consistently kept safe from harm.

People felt safe living at Ocean Breeze Residential Care Home and they were very much at the heart of the service. We received positive feedback from people and their relatives about the care provided.

Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.

The risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies and fire safety checks were carried out.

Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills. However, we did find one staff member had not provided a full employment history. This was addressed at the inspection.

People were supported with their nutritional needs. People received varied meals including a choice of fresh food and drinks.

People were cared for by a motivated staff team, who always put people first. Staff received regular support and felt valued and listened to by management.

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

The last rating for this service was requires improvement (published 27 September 2019) and there were two breaches of regulation. 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.

Why we inspected

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, Effective and Well-led which contain those requirements.

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.

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

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

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.

Ocean Breeze Residential Care Home is a care home, providing personal care to older people 65 and over, some of whom are living with dementia. The service can support up to 24 people.

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

People, relatives and healthcare professionals told us they thought people were safe at Ocean Breeze and were very happy with the care people received. Although we received positive feedback, we identified some concerns during our inspection. We found risks to people’s health and wellbeing had not always been identified and mitigated. Accidents and incidents were recorded although these had not always been reviewed and thoroughly investigated by the registered manager to reduce the risk of reoccurrence and enable learning. We have made a recommendation about the management oversight of incidents and accidents. Medicines were well managed most of the time and staff received training in administering medicines. However, we were not assured training was always effective as a serious administration error had not been identified for 28 days. Safeguarding procedures were understood by staff and referrals were made to the local authority when concerns were identified. Recruitment processes were in place to ensure only suitable staff were employed. There were enough staff on duty to meet people’s needs and keep them safe.

Staff obtained consent from people for day to day decisions. However, people without capacity to make decisions were not always supported in line with the Mental Capacity Act 2005 to ensure their rights were protected. People were supported to access healthcare services to maintain their health and wellbeing. People had a choice of nutritious, home-cooked foods which met their needs and preferences, and were assisted to eat their meals if required.

Staff supported people with patience, kindness and respect and involved them in decisions about their care. People were encouraged to be as independent as possible. Family and friends could visit at any time and felt welcomed by staff. Staff knew people well and were responsive to their care and support needs, preferences and wishes. People enjoyed a range of activities which enabled social interactions and reduced risks of isolation. People and relatives knew how to make a complaint if they needed to and felt confident it would be addressed.

Quality monitoring systems were in place to help drive improvement. However, these were not always effective in identifying shortfalls as they had not identified most of the concerns we found during inspection. The registered manager had not ensured policies and procedures were consistently shared with staff and implemented appropriately. Record keeping required improvement. People’s care records were not always well organised and up to date. The registered manager had not always submitted statutory notifications in relation to safeguarding concerns to CQC when required. People, relatives and staff spoke highly of the registered manager. Staff felt well supported by the registered manager who was approachable and available.

At this inspection we found two breaches of regulation. You can see the action we have asked the provider to take at the end of this report.

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 13 August 2016)

Why we inspected

This was a planned inspection based on the previous rating.

The inspection was unannounced and was carried out on 23 and 24 November 2016.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People, relatives and health professionals told us they felt the home was safe. Staff had received safeguarding training, demonstrated an understanding of the provider’s safeguarding policy and explained the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks. Risk assessments were personalised and provided detailed guidance to staff in how to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development, supervision and appraisal to enable them to meet people’s individual needs. There were sufficient numbers of staff deployed to respond to and meet people’s needs in a timely way.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments.

People were supported to maintain their health and well-being and had access to healthcare services when they needed them.

Staff developed caring and positive relationships with people, were compassionate and reassuring, and sensitive to their individual choices. Staff treated people with dignity and respect and ensured their privacy was maintained.

People were supported to have enough to eat and drink and that met their specific dietary needs. Mealtimes were a social event and staff supported people in a patient and friendly manner.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

The service was responsive to people’s needs and staff listened to what people said. People and, when appropriate, their families or other representatives were involved in discussions about their care planning. Staff identified issues about people’s health promptly and people were referred to health professionals when needed. People were confident they could raise concerns or complaints and that these would be dealt with.

People were encouraged to provide feedback on the service provided both informally and through satisfaction surveys.

Staff felt supported and empowered to raise any issues or concerns with the management team. Quality assurance systems were in place to monitor and assess the standards of care delivered, and actions taken to address any shortfalls. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

The service did not have a registered manager in place. 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.

We inspected Ocean Breeze on 17 & 18 March 2016 to check the provider had made improvements required following our inspection in April 2015, and in response to some concerns we had received. This was an unannounced, focussed inspection.

At our unannounced inspection on 29 & 30 April 2015, the provider was in breach of two regulations relating to; safe care and treatment (medicines management) and governance (record keeping). The provider sent us an action plan telling us what they would do to meet the requirements.

We undertook an unannounced focused inspection on 17 & 18 March 2016 to check they had followed their plan and to confirm that they now met legal requirements in relation to the regulations. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ocean Breeze on our website at www.cqc.org.uk. We also wanted to check the provider had appropriate recruitment procedures in place due to some concerns that had been raised with us.

There had been a second change of manager at the home the week before our inspection. The new manager had not yet started the application process to register with the commission.

There were systems in place to manage, record and administer medicines. Medicines were ordered, stored and disposed of safely. People were given their medicines in accordance with instructions.

Recruitment processes were followed to ensure only staff suitable to work in a care setting were appointed. Where standards of staff practice fell short, disciplinary procedures were followed.

The home was mainly well led. However, people’s care records were not always accurate or fit for purpose. This had been identified by an internal audit and the new manager who had an action plan to redesign the care records in addition to implementing other improvements to the home.