Marine Park View

Updated 18 August 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 carried out by 1 inspector, 1 assistant inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Seahaven Care Home 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 Care Home 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 previous registered manager had recently left the service. A new manager had been appointed, but had not yet started work at the service.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 20 June 2023 and ended on 29 June 2023. We visited the service on 20 June 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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

During the inspection we spoke with 9 people who used the service and 14 relatives about their experience of the care provided. Not everyone who used the service communicated verbally or wished to speak, therefore they gave us permission to speak with their relatives on the telephone. We spoke with 9 members of staff including the nominated individual, 1 director, 1 regional manager, 4 support workers, including one senior support worker, 1 domestic and 1 cook. We received feedback from one health and social care professional. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 5 people’s care records and multiple medicine records. We looked at 4 staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including training information, policies and procedures and quality assurance documents were reviewed.

Updated 18 August 2023

About the service

Seahaven Care Home is a residential care home providing accommodation and personal care to up to 30 people in one adapted building. The service provides support to older people, including people who may live with dementia or a dementia related condition or a learning disability. At the time of our inspection there were 23 people using the service.

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.

The service had not been meeting the underpinning principles of Right support, right care, right culture. Significant improvements were being made to address the principles for all people using the service. However, changes implemented had not yet had time to become embedded or sustained and additional improvements were needed.

Right Support: Improvements were being made to the service to ensure the service was flexible and adapted to people's changing needs and wishes and promoted their independence. Care had not been person-centred and tailored to each individual, but improvements were being made so people were listened to and were becoming central to the focus of care delivery. Some people and relatives said communication could be improved. There were opportunities now for people and staff to give their views about the service. Improvements were being made to involving people in the running of the service and to consult with them. We have made a recommendation about ensuring information is accessible, where needed, to keep people informed and to assist with their decision making.

Improvements were being made to give people control in their lives and involve them in decision making. People had not been supported to have maximum choice and control of their lives and staff had not supported them in the least restrictive way possible and in their best interests; the policies and systems in the service had not supported this practice.

Robust systems were not in place to monitor risks to people’s safety and ensure the environment was appropriately maintained. Medicines were not all managed safely, improvements were needed to medicines storage and medicines records required more information for the use of ‘when required’ medicines, where prescribed. The building was not well-maintained, with ineffective infection prevention and control procedures to keep people safe. Bedrooms were not personalised. Staff had received safeguarding training and it was planned they would receive local authority safeguarding training, so they understood how to report any concerns to external agencies, if they were not addressed internally.

Right Care: Improvements were being made to ensure care was person-centred and promoted people’s dignity, privacy and human rights. Staffing levels had increased and staff had received additional training to ensure they understood their role and responsibilities. Improvements were being made to records to ensure staff had guidance about how to support people. However further improvements were needed including the provision of more activities and outings to ensure people remained occupied and engaged and received person-centred care.

Right Culture: Substantial improvements were being made to the running of the service to ensure people were the main focus of care delivery and they received safe, effective care that met their needs. There had been a change in management and staff had received training to ensure the ethos, values, attitudes and behaviours of leaders and care staff ensured people using services would be supported to lead confident, inclusive and empowered lives.

Staff were positive about the changes being introduced and working at the service. They said the new management team were approachable and they were supported in their role. Communication needed to become more effective with relatives and people, to keep them informed and receive their feedback about service provision, and to respond to complaints and concerns. A quality assurance system was in place, but it needed to become more robust to assess the standards of care in the service.

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 good (published 18 May 2018).

Why we inspected

We undertook a focused inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about people’s care, staffing, management and the culture at the service. A decision was made for us to inspect and examine those risks.

We inspected and found there were concerns with other aspects of people’s care, so we widened the scope of the inspection to become a comprehensive inspection which included all the key questions of safe, effective, caring, responsive and well-led.

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.

We found evidence during this inspection that people were at risk of harm from these concerns. The provider was taking action to mitigate the risks from some of these concerns. Please see the safe, effective, caring, responsive and well-led sections of this full report.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, fit and proper persons employed, the environment, person-centred care, records and good governance at this inspection.

We have made the following recommendations:

Information should be made accessible to meet people’s needs.

Relatives and visitors to be made aware that visiting is not restricted. Systems to communicate with relatives to be strengthened to ensure people and relatives are kept up to date with changes being introduced and to gather their feedback.

Improvements to be made to people’s dining experience.

Improvements to be made to activities and outings to keep people engaged and occupied, as they choose.

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.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.