Background to this inspection
Updated
22 February 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
Two inspectors carried out this inspection.
Service and service type
Seaswift House is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. Seaswift House 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 a registered manager in post. However, they had given notice to the provider and would leave the service on 26 February 2023. The Care Quality Commission had received an application from the registered manager to deregistered prior to the inspection. They were deregistered on the 24 January 2023.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
In September 2022 the provider had been placed into the local authorities Provider Quality Support Process (PQSP). As part of this process they received support and visits from the local authorities Quality Assurance and Improvement team and Eastern Care Services team. We were copied into the reports from these visits and reviewed this information.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
During our visit to the home we observed the care and support people received in the main communal areas. We met all of the people who lived at the home and spoke with 7 of them about their experience of living at the service. We also spoke with 2 visitors.
We spoke with the registered manager, 1 of the partners, 2 team leaders, 1 carer and the cook. We also spoke with an agency worker.
We reviewed 5 people’s care records and 7 people’s medicines records. A variety of records relating to the management of the service were reviewed, these included recruitment records, staff rotas, fire documents, quality monitoring and quality assurance records. We also looked at the provider’s service improvement plan.
Updated
22 February 2023
About the service
Seaswift House Residential Home (hereafter known as Seaswift House) is a residential care home in the town of Seaton in walking distance of the town and seafront. The home is three converted town houses linked together and provides personal care for up to 15 people aged 65 and over. At the time of our inspection there were 14 people using the service, 1 of these people was in hospital at the time of our visit.
People’s experience of using this service and what we found
People and relatives said they felt safe at the service and complimented the staff team and the engagement with the registered manager and provider.
We found the quality and safety of the service had deteriorated since our last inspection in September 2022 and some previous breaches of regulation remain along with additional breaches. The provider's systems and processes designed to identify shortfalls, and drive improvement had not been fully completed and remained ineffective.
Risks to people were not always assessed, monitored, mitigated or managed effectively. Care plans were not always put in place to guide staff to mitigate risks. This meant staff were not always aware of the risks to people they supported.
People's needs were not fully assessed to ensure care was appropriate for their needs and they were not always supported by enough staff to support them safely.
Due to staff shortages the registered manager had needed to undertake care duties to support people. Improvements were made after the inspection visit and additional agency staff were requested to cover staff shortages and enable the registered manager to be able to undertake managerial responsibilities.
People's medicines were not safely managed to ensure people received their medicines safely.
People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the care plans and systems in the service did not support this practice.
The recruitment process in place had improved. The registered manager had a checklist in staff recruitment files to ensure they had the required recruitment checks in place.
The registered manager and provider were very visible at the home and spoke with people and relatives on a daily basis. They were open and honest and recognised that some areas of the home’s management process had deteriorated, which placed people at risk. As part of the local authority Provider Quality Support Process (PQSP) they were working with the local authority to manage those risks and keep everybody informed.
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 28 October 2022) and there were 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 the provider remained in breach of regulations.
Why we inspected
Seaswift House came out of the local authority whole service safeguarding process on 29 September 2022 and received ongoing support from the local authority Quality Assurance and Improvement team in a Provider Quality Support Process (PQSP).
As part of this process the local authority Quality Assurance and Improvement team and Eastern Care Services team visited the home at the beginning of January 2023. They shared worrying information about what they had found at their visit, which raised significant concerns. The areas of concern they raised were around risk management, staffing, medicines, safe working practices and escalating concerns. A decision was made for us to inspect and examine those risks.
We undertook a focused inspection to review the key questions of safe and well-led only. 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 has changed from Requires improvement to inadequate based on the findings of this inspection.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Seaswift House Residential Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to staffing, safe care and treatment, consent, safeguarding people from abuse and improper treatment and good governance at this inspection. Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The provider has informed us they will be submitting an application to CQC to deregister the service. We will work with the local authority to monitor progress during the home closure. We will continue to monitor information we receive about the service, which will help inform our next action.
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 the provider does not deregsiter the service, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe 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.