Seabreezes

Seabreeze’s is a care home without nursing for six people living with learning disabilities and/or autistic spectrum disorder. There were five people living in the service at the time of our inspection visit. The vacancy had been allocated and that person was having transitional visits to Seabreeze’s before they moved in.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People's experience of using the service and what we found

People were safe. The premises were clean and well maintained. Staff attended fire training and drills, so they knew how to respond in a fire to keep people safe. Accidents and incidents were acted upon appropriately and records of these were monitored and analysed for any trends or patterns that needed looking into.

We observed people to be calm and relaxed with staff who knew them well and had supported them for many years. Staff showed affection and kindness towards people and cared about changes that may affect them. People were encouraged to do things for themselves as much as possible. Staff understood peoples preferred methods of communication and were observed to adhere to these.

Two people were able to tell us they were happy where they lived. Relatives spoke positively about how well their family members were treated and had praise for the staff team.

Personal care was delivered in accordance with peoples known preferences and people were consulted at all stages. Staff had received training and guidance, on how to deliver personal care and support in a dignified manner that protected people’s privacy.

Staff were trained to keep people safe and to understand their specific health and social care needs, they supported people to use health services. People enjoyed their meals and made choices about what they wanted to eat. People spent time alone when they wanted to and there was ongoing work to develop new activity programmes that better reflected their interests and achievable skills development.

There were enough staff to support people and this was kept under review. Staff received an appropriate range of training to give them the basic knowledge and skills needed for their role. Medicines were managed safely. Staff felt supported and able to express their views.

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. Relatives told us they were kept informed about important information affecting their family members wellbeing and had participated in best interest discussions as and when required.

A range of quality checks and audits were undertaken each week and month to ensure standards were maintained.

For more details, please read the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating inspection for this service was Good (published 14 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

The service is registered to provide accommodation and personal care for up to six people who have learning disabilities, including autism and some complex and challenging behavioural needs.

Accommodation is provided in a detached house in a quiet residential area of New Romney, close to public transport, local amenities and shops. Accommodation is arranged over two floors and each person had their own bedroom. Seabreezes has a spacious enclosed back garden. At the time of the inspection there were six people living at the service and receiving support.

The service had a registered manager, who was not available during the inspection; however a senior support worker and the regional manager were. 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 and associated Regulations about how the service is run.

People received their medicines safely and when they needed them. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely. Medicine audits were regularly carried out by the registered manager and team leaders.

People told us they felt safe and observations showed that staff knew people well and understood their communication needs. Staff had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Systems were in place to ensure people were protected from the risk of financial abuse. Risks to people's safety had been assessed and measures put in place to manage any hazards identified. The premises were maintained and checked to help ensure the safety of people, staff and visitors.

There were enough staff with the right skills and knowledge to meet people's needs. Staff received the appropriate training to fulfil their role and provide the appropriate support. Staff were supported by a management team who they saw on a regular basis. Staff worked well as a team and felt supported by one another. Recruitment practices were safe, checks were carried out to make sure staff were suitable to work with people who needed care and support.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care services. People living at the service were under constant supervision from staff to keep them safe, therefore DoLS requirements applied; and all required applications for DoLS authorisations had been made.

The registered manager and the management team understood their responsibilities under the Mental Capacity Act 2005. Mental capacity assessments and decisions made in people's best interest were recorded. People were asked their consent before any care or support was given.

People were treated with kindness and respect. People's needs had been assessed to identify the care they required. People's individual care and support plans were person centred and gave staff the information and guidance they required to give people the right support. Detailed guidance was available for staff to follow to support people who displayed any behaviour which caused a risk to themselves or others. People had clear communication plans and guidance in place to ensure staff were able to communicate effectively with them.

People were supported to remain as healthy as possible with regular access to healthcare professionals. Detailed guidance was provided to staff about how to meet people's needs including any specialist support needs. Staff ensured people were able to maintain contact with those who mattered to them.

People had a varied diet and access to food they enjoyed. Their nutrition and hydration needs had been assessed and recorded together with any allergies or risks. People were encouraged and supported to be as independent as possible. Care and support was planned with people and, where possible, their family members and reviewed to make sure people continued to have the support they needed.

People participated in activities of their choice within the service and the local community. There were enough staff to flexibly support people to participate in activities they chose.

Processes were in place to monitor and improve the quality of the service being provided to people. The provider had a set of values which were followed and applied by the staff team.

The service is registered to provide accommodation and personal care for up to six people who have learning disabilities, including autism and some complex and challenging behavioural needs.

Accommodation is provided in a detached house in a quiet residential area of New Romney, close to public transport and local amenities and shops. Accommodation is arranged over two floors and each person had their own bedroom. The home benefitted from an enclosed back garden.

This service had a registered manager in post. A registered manager is a person who is 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.

At the time of inspection five people lived at the service and we were able to meet and speak with each person. People told us that they liked living in the home, they were happy, they liked the staff and the staff were kind. They thought the home provided a relaxed and comfortable living environment.

To help us understand the experiences of people did not readily communicate with us or preferred not to, we observed their responses to the daily events going on around them, their interaction with each other and with staff.

Our inspection found that whilst the service offered people a homely environment and their care needs were being supported; there were shortfalls in some areas that required improvement.

Arrangements to ensure sufficient staff were always on duty in instances of short notice absence were not always responsive enough. A recent instance meant there were insufficient staff to meet people’s needs and address the possibility of behaviour that challenged; this resulted in a member of staff being injured.

The condition, décor and flooring in one bedroom meant it could not be effectively cleaned. This presented an infection control risk.

The service had not notified us of a recent event which they were legally obliged to.

The service had access to the local authority safeguarding protocols, and incidents that warranted referrals to the authority were made.

Medicines were safely administered and stored. Checks ensured sufficient medicines were ordered, the right amount was given and that people received the right medicines when they were supposed to.

The service was responsive to people’s needs. People’s goals and wishes were progressed to encourage development of learning and exploring new activities and challenges. People told us that they felt safe in the service and when they were out with staff.

Authorisations and decisions, made under the Mental Capacity Act 2005 to deprive people of their liberty, were notified to the Care Quality Commission when they needed to be.

All staff had an understanding of the Mental Capacity Act 2005, and Deprivation of Liberty safeguards, they understood in what circumstances a person may need to be referred and when there was a need for best interest meetings to take place. Advocacy services were made available to people.

People had personalised records detailing their care and support, including well developed support plans for their emotional and behavioural needs. People were supported to access routine and specialist health care appointments. People told us staff showed concern when they were unwell and took appropriate action.

People felt comfortable in complaining, but did not have any concerns. People, relatives and visiting professionals had opportunities to provide feedback about the service provided both informally and formally. Feedback received had been positive.

People felt the service was well-led. The registered manager adopted an open door policy and sometimes worked alongside staff. They took action to address any concerns or issues straightaway to help ensure the service ran smoothly.

The provider had a set of values, which included treating everyone as an individual, working together as an inclusive team and respecting each other. Staff were aware of these and they were followed through into practice.

We found a number of breaches the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.

Seabreezes had a very relaxed atmosphere and staff and people using the service appeared comfortable with each other. Staff spoken with were well informed about their role and confident in how they would manage any issues arising unexpectedly. One person spoken with showed a very good understanding of safeguarding issues and felt able to manage any situation that might have arisen. They were fully informed of the company policy and that of the local authority. They told us they were very happy at Seabreezes and had worked there many years. The staff team appeared to be very settled making the home a consistent and stable environment for those using the service.

People made choices about their daily lives and things that were important to them. They chose what to eat, what to do and how to spend their time each day. They made decisions such as where to go on holiday and whether or not to have a key to their room. People said they liked their rooms and liked the staff. A person said 'It is better than where I have lived before' and 'I have mates here and I have money'. They also said 'I have my own routine, I am used to it'.

Staff treated people with dignity and respect. They understood people's needs and preferred methods of communication. People's health care needs were well met and they were supported to keep in contact with health care professionals.

People had information about who to speak with if they had concerns, processes were in place to make sure that concerns they were listened to and taken seriously.

There were enough staff on duty to support people safely and in the ways they preferred. Staff received the training they needed for their roles. The organisation had processes in place to regularly check on the quality of the service people received.