Seaview Haven

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.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

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

The service was in breach of legal regulations in relation to people’s safe care and treatment, and meeting nutritional and hydration needs.

This service scored 50 (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. Feedback obtained from several people using the service and their relatives indicated that while there was some involvement during the initial development of care plans, most reported no meaningful or sustained participation in subsequent care plan reviews. One relative stated: “No never been shown it (the care plan). When [relative] went in, I was there for the initial talk about things they liked and didn’t like but that was with someone who left abruptly and didn’t think there was much info handed over”. This reflected a lack of consistent, person-centred engagement and failed to demonstrate meaningful partnership working with people and those important to them in shaping and reviewing their care and support.

Another relative told us: “Not seen the care plan or been involved with it since [my relative] moved in”.

There were regular reviews of care plans, but these were not effective. In several instances, care plans contained inconsistent or contradictory information about individuals’ assessed needs, creating confusion and posing potential risks to the quality and safety of care provided.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards. Where people were assessed as requiring specialised diets, we found these needs were not suitably met. The choice of meals and snacks on offer were not made readily available and did not meet individual’s needs and known food preferences. The 4-week menu was not consistently shared with people. One relative told us: ‘"Having a monthly printed menu with alternative options is really important for people living in a care home. It helps people know what’s coming up and gives people the chance to choose what they want to eat. Being able to make their own decisions about food makes people feel more in control and respected”.

Where people were unable to make verbal choices regarding their mealtime choice, pictorial menus were not in place nor were they visually shown the options to give them the opportunity to choose at mealtimes. This meant people unable to communicate their preferences were not given the same options as those who were.

We saw from two people’s daily records; they were given food which was not in line with their assessed needs which placed them at risk of choking. One relative told us: “They sent a dinner with peas on, [pronoun] can’t eat them because of the shell, it gets stuck. They took it back and sent out a meal with baked beans on it, still unable to eat it because of the husk. [Relative] did eventually get a meal that was in the right category”.

In addition, we saw from records that 1 person was given foods which were detailed in their care plans as foods ‘they did not like’. We also saw from food records that the manager and provider had failed to identify this and had not taken action to improve the mealtime experience for such people. One person told us on inspection: “Quite frankly, the food isn’t suitable, majority of it goes in the bin because people don’t eat it”. Another person told us: “There are vegetables on some days, it’s not a menu I’d recommend to anyone”.

We observed drinks were accessible in the communal areas and people’s bedrooms.

The provider did not always work well across teams and services to support people. The provider did not always ensure staff were supported when providing care for people. Staff did not always feel there was consistency to ensure they were able to work effectively together when providing care. One staff told us, “There are three floors with different teams and numbers. It takes time to support people to eat and [not all staff] offer much help. It’s difficult”.
We observed one member of staff was left alone to support 4 people with high levels of needs due to ineffective deployment of other staff. During this time, we observed people experiencing distress and wanting to leave the communal area. We observed leaders were not always visible and present and therefore were not always able to identify examples such as this where staff required additional support, and to identify how effectively teams worked together. Staff also told us, “Not enough [staff] on the ground floor”. This did not ensure care was always provided with continuity, and staff felt supported to work together.

The provider 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.

Some people were not supported to maintain healthy weights when their care plan identified they required support with this. This placed them at risk of avoidable harm.

Following the inspection the provider told us they ensured identified risks were managed more effectively through individualised care and regular health monitoring.

People were supported to access routine health appointments, for example, access to dentistry and podiatry services. We saw appropriate and timely referrals were made, for example to the occupational therapy team, community nurses and the GP.

The provider 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.

People’s care plans had not been monitored to check they included accurate information and were clear and concise. For example, we identified a significant inconsistency in the documentation relating to one person’s skin integrity care.

One medical professional told us: “There are definite improvements that need to be made. However, it has been very evident with our training that staff have improved knowledge and awareness, but they may need more assistance with putting it into practice”.

The provider told people about their rights around consent and respected these when

delivering person-centred care and treatment.

Improvements had been made since our last inspection. For example, the provider confirmed the installation and use of CCTV had been discussed with people using the service, relatives and staff. Records were in place to evidence people’s human rights and data protection regulations had been considered.

There were systems in place to evidence people had consented to receive care at the home, if they had capacity to do so, and to ensure the principles of the Mental Capacity Act 2005 (MCA) were followed when people lacked capacity to make decisions about their care.