Seagrave House Care Home

Seagrave House Care Home is a residential care home providing personal to older people living with dementia and or physical disability. At the time of the inspection 55 people were using the service. The service can support up to 84 people.

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

People told us staff helped them to stay and feel safe but we found risk was not always identified or recorded. Risk management plans were not always in place or up to date. Staff did not always follow policies and procedures for the safe management of people’s medicines.

Quality monitoring was not always effective and did not identify all risks or improvements required. People and staff were consulted and involved in making decisions about their care and support. People liked the staff and had confidence in them. The culture at the service was open and inclusive. People and staff found the manager approachable.

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 Good (report published 5 July 2018).

Why we inspected

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 coronavirus and other infection outbreaks effectively.

We received concerns in relation infection control, PPE (personal protective equipment) and record keeping. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. 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 good to requires improvement. This is based on the findings at this inspection.

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 Seagrave House Care Home on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At our last inspection in May 2016 we rated the service good. This inspection took place on 8 May 2018 and was unannounced. At this inspection we found that the evidence supported an overall rating of good with improvements to the well led domain required.

We found that improvements were required to the way in which records were maintained, reviewed and actioned. We found that people regularly received good standards of care however, people’s records did not reflect the care that had been provided. Minor improvements were also required to ensure that auditing procedures adequately reviewed people’s care records to ensure they received care in accordance with their preferences.

This home is required to have a registered manager in post. At the time of inspection, the home had a registered manager in post. 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.

People received their medicines safely and there were adequate numbers of staff available to support people with the care they required. Staff were knowledgeable about safeguarding procedures and these were reported and investigated appropriately. Infection control practices were in place and accidents and incidents were reviewed to ensure learning was implemented to prevent similar incidents occurring where possible.

People’s care needs were appropriately assessed and people’s nutritional and healthcare needs were effectively supported. People were supported to receive good support from other services and staff made efforts to ensure this was a fluid process for people who required additional support. Staff received regular training relevant to people’s care needs, and were adequately supervised and supported in their roles.

People were supported by kind and compassionate staff who took time to build positive and trusting relationships with people. People were encouraged to make their own choices and decisions and these were respected by staff. People’s dignity was maintained and people were supported to maintain relationships with people that were important to them.

People had care plans in place which accurately reflected their care needs and these were updated when people’s needs changed. Staff were knowledgeable about people’s preferences and encouraged people to join activities if they wished. People’s end of life care plans were discussed with people and their relatives to ensure this would be in accordance with their wishes. Complaints were investigated and outcomes were communicated to people.

Procedures were in place to receive feedback from people and their relatives and this was considered and actioned where necessary. People and their relatives were happy they could approach the registered manager and their feedback was listened to. Appropriate notifications were submitted to the CQC and the home’s rating was clearly displayed within the home.

Further information is in the detailed findings below.

There was not a registered manager in post. 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. A registered manager had recently left the service, and an interim manager was in place supporting the home. A new permanent manager had been appointed and was in the process of having their background checks completed.

People felt safe in the home. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times it was needed. There were sufficient staff to meet the needs of people who lived there and recruitment procedures protected people from receiving unsafe care from unsuitable staff.

People received care from staff that had adequate supervision and support from senior staff. Staff received training in areas that enabled them to understand and meet the care needs of each person.

Care records contained risk assessments and risk management plans to protect people from harm. Individual plans of care provided staff with information on the measures required to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Care plans were written in a person centred manner and focussed on empowering people; personal choice, ownership for decisions and people being in control of their life. They detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.

The home had an extensive quality monitoring system in place which reviewed the quality of care that people received. People at the home reacted positively to the manager and the culture within the home focussed upon supporting people’s health and well-being and for people to participate in activities that enhanced their quality of life. Systems were in place for the home to receive and act on feedback and policies and procedures were available which reflected the care provided at the home.

We found from looking at care plans that people and their relatives or representatives had been involved in decisions about their care. People's care had been planned and delivered in a way that met people's individual needs and preferences. Our observations of staff were that staff were attentive to people's needs and treated people with dignity and respect. People had been supported to lead active lives through a wide range of home and community based activities.

Staff had been trained to understand the needs of the people they supported. Some staff had on occasions worked in excess of their contracted hours but they understood that the service had "put resident's needs first." Only staff who had been trained to handle and administer medications had done so. The service had effective arrangements for management of medicines.

The service had robust arrangements for assessing and monitoring the quality of care people received.