Seaton Court

Seaton Court is a residential care home providing personal and nursing care for up to 68 people in two separate buildings. The service provides support to older people, including people living with dementia and people with physical and sensory disabilities. At the time of our inspection there were 23 people living in the home.

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

During the last inspection we raised concerns over the care and support people received. During this inspection, we found steps had been taken to improve the care provided. However, further improvements were needed to ensure care plans and risk assessments were updated in accordance with people’s changing needs. Environmental safety concerns needed to be addressed to ensure the living environment was safe and free from potential hazards.

Quality monitoring and auditing systems showed improvement from the last inspection. Although, further improvements were needed to ensure people received person centred care and risks to people were being monitored and quality controlled.

People were protected from harm and abuse. Staff received safeguarding training and told us how they would report concerns.

There were enough staff deployed to keep people safe and staff were recruited safely. People told us they felt safe with the staff who supported them.

Medicines were managed safely by suitably trained staff and people were offered and received pain relief medication. Staff used personal protective equipment (PPE) effectively and received infection prevention control training.

Lessons learnt were shared with the staff team. Accident and incident forms were investigated by the management team. Trends were identified and actions taken to reduce the risk of reoccurrence.

Staff told us they felt supported by the manager and attended regular meetings. Relatives told us they felt included in the service and felt confident to raise concerns.

The manager and staff worked in partnership with other health and social care agencies to deliver good outcomes for people and ensured their needs were met and reviewed.

The provider acted quickly to the concerns identified in this inspection and took action to address these areas by implementing new systems.

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 inadequate (published 15 June 2023) and there were breaches of regulation.

At this inspection we found the provider had made significant improvements and was no longer in breach of many of the regulations found in the previous inspection. However, there were still improvements to be made and time was needed to establish the newly implemented systems. Therefore, the provider remained in breach of 2 regulations.

This service has been in Special Measures since 15 June 2023. During this inspection the provider demonstrated that improvements had been made. The service is no longer rated as overall inadequate or inadequate in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

During the last unannounced inspection of this service, breaches of legal requirements were found. The provider shared their actions they had taken to improve their service.

We undertook this focused inspection to check whether improvements had been made and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led.

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 Inadequate to Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Seaton Court on our website at www.cqc.org.uk.

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 have found evidence that the provider has improved, although further improvements were identified. Please see the Safe and Well Led sections of this full report. The provider took action on all concerns raised.

Enforcement

We have identified continued breaches relating to the governance of person-centred care and maintaining care documents in accordance with people's changing needs. Safety concerns were raised regarding the monitoring of the living environment, ensuring this was free from potential hazards.

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.

Seaton Court is a residential care home providing personal and nursing care for up to 68 people in two separate buildings. The service provides support to older people, some of whom were living with dementia and/or a physical or sensory disability. At the time of our inspection there were 31 people using the service.

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

People's safety was not appropriately managed. Risks to people’s safety were not always managed as staff were not following peoples risk assessments and care plans. Medicines were not always managed appropriately. People had not received their medicines in line with their prescriber’s instructions and medicines were not stored safely.

There were insufficient staff to meet people’s needs. Staff were not able to give people the care they needed at the time they needed it. Staff were not always recruited safely. There was limited information held about agency staff working with people at the home. Staff were not consistently following guidance for preventing the spread of infection at the home. Incidents were not always investigated appropriately, and actions taken to prevent future occurrence.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People did not receive effective support with eating and drinking.

Staff were unaware of risks to people and their dietary needs. People’s needs and care plans were not understood by staff. People were not always supported to make decisions about their care. Staff were rushed and peoples care was delivered in a task-based way which was not person-centred. People received care which did not consider their dignity and their communication needs were not consistently met.

Systems had failed to identify where improvements were needed to the care people received. Audits had not identified concerns about care not being delivered and medicines not being administered and stored safely. Where incidents had occurred, these had not been reported to other agencies and changes were not made to ensure these did not happen again.

Rating at last inspection

The last rating for this service was good (published 16 May 2022).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and how risks to people were mitigated. A decision was made for us to inspect and examine those risks.

The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury and died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of falls. This inspection examined those risks.

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.

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

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.

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

Enforcement

We have identified breaches in relation to risk management, staffing levels and recruitment, dignity, person-centred care, consent to care and governance at this inspection.

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 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.

Seaton Court is a care home providing personal and nursing care to 21 people at the time of the inspection, some of whom were living with dementia. The service can support up to 68 people. Accommodation is provided in two buildings adjacent to each other. One purpose-built building and one adapted building. Owing to refurbishment works, at the time of the inspection, accommodation was only provided in the one purpose-built building.

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

People were protected from the risks of ill-treatment and abuse. Staff had been trained to recognise potential signs of abuse and understood what to do if they suspected wrongdoing.

People received their medicines as prescribed by trained and competent staff.

The provider had assessed the risks to people associated with their care and support. Staff were knowledgeable about these risks and knew what to do to minimise the potential for harm to people.

People were supported by enough staff who were available to assist them in a timely way. Staff had received training which enabled them to support people safely.

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.

People, and staff, felt Seaton Court was well managed and were given opportunities to share their views about the service they received. The manager and provider undertook regular checks to ensure the quality of care provided was good.

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 (published 24 March 2021).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe section of this report.

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 the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Seaton Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Seaton Court is a care home providing personal and nursing care to 17 people at the time of the inspection. The service can support up to 68 people.

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

There had been a period of instability at the service due to multiple management changes. There was a new manager at the service who had been in post one week at the time of inspection and had not yet registered. Statutory notifications had not always been submitted to the CQC in the correct format.

Audits were in place; however, some were not recorded consistently to ensure follow up actions could be monitored.

People were protected by staff that understood safeguarding procedures and had received appropriate training to enable them to support people safely.

Care plans were in place and staff told us they used these to help them support people in line with their needs and preferences.

People's medicines were stored and administered safely. There were enough staff to support people and to assist them to eat and drink when required.

People were supported to have 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.

People were offered activities by the activities coordinator and care staff. People were able to choose how they spent their time and we saw people partaking in various activities during inspection.

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 the service under the previous provider was requires improvement, published on 11th December 2019.

Why we inspected

This was a planned inspection based on concerns received regarding lack of management oversight and whistle blowing concerns.

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.

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.