Seaview Residential Home Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home accommodates up to 18 people and at the time of our inspection 12 people were living at the home. These people were all aged over 65 years and some were living with dementia. The service had two double bedrooms and 14 single bedrooms over three floors. There was a passenger lift so people could access each floor. Ten bedrooms had an en suite toilet with a wash hand basin and two bathing facilities were available to people. The home also had a main lounge, two smaller lounges, a conservatory and a separate dining room.
This inspection took place on 27 February and 7 March 2018 and was unannounced. The gap in the inspection dates was due to adverse weather conditions and the availability of key people.
At the time of the inspection there was not a registered manager in post at the service, there was a manager who had taken over the overall running of the service and was planning to apply to become registered to manage the home. 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.
The laundry area was not properly maintained, in a poor state of repair, was unclean and cluttered. There was no process in place to prevent cross contamination between dirty items entering the laundry and clean items leaving the laundry. There were no records to show when the laundry room had last been cleaned and it was not a clean, hygienic or safe environment in which to launder people’s clothes which increased the risk of cross infection.
Not all staff had up to date infection control training and infection control procedures were not robust and put people at risk of harm.
Where accidents, incidents, and near misses had occurred there was a process in place which recorded the incident. However, the information provided of the incident/accident or near miss was not always detailed and actions required to mitigate risks or prevent reoccurrence had not always been considered, followed up or implemented.
People and their families felt the home was safe and staff were aware of their responsibilities to safeguard people.
There were enough staff to meet people’s needs and recruiting practices ensured that all appropriate checks had been completed.
People received their medicines safely. Staff who administered medicines had received training and had their competency to administer medicines assessed to ensure their practice was safe.
Staff understood the need to gain people’s consent to care and treatment. However, people’s capacity to make decisions had not always been assessed in line with The Mental Capacity Act 2005.
People's needs were met by staff who were supported appropriately in their roles, however some staff refresher training in essential subjects was overdue.
People were supported to have enough to eat and drink and there was a choice of food which people told us they enjoyed eating.
Staff demonstrated an understanding of people’s health care needs and people were supported to access healthcare services when required. There were clear procedures to help ensure people received consistent support when they moved between services.
Staff knew people well and demonstrated an in-depth knowledge of their individual needs. Staff developed caring and positive relationships with people and treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.
People were provided with appropriate mental and physical stimulation through a range of varied activities.
People’s wishes and preferences for the care they wished to receive at the end of their life was clearly recorded which would, if provided, help to support people to have a comfortable, dignified and pain-free death.
People and when appropriate their families were involved in discussions about their care planning, which reflected their assessed needs. People and their families were encouraged to provide feedback on the service provided both informally and through quality assurance questionnaires.
People and their families were able to complain or raise issues on a formal and informal basis with the manager and were confident these would be resolved. This contributed to an open culture within the home.
There were systems in place to monitor the quality and safety of the service provided. With the exception of the laundry area, the environment was well maintained and measures had been taken to adapt the environment to aim to meet the needs of people living at the home including those people living with dementia.
People and their families told us they felt the home was well-led and were positive about the manager who understood the responsibilities of their role.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.