Seabrook House Limited

Updated 5 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 28 January 2019 and was unannounced. The inspection team consisted of one adult social care inspector and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we looked at all the information we held about the service. This included the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Providers are required to notify the Care Quality Commission about events and incidents that occur including unexpected deaths, injuries to people receiving care and safeguarding matters. We reviewed the notifications the provider had sent us.

During the inspection, we spent time with 15 people living at Seabrook House. We spoke to two visiting relatives, two health professionals, the registered manager and deputy manager and community manager. We also spoke with five support staff. Due to most people living with mental health disorders or cognitive disabilities, some people did not wish to or were unable to share their experiences of living at Seabrook House directly. Some people did not want to talk but were happy to spend time with us. Therefore, we also spent time observing care and interactions with staff in the communal areas.

The records we looked at included three people's care records, people's medicine records and other records relating to people's care, three staff recruitment files and staff training records. We also looked at maintenance records in respect of the premises and records relating to how the provider monitored the quality of the service such as audits and quality assurance surveys.

Updated 5 March 2019

Seabrook House provides accommodation and personal care for up to 26 people with a mental illness. They do not provide nursing care. Seabrook House is also registered to provide a personal care service to people living in their own homes in the community. At the time of this inspection there were 21 men living at Seabrook House. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

They also provided a supported living service to a number of people living in the local community. Of these, only two people received assistance with their personal care. The other social care activities of a supported living service are not regulated by CQC.

Seabrook House offers opportunities to help people regain independence and to move on to live in their own homes in the community if appropriate. Each person was carefully assessed, before the service began to support them, to ensure Seabrook House was suitable for them. Some of the people who used the service had previously lived in secure hospitals or prison and had mental illness and criminal backgrounds.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Seabrook House was providing a good service, especially in meeting people’s very individual and complex needs, often on a one to one basis. The premises were spacious and sprawling with various areas of outside space and garden. This enabled people to have space and areas to be quiet which can be important for people living with mental illness. There was a homely feel with people going about their day in a relaxed, comfortable environment.

There was a registered manager and deputy manager employed at the home who were clearly passionate about providing a high quality, individualised service. 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 were supported by kind, caring and compassionate staff who, along with the management team, knew people very well. This was important as people often displayed complex behavioural needs which relied on personalised care and understanding to minimise the risk of distress or behaviour which could be challenging for staff. This understanding of people’s needs enhanced people's quality of life and wellbeing. We saw examples of how people’s quality of life had improved hugely since living at Seabrook House.

Staff were also passionate about providing people with support that was based on their individual needs, goals and aspirations and followed the management team’s lead. They were pro-active in ensuring care was based on people's preferences and interests, seeking out activities in the wider community and helping people live a fulfilled life, individually and in inclusive groups. Most people were able to go out independently and staff supported people to do this safely whilst respecting their choices.

Staff were happy working in the home and felt supported in their role. They told us they learnt from each other and worked well as a team. They were clear about their individual roles and responsibilities and felt very valued by the registered manager and deputy manager. All staff said they felt they could be more valued by the provider and through their pay level and sick pay arrangements. They said the pay level sometimes meant staff did not always remain with the service once trained. However, there was a core of long serving staff who clearly felt passionate and loved the work they did. They worked hard as a team, were very knowledgeable about the complex needs of people they supported and saw their work as a vocation, often attending events and visiting people outside of paid hours. There was a pro-active effort to encourage ideas from staff to further benefit the people in their care and maintain a strong, stable staff team with a shared goal. We saw people receiving timely care in a person centred way depending on people’s daily routines.

People were safe living at Seabrook House. There were enough staff to meet people's care needs safely and also to provide individualised support in and out of the service. Some people received funded one to one care due to their individual needs to keep them and other people safe. Risks were identified and assessed regularly, with clear records showing staff how to manage them effectively. Where there were risks to others, the registered manager had referred to relevant health professionals and safety measures were put in place. Support was a team effort including relevant healthcare specialists with the shared goal of enabling people to achieve their best potential.

There was a culture within the home of treating people with respect. Staff were visible and listened to people and their relatives/friends, offered them choice and made them feel that they mattered. Staff had good rapport with people living at Seabrook House. Staff spent time with people to get to know them and their needs. This ensured that behaviours that could be challenging for staff and distressing for people were minimised. People and the staff knew each other well and these relationships were valued.

People’s equality and diversity was respected and people were supported in the way they wanted to be. Care plans were person centred and held full details on how people’s needs were to be met, taking into account people preferences and wishes. For example, some people liked to live with strict routines to help them remain well and staff knew and respected those. They also ensured people knew the house rules before they moved in and helped them to follow these in a friendly and positive way.

Staff had received appropriate training in line with nationally recognised qualifications and regular supervision to provide them with the necessary skills and knowledge to provide people with effective care. It was not unusual for some people to gain independence during their time at the service to enable them to return to live in the community with support, or enable them to become more independent within the service. This was reflected within training. People received their medicines when they needed them. Timely action was taken by the staff when they were concerned about people's health. Mental health and behaviours were well understood by staff and records showed careful and detailed monitoring, relating progress and findings in a holistic way to people’s goals and medicine regimes. This meant people progressed at their own pace depending on how they were feeling.

People received a nutritious diet and enough to eat and drink to meet their individual needs. People were able to take meals when they wanted to, with meals put back for them if they were out, and a flexible meal time. They were involved in learning practical daily living skills, cooking for themselves and visitors if they wished in the training kitchen including preparing meals and shopping.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were effective systems in place to monitor the quality and safety of the care provided. People felt able to raise any concerns and be confident they would be addressed. Where concerns were raised by people, relatives or through regular auditing we saw the home took them seriously and took appropriate actions to focus on learning and improvement for the benefit of the people using the service.

Further information is in the detailed findings below