Archived: Seabrooke Manor Care Home

Updated 14 April 2016

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 2 and 8 February 2016 and was unannounced on the first say and announced on the second day. The inspection team comprised of an inspector, a pharmacist inspector and a specialist advisor in dementia on the first day and an inspector on the second day.

Prior to the inspection we looked at the information we held about the service including notifications they had sent us and information from the local authority and the local Health watch. We had received information from a whistle blower alleging neglect on one of the units. Two relatives had also contacted us about staff who did not understand people’s needs on one of the units. We also spoke to the commissioners who had completed a monitoring visit a day before our inspection.

During the visit, we spoke with 12 people who used the service, four relatives, three nurses, six care staff, a unit lead, a visitor from a local charity, a staff trainer, the deputy manager and the registered manager. We observed how staff interacted with 40 people who used the service in communal areas on the four units. We observed interactions for a further five people who were at the time of observation in their individual rooms.

We looked at 16 people’s care records, 20 medicine administration records and seven staff records. We also looked at records related to the management of the service. This included a range of audits, the complaints log, minutes for various meetings, safeguarding records, health and safety, and policies and procedures for the service. After the inspection we also received comments and complaints from two relatives.

Updated 14 April 2016

This inspection took place on 2 and 8 February 2016 and was unannounced. At the last comprehensive inspection in October 2015 this service was placed into special measures by CQC as it was rated inadequate in the “safe” and “well-led” domains. This inspection found that there was enough improvement to take the service out of special measures. However, we will continue to monitor to ensure that improvements made are sustained as there were still some regulation breaches.

Seabrooke Manor is a 120 bed care home providing residential and nursing care. The service is divided into four units. Norman House and Belgae House provide nursing and residential care. Saxon House provides residential dementia care and Roman House provides nursing dementia care. On the day of our visit there were 90 people living at Seabrooke Manor.

On the days of our inspection there was 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 and associated Regulations about how the service is run.

During this inspection we found that improvements had been made. Although continence risk assessments had improved, risk assessments for behaviours that challenged were still not specific enough to enable staff to manage the risks appropriately. Care records we looked at were up to date with the exception of one aspect of care. Future decisions care planning was in progress but was still falling short as most plans were either not completed properly or just said, “not willing to discuss.” We recommend further guidance is sought on having difficult conversations.

Staffing levels were reviewed regularly. On the day of our visit call bells were answered in a timely manner. However prior and after our inspection we were told of incidents on Belgae Unit where non- permanent staff were not responding to people in a timely manner. We recommend that action be taken to ensure consistent skills mix is achieved on Belgae unit in order to deliver consistent, safe care delivery.

Improvements had also been made to the activities provided to ensure that people cared for in their rooms and people living with dementia had appropriate activities. Although significant progress had been made with further training for the staff on dementia care, time was needed to ensure all staff had attended the training, and were confident in effectively managing certain behaviours. Staff also needed further training to use the various resources available within the service to engage with people.

Improvements had been made to ensure equipment such as pressure relieving mattresses, hoists and slings were checked regularly to ensure they were safe to use. Topical medicines were now managed safely and there were completed “as required” medicines protocols on three of the four units. In addition units audited each other’s medicine management monthly using a generic audit tool to ensure that safe medicine management guidelines were followed.

People told us they were treated with dignity and respect and that they could receive visitors at any time. They told us most staff listened to their wishes and respected them as individuals by delivering care where possible according to their preferences. Staff had attended equality and diversity training and were able to explain how they applied this in their daily practice by promoting people’s individual choice.

Before care was delivered consent was sought. Staff understood how the MCA applied to their practice and were aware of the people with a current deprivation of liberty authorisation.

People were supported to eat sufficient amounts that met their needs. Where required input from other healthcare professionals was sought and acted upon to ensure people’s health was maintained.

There were appropriate recruitment checks in place to ensure that only staff who had undergone the necessary identity, occupational health, reference and disclosure and barring checks (checks to see if the applicant has a criminal record) were employed.

Staff attended training regularly and were supported by means of regular supervision and yearly appraisals.

There was a registered manager in place at the time of the visit. Staff were aware of their roles and responsibilities. There were still variable leadership styles on each unit, however staff from two units where we identified concerns at the previous inspection were moving away from task allocation towards person-centred care in order to support people effectively.

Quality assurance was monitored as feedback was sought regularly from people, their relatives and staff and acted upon. We saw action plans with specified timelines in place in order to improve the quality of care delivered.

We found three breaches to 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 the report.