Sea Bank House was inspected on the 08 and 14 November 2018 was unannounced. Sea Bank House is a ‘care home’. 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.
Sea Bank House Care Home is situated in the seaside town of Knott End On Sea. The home is registered to provide care and accommodation for up to 23 older people and there are two lounges and a separate dining room for people to enjoy.
At our last inspection in July 2017, the service was rated as ‘Requires improvement’. We found medicines were not always managed safely as records relating to medicines were not always accurate. This was a breach of Regulation 12 of the Health and Social Act Care Act 2008 (Regulated Activities) Regulations 2014.
Following the inspection, the registered provider sent us an action plan indicating how improvements would be made and compliance with the regulation reached. Due to technical problems, we were unable to review this prior to the inspection. In addition, after the last inspection we met with representatives of the provider and asked the provider to complete an improvement plan to show what they would do and by when to improve the key questions ‘safe’ and ‘well-led’ to at least good.
At this inspection in November 2018 we found some improvements had been made. We looked at four people's medicine records and saw three of these were accurate. The fourth person's record required updating. Prior to the inspection we saw this had been carried out and the person's medicines had been reviewed by external health professionals. We have made a recommendation about the safe management of medicines.
We found a risk assessment was not followed in relation to a person's equipment and we were informed no manufacturers instructions had been followed when the equipment was fitted by staff. This was a breach of Regulation 12 of the Health and Social Act Care Act 2008 (Regulated Activities) Regulations 2014.
We noted documentation did not consistently reflect people’s needs and audits had not identified the concerns we found on inspection. This was a breach of Regulation 17 of the Health and Social Act Care Act 2008 (Regulated Activities) Regulations 2014.
You can see the action we told the provider to take in the full version of the report.
At the time of the inspection visit there was a no manager in place who was registered with the Care Quality Commission. 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.
We reviewed recruitment records and saw checks were carried out to ensure prospective employees were suitable to work with vulnerable people. On discussion with the manager we learnt that following initial checks being carried out, these were not repeated during the person’s employment at the home. The manager told us they were in the process of addressing this.
Relatives and people who lived at the home told us they were consulted and involved in care planning. People and relatives told us staff were friendly and respectful and caring in nature.
We found the home was clean and tidy and staff were seen to wear protective clothing when this was required. We noted the newly refurbished shower room did not have facilities for hand washing. The manager told us they were addressing this and on a second day of the inspection we saw hand washing facilities were being installed.
We saw documentation which evidenced the service sought feedback from people who lived at the home and relatives. Documentation asked people to share their opinions on what the home did well and what needed to improve. The manager told us they were preparing to repeat the annual survey and would respond to comments when they were received. There was a comments box in the reception of the home for people, relatives and visitors to leave any comments they wished.
People told us they did not have to wait for help and staff were attentive to their needs. We timed two call bells which were answered promptly. We observed staff were patient and spent time with people chatting and supporting them when they needed help. Staff and relatives we spoke with voiced no concerns regarding the staffing arrangements at the home. Rota’s we viewed showed the staffing was arranged in advance and staff confirmed replacement staff were provided if unplanned absences occurred.
Staff told us and we saw documentation which evidenced staff attended training to enable them to maintain and update their skills. We also saw evidence and staff confirmed, they had regular supervision with their line manager to discuss their performance.
People were asked to express their end of life wishes. Documentation was available to plan this area of people’s care if people wanted to share their needs and wishes.
People told us they had access to healthcare professionals and their healthcare needs were met. Documentation we viewed showed people were supported to access further healthcare advice if this was required.
People told us they had a choice of meals to choose from and they enjoyed the meals provided. We observed the lunchtime meal. We saw people were given the meal of their choice and were offered more if they requested it. We found staff were available to help people if they needed support.
Staff we spoke with knew the needs and wishes of people who lived at the home. Staff spoke fondly of the people they supported and said they valued them as individuals. Staff were gentle and patient with people who lived at the home and people told us they felt respected and valued.
Staff told us they were committed to protecting people at the home from abuse and would raise any concerns with the manager or the local authority safeguarding team so people were protected. During the inspection process we received information of concern from a member of the public. We discussed this with the manager who immediately acted to investigate the concerns raised.
There was a complaints procedure available at the home. People we spoke with told us were confident any complaints they may wish to make would be addressed by the manager. Relatives told us they were aware of the complaints procedure and told us the manager would respond to any complaints made.
People told us there were a range of activities provided. They said they could take part in these if they wished to do so. People told us they were asked if they wanted to take part in activities and if they declined, their wishes were respected. We saw there was an activities planner on display at the home.
The manager demonstrated their understanding of the Mental Capacity Act 2005. People told us they were enabled to make decisions and staff told us they would help people with decision making if this was required. People were supported to have maximum choice and control in their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Relatives we spoke with told us they could speak with the manager if they wished to do so and they found the manager approachable.
This is the third time the service has been rated Requires Improvement.
Further information is in the detailed findings below.