We carried out a review of the data available to us about Seabrook House Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Seabrook House Limited, you can give feedback on this service.
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
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. 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. 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 a mental illness and criminal backgrounds.
Health and social care professionals told us the staff were willing to accept a degree of risk, but were also realistic about the support they could offer. Comments included “Seabrook don’t give up on people easily. They give people a ‘fair shot’.” They also said “I have a lot of confidence that they will pick up the phone and work with us. They are personable, genuinely supportive and helpful to people moving into Seabrook.” We heard about people whose lives had been positively transformed as a result of the help and support they had received from the service. These people had gone on to live independently in their own homes, and some had gained employment.
We also heard about some people who had returned to hospital appropriately when they had become ill. Health professionals told us staff always managed to de-escalate difficult situations and behaviours, and then reported the incidents promptly. This meant the health professionals were able to take prompt action, for example, to return the person to a secure hospital or prison if necessary. We heard that some people returned to Seabrook House after treatment.
There was a positive and stable staff team with low staff turnover. Staffing levels were sufficient to meet each person’s support needs. People were supported by an experienced and well trained staff team who knew them well and understood their needs. There were good communication systems in place and staff received regular supervision and support. Staff had been carefully recruited to ensure they were suitable for the job. Staff knew how to protect people from possible abuse, and how to report any suspicions of abuse.
Each person had been consulted and involved in drawing up a plan of their support needs. The support plans set out the goals each person wanted to achieve, and agreed how these would be met. Each person had a key worker who met with them regularly to review their progress towards their goals, and to adjust their support plan where necessary.
People were encouraged to have their say about all aspects of the service. There were regular meetings between staff and people who used the service to discuss the service and agree any changes or improvements. This included discussions about menus, holidays and activities.
Medicines were stored and administered safely. The incidence of medicine errors was low, but where errors occurred they were taken seriously, investigated fully, and a range of actions were taken to reduce the risk of the errors happening again.
The service was well-led. 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 2008 and associated Regulations about how the service is run. The registered manager had monitoring systems in place to check all areas of the service and ensure staff were working effectively in line with the provider’s policies and procedures. The provider had systems in place to monitor the quality of the service and make improvements where necessary.
The care home was well maintained. At the time of this inspection contractors were in the process of installing replacement doors and windows to one part of the home. A maintenance person was decorating a bedroom and we heard a number of other areas were about to be redecorated. We also heard about other improvements that had been recently completed and others that were planned for the near future. These included improvements to the laundry room and bathrooms.
This inspection was unannounced and took place on 24 and 25 August 2015. The inspection was carried out by one inspector. The last inspection of the home was carried out on 19 and 22 November 2013. No concerns were identified with the care being provided to people at that inspection.
Seabrook House Limited provides accommodation and personal care for up to 26 adults with mental illness. They have chosen to provide support only to men. At the time of this inspection there were 26 men living there. Accommodation is provided in two buildings - Seabrook House and Seabrook Cottages. In addition Seabrook House Limited is registered to provide a personal care service to people who live in the community. At the time of this inspection they supported two men who required personal care who shared a flat in a residential area of Exeter.
During our inspection we case tracked six people and spoke with five people who lived at Seabrook House in depth. We also met and spoke briefly with many of the other people who lived there. We also visited two people who shared a flat in the community and received personal care and support from Seabrook House Limited. The service they received is usually referred to as ‘supported accommodation’.
There is 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 2008 and associated Regulations about how the service is run.
People who lived at Seabrook House had been involved and consulted in drawing up and agreeing a plan of their care and support needs. Their care plans set out their goals and showed the steps they had agreed to enable them to gain greater independence. Risks to their health and safety had been assessed and measures were in place to reduce the risks where possible. However, care plans for those people who received personal care did not provide sufficient information on their health, personal care and support needs. Risks had not been fully assessed and there was no guidance to staff on how to support each person to minimise the risks.
There were enough staff to meet people’s complex needs and to care for them safely. People were protected from the risk of abuse and avoidable harm through appropriate policies, procedures and staff training. Staff received relevant training to effectively support each person’s mental and physical health needs. Staff were positive and enthusiastic.
Overall Seabrook House and Seabrook Cottages were maintained to a reasonable standard although some areas were in need of redecoration and refurbishment. All equipment such as gas, electrics, water and fire alarms were regularly serviced and checked. The maintenance records showed repairs were carried out promptly and there was a plan in place to redecorate and improve many areas of the home both inside and out.
Medicines were securely stored and administered safely by staff who had been trained and competent. People who were able to administer their own medicines were supported to do so safely.
People were supported to be fully involved in the local community. They lead active lives and participated in a wide range of activities each day. Each person had agreed a weekly timetable of the activities they regularly wanted to do, and they received the support they needed from staff to ensure their planned activities took place. People told us they were happy living there, and their comments included “They motivate me when I need it” and “They help me with the things I really need support with.”
People were supported to maintain good health. People had regular health checks and the service received good support from a wide range of healthcare professionals. Local health professionals visited the home when this was requested. Staff from the service supported people to attend hospital and community appointments when needed.
The provider had a range of monitoring systems in place to ensure the home ran smoothly and to identify where improvements were needed. People were encouraged to speak out and raise concerns, complaints or suggestions in a variety of ways. Regular resident’s meetings were held and people told us they could speak out in these meetings. People were also asked to complete survey forms seeking their views on all aspects of the service. We also saw evidence of formal complaints raised with the manager and these had been investigated and responded to.
You can see what action we told the provider to take at the back of the full version of the report.
Most people told us they were happy with the services and support they received. Comments included 'Home from home' and 'Amazing'. One person told us they felt they had 'Too much support' but we were satisfied staff understood the person well and adapted their methods of support to suit their individual needs.
People were supported to work towards greater independence by identifying and agreeing goals with them. We saw and heard evidence of positive changes to people's lives and how they had become happier and more fulfilled due to the support they had received from Seabrook House.
People were offered a balanced and varied range of meals. They were encouraged to be fully involved in planning menus and preparing meals if they wished or were able.
The home was in good decorative order and well maintained. The providers had identified areas where improvements were needed, for example, some carpets were about to be replaced.
When new staff were employed they had followed safe recruitment procedures. The providers had a range of systems in place to ensure all areas of the home and services were running smoothly and were well managed.
People's views and experiences were taken into account in the way the service was provided and delivered. People told us they had been involved in drawing up their support plan. The plans were regularly reviewed and updated with them. They told us they were happy living at Seabrook House. Comments included 'The staff are all OK. I like all of them. I enjoy talking to them.' A relative told us 'They are brilliant!'
People experienced care, treatment and support that met their needs and protected their rights. People told us staff helped them to plan their health and personal support needs and identify their goals. They had been helped to gain independence skills and move towards more independent living where possible. People were supported to lead active and fulfilling lives.
There were enough qualified, skilled and experienced staff to meet people's needs. Staff understood how to protect people from the risk of abuse.
The home was well maintained and suitable for people living there.
The provider had an effective system to regularly assess and monitor the quality of service that people receive.
Many people were out during the day doing various activities including five a side football and other sports, clubs and work opportunities. We talked to five people who lived in the home, two staff, and also the manager. After our visit we spoke to six health and social care professionals on the telephone and one relative.
We talked to two people individually. They told us they were satisfied with the support they received at Seabrook House and felt they had plenty of opportunities to do a wide range of activities. They told us they liked the staff and felt able to raise any concerns at any time.
We also talked to a group of three people. They told us there were some good staff and they trusted the manager, but they were worried about speaking up about things they were unhappy about. They gave some examples of how they felt things could be improved. They agreed to let us talk to the manager to see if he could help them air their concerns without fear of recrimination. A few days after this inspection we contacted the manager and a senior representative from U K Health Care to find out if they had addressed the concerns raised during our visit. We were satisfied that they had taken a range of actions to enable people to speak out and raise concerns. Some issues had already been addressed.
A relative told us she was very happy with the care her son received. She said she visited regularly and the home always kept her updated with news about her son. She said there were 'some good staff there'. Another relative also told us she was happy with the care her son received, saying "I have always felt that staff were doing their best to meet my son's needs".
Comments from the health and social care professionals we talked to included -
'I think they do a very good job.'
'Seabrook House could not have done more ' they are utterly brilliant! They are really sincere people. I am very impressed.'
'The home offers excellent value for money. They stepped into the breach and they were very professional.'
We looked at all of the communal areas and some of the bedrooms. People were encouraged to keep their own bedrooms clean and tidy and to do their own laundry, although support was provided for those people who found this difficult. A few people had taken a pride in their rooms and provided items of their own furniture, pictures and personal effects to make their rooms feel homely. The general standard of decoration and furnishings was satisfactory. A health care professional we talked to said "I have found the accommodation/environment to be of a high standard and would not hesitate to refer to Seabrook House if the need arises again."
We saw evidence to show that people were consulted and involved in the home through monthly resident's meetings, care plan reviews, meetings with key workers, and through questionnaires and quality monitoring processes.
We saw and heard evidence of how people have been supported to lead active lives, learn new skills, and work towards living independently. Learning opportunities included attendance on college courses, work opportunities, farm projects, and arts courses. People also attended clubs and sporting activities, and the home organised four opportunities to go on holiday each year ranging from camping or caravan to holidays abroad.
At the time of this inspection Seabrook House was also registered to provide a personal care service to people living in their own homes in the community. However, the service had not yet begun operating. We are therefore treating the personal care service as 'dormant' until such time as the provider contacts us to confirm that they have begun to provide a service. This report relates only to the regulated activity of accommodation for people who require personal care. The home does not provide nursing care.