Archived: Seagull Rest Home EMI

Updated 15 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection checked 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.

The inspection took place on 13 December 2016 and was unannounced.

The inspection team consisted of an inspector and an Expert by Experience, who had experience of services for older people. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before the inspection, the provider completed a 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 any improvements they plan to make. We reviewed information we held about the service, including previous inspection reports and notifications of significant events the provider sent to us. A notification is information about important events which the provider is required to tell the Care Quality Commission about by law.

During the inspection we spoke with three people who lived at the home and to relatives of two people. We also spoke with four care staff and the registered manager.

Many of the people at the service were living with dementia and because of this had limited communication. Members of the inspection team, therefore, used observations to check people’s experiences. We also spent time observing the care and support people received in communal areas of the home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not talk with us.

We looked at the care plans and associated records for four people. We reviewed other records, including the provider’s internal checks and audits, staff training records, staff rotas, accidents, incidents and complaints. Records for five staff were reviewed, which included checks on newly appointed staff and staff supervision records.

We spoke with a community nurse who treated people at the home and to a member of the local authority who commissioned services from the home and carried out monitoring visits. These professionals gave their permission for their comments to be included in this report.

This service was last inspected on 26 and 28 October 2015 when we identified six breaches of the Regulations.

Updated 15 February 2017

The inspection took place on 13 December 2016 and was unannounced.

Seagull Rest Home EMI provides care and accommodation for up to 23 people and there were 20 people living at the home when we inspected. The service specialises in the care of those living with dementia. These people were all aged over 65 years and had needs associated with old age and frailty as well as dementia.

The home is single storey. Twenty one bedrooms are single and one is a double. All bedrooms were occupied by one person. One bedroom has an en suite bathroom which had a toilet and shower. There is a bathroom with a toilet and two further bathrooms with a shower and toilet in each. There are four other toilets in the home. The service has two lounge areas which also have dining areas. There is garden area with tables and chairs for people to use.

The service had a registered manager. 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.

At the last inspection in October 2015 we found the provider in breach of Regulations associated with meeting people’s nutrition and hydration needs, ensuring staff received appropriate support and supervision, secure storage of confidential records, managing and responding to risk. At this inspection, we found that improvements had been made in these areas and the provider had met the requirements of these Regulations. However we also found that improvements had not been made in all areas since the last inspection and the provider remained in breach of Regulations associated with ensuring a safe and clean premises and providing person-centred care.

At the last inspection in October 2015 we found the provider had not ensured the premises were secure, clean and properly maintained. This was in breach Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider submitted an action plan to say how they would meet this regulation. At this inspection we found the home was still in need of repair and areas were not always clean. This regulation was still not met.

At the last inspection in October 2015 we found the provider had not ensured each person’s needs were fully assessed and care plans designed to meet those needs. This also included a lack of activities for people. This was in breach Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider submitted an action plan to say how they would meet this regulation. At this inspection we found action had been taken to improve the assessments and care plans but that the provider had still not ensured people were adequately supported by the provision of psychological and emotional support in the form of activities. This regulation was still not fully met.

During this inspection we found the service had not ensured medicines were managed safely. This included one person not receiving their medicines for pain relief as prescribed and a lack of supervision when people took their medicines.

The provider’s systems to assess, monitor and improve the quality and safety of the service were not adequate. Requirements made from the previous inspection were not fully met and there were also new breaches of Regulations identified. There was a lack of an effective audit and system to check medicines were managed safely. As a result, the service remains “Requires Improvement” overall.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe at the home.

There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures ensured only those suitable to work in a care setting were employed.

Staff had access to a range of relevant training courses including national recognised qualifications in care.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were trained in the MCA and the DoLS. Appropriate assessments were carried out where people did not have capacity to consent to their care. The service made applications to the local authority for a DoLS authorisation where people did not have capacity to consent to their care and treatment and whose liberty was restricted for their own safety.

People’s health care needs were assessed and monitored. The staff liaised with health care services so people got the right care and treatment.

People and their relatives said staff treated people with kindness and respected people’s privacy.

The complaints procedure was available and displayed in the entrance hall. People and their relatives said the management of the service were approachable and dealt with any issues raised.

The provider sought the views of people and their relatives about the standard of care in the home.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including two repeated breaches. You can see what action we told the provider to take at the back of the full version of this report.