Seaview

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The key question of Safe was rated Good at our last inspection. Although we found areas of concern at this assessment, until we have assessed more quality statements in Safe the rating for this service remains the same. We found breaches of regulation in relation to risk management and identifying safeguarding concerns. We found people were not receiving support following Right Support, Right Care, Right Culture guidance. There were enough staff to meet people’s needs, but they had not always received supervision and training to make sure they had the skills required to meet people’s needs. Staff had not always recognised when incidents needed to be reported as safeguarding concerns to the local authority. Accidents and incidents had not always been reported and action had not always taken to reduce the risk of them happening again.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

A relative told us they had not been concerned about their loved one’s safety at Seaview until recently, when they had received a call informing them of an incident which had occurred approximately 6 months before. They were concerned that staff had not identified a potential risk to their relative and taken action to protect them from future harm.

The provider had systems in place to report accidents and incidents, record the actions taken and any lessons learnt. The systems in place had not always been followed by the registered manager or staff. There were incidents which were recorded in the daily handover sheets but had not been put onto the provider's system and therefore were not known about by the registered manager. These incidents had not been used to inform people's support needs or identify risks and management strategies. Some incidents had not been recorded correctly and therefore the appropriate action had not been taken to reduce the risk of them happening again.

There were systems in place to report accidents and incidents but staff were not always aware or did not follow these systems. Staff told us there was a communication book and handover between staff but events were not always reported and they often did not find out about incidents quickly. Some staff were able to describe the system, "All issues are documented and reported. You would give a report to the senior depending if the manager is around or not. At the weekend it would be reported to the manager." Staff also told us, "There's meant to be a handover. Some staff do it some staff don’t. I always read the folder to see what people have been doing what they have been up to. If I didn’t do that then I wouldn’t have a clue about what's been happening." Another member of staff told us, "There's a communication book. Things aren't always written down. I get feedback from friends who were here on the day. No system in place to inform about incidents. We find out things later than we should." The registered manager told us that staff had fed back to him that the handover system was not working. The operations manager told us that audits had identified that the handover document was not being fully completed or utilised. This was picked up as an area to be discussed within the upcoming staff meeting.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff had received training to know how to protect people from abuse and discrimination. Staff described different types of abuse and what they would look for as signs of abuse. Staff told us, they would report concerns to the senior on duty or registered manager and would expect them to take appropriate action. Staff told us they would follow the whistle blowing procedure if they had serious concerns about the action taken. The registered manager understood their role to report concerns to keep people safe. The registered manager and operations manager told us that following a safeguarding incident new risk assessments had been completed and shared throughout the company.

The provider had systems in place to protect people from discrimination and abuse. However, the registered manager had not completed the provider's recording system correctly when incidents should have been recorded as safeguarding concerns. The registered manager had not always reported incidents to local authority for investigation to make sure people were safe. Staff had not always reported incidents when they happened and had not always sought support quickly, including support from healthcare professionals. Following, the onsite assessment, the provider reviewed incidents and spoke with staff. They identified further incidents which had been reported to the registered manager and senior carer which had not recorded or referred to the local authority. The provider has now taken the appropriate action.

People described to us how they were supported to take some risks, such as making hot drinks and doing their laundry. One person described to us how they used the washing machine and tumble dryer and explained they did not tumble dry their jumpers and they may shrink. They told us the laundry room was kept locked because of the cleaning fluids stored there but staff unlocked it for them when they wanted to do their laundry. People had practiced leaving the service in the event of a fire and told us where they fire exits and muster points were.

When a person raised concerns that they had been hit be another person we observed the registered manager offering them reassurance. However, they did not fully investigate the accusations to reduce the risk of it happening again. This left the person anxious it would happen again.

Potential risks to people's health and welfare had not been consistently assessed and there was not always guidance in place for staff to reduce risks. Some people were living with diabetes, the guidance for staff was not contradictory, and did not include what to do if the person refused staff support. People's support plans did not include all the risks to people's health such as foot and nail care when people live with diabetes. Some people expressed themselves non-verbally when expressing anxiety or distress. When there was a risk people would approach others in a way that could be physically aggressive, there was limited guidance in place to keep people safe. When people had been prescribed medicines to be given as required for anxiety, constipation and pain relief, there was no guidance for staff about when to give these medicines.

Staff described how they supported people with potential risks to their health and welfare. Staff knew how to reduce the risk to people who maybe living with diabetes and epilepsy. Some people required support to monitor the portion size of their meals. One staff member told us, "We make them sandwiches up, we try not to offer crisps, we try to encourage them to have fruit and not to snack as much." When people were living with diabetes staff knew how to recognise when people were unwell. Staff told us, "I look out for the sugar levels, look for changes in behaviour and report everything and go from there." The registered manager showed a good understanding of risks of people, and told us care plans were in place to support people’s individual needs. They told us, "(Name) you can let them know you gained some weight then they will only have one biscuit instead of 2. we have support plans for healthy diets." and "(Name) has just been discharged from dietician. Asked for some advice whilst awaiting assessment. They had fortified meals and gained weight, also has AIMS shakes."

We observed people were supported to take some risks, such as making hot drinks with a kettle. They did this safely with staff support when necessary. However, people were not supported to complete other lower risk tasks, such as preparing their own meals and snacks. At lunchtime staff prepared sandwiches for everyone. People were not supported or encouraged to get involved in this task and despite having the manual dexterity to do it. Everyone was able to move around the building without support. People with visual impairments knew the layout of the building and their bedroom and we observed them moving around safely.

People described to us how they were supported to take some risks, such as making hot drinks and doing their laundry. One person described to us how they used the washing machine and tumble dryer and explained they did not tumble dry their jumpers and they may shrink. They told us the laundry room was kept locked because of the cleaning fluids stored there but staff unlocked it for them when they wanted to do their laundry. People had practiced leaving the service in the event of a fire and told us where they fire exits and muster points were.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We observed staff did not always take the time to have positive and supportive interactions with people. For example, at lunchtime staff did not sit with people and chat to them or eat their meal with people to create a relaxed atmosphere. We observed one staff member standing watching people but not speaking to them. Throughout the inspection we observed little interaction between some staff and people. Not all staff took the time to chat with people or involve them in what they were doing. Some people spent most of their time sitting watching television with no interaction with staff. We observed positive interactions between the registered manager and people. Supporting them to be involved in tasks and sitting chatting with them at meal times. They sat with one person and encouraged them to be as independent as possible at lunchtime while reducing any risks to them. They also ensured people were given choices and acted on their requests, for example, describing all the cups in the cupboard when making a drink with a person and then searching for the one the person requested. However, we did not observe other staff shadowing this good practice and the registered manager did not encourage staff to be more involved

Staff were recruited safely. Checks had been completed before staff started work to make sure they were of satisfactory character to support vulnerable people. The amount of staff required had been calculated to make sure people's needs were met including when people went out. Records showed the required number of staff had been available in the month before this assessment. Staff had received training appropriate to their role and there was a continuous training programme to make sure staff received all the training needed. Staff had received an induction and their competency had been checked before they were able to work independently.

Staff had mixed opinions about if there were enough staff to meet people's needs. Staff told us they often had to manage how they took people out to make sure everyone was able to go out. Staff also explained there were occasions when staff were preparing food, there were not always enough staff to support people. Staff told us they received the training they needed to meet people's needs. One staff member told us, "I did a lot of training. Did some on job training, shadowing. After online training I did shadowing. You keep noting down certain things. You have to come back for discussion and that will help. I've learnt a lot from it." Staff told us they had been supported when there had been a traumatic incident and been offered time to reflect on the incident. The registered manager told us that he would speak with the senior staff about the allocation of workload. For example, if it is lunchtime then maybe do the medicines before or after so there are more staff to support during meal times. The registered manager told us this would be discussed during the next team meeting.

People were asked for their thoughts about staffing within the service. People did not provide definite feedback but did not raise any specific concerns about staff or the number of staff.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.