Seacroft Court Nursing Home

Seacroft Court Nursing Home is a care home providing personal and nursing care to up to 50 people. At the time of the inspection, 32 people were using the service. The service can support up to 50 people. The service provides accommodation for people on two floors.

People’s experience of using this service and what we found

Risk management was poor. A lack of support plans and assessments in place meant people’s needs were not identified assessed or managed effectively. Ineffective care planning led to people experiencing increased periods of distress and restrictive practices.

The service failed to protect people from poor care and abuse. Staff had failed to identify, record and report incidents, the provider had failed to monitor the quality of the service resulting in poor care and incidents of a safeguarding nature occurring.

There were indicators of a closed culture and a punitive approach used by staff. Staff had a lack of support or guidance on how to support people to lead inclusive and empowered lives.

The provider demonstrated specialised training had been delivered. However, the training needed to be implemented and embedded and further developed, to demonstrate staff knowledge and competency to improve outcomes for people.

Organisational governance and quality assurance arrangements had not been effective in monitoring and improving the quality and safety of the service. We found systemic failures with oversight and quality assurances; posing significant risk to service users.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 19 April 2023). The service is now rated inadequate. This service has been rated requires improvement for the last four consecutive inspections. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had not been made and further risk was found.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of behaviour, safeguarding’s, accidents, and incidents. This inspection examined those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Seacroft Court Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to risk management, safeguarding, governance and leadership at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Seacroft Court Nursing Home is a residential care home providing personal care to up to 50 people. The provider has decided to no longer provide nursing care. The service provides support to older people, some of whom may be living with dementia. At the time of our inspection there were 33 people using the service.

People’s experience of using this service and what we found

The home had been rated as requires improvement for the last three inspections. The provider had failed to ensure a high standard of care was embedded in the home.

People were not always supported to express their individuality. Family members reported people’s laundry was not always returned correctly and people sometimes wore clothes that were not their own. People’s bedrooms were not always personalised to represent their lives and interests.

People raised concerns that staff did not always respond to the bell immediately. The registered manager had identified this as a concern and had recruited more staff. Records showed that going forwards they would have more permanent staff to ensure the standards of care were maintained.

In addition, attention had not been paid to all areas of the home which needed cleaning. More housekeeping staff had been employed to help with this issue.

Staff received the training and support needed to enable them to provide safe care. This included training on how to keep people safe from harm and how to raise concerns. They felt able to raise concerns with the registered manager and were confident that their concerns would be taken seriously and acted upon. Recruitment practices at the home ensured staff were safe to work with people who might be made vulnerable.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Risks to people were identified and care was planned to keep people safe. When incidents occurred, action was taken to keep people safe and to reduce the risk of similar incidents. Medicines were safely managed and available to people when needed.

The registered manager had audits in place to monitor the quality of the care provided. They had identified the concerns we raised, and action had been taken to improve the care people needed.

The registered manager worked collaboratively with health and social care professional to meet people’s needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 2 December 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about infection control and staffing levels. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Seacroft Court Nursing Home is a care home providing personal and nursing care to 32 people at the time of the inspection. The service can support up to 50 people. The service provides accommodation for people on two floors.

People’s experience of using this service and what we found

The provider had quality assurance processes in place. However, there were shortfalls in recording systems, meaning documents were not always accurate. We found no risk to people.

Systems were in place for people to raise complaints. These were dealt with in a timely way. However, systems were not robust enough to ensure effective oversight of complaints.

There were enough staff to meet the needs of people. Staff had sufficient training to meet people’s needs. Safe recruitment systems were in place to ensure staff were suitable to work with people.

Effective infection control measures were in place and people and staff were protected from the risk of infections. The provider had systems in place to monitor infection control practices and processes.

Medicines were managed safely. People received their medicines in the prescribed way.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last inspection for this service (published 12 December 2020) was a targeted inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 12 (Regulation description, e.g. Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found the provider had made improvements and the service was no longer in breach of regulation 12. This was a targeted inspection and we did not review entire key questions; therefore, we did not review the rating at this inspection.

The last rating for this service was requires improvement (published 28 November 2020) and there was a breach of regulation 17 Good Governance. The provider completed an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We received concerns in relation to the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Seacroft Court Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Seacroft Court Nursing Home is a care home with nursing providing personal and nursing care to 41 people at the time of the inspection. The service can support up to 50 people. The service provides accommodation for people on two floors.

People’s experience of using this service and what we found

People and staff were protected from the risk of infections. Staff followed good infection control practices. Staff had received training around infection control and followed the providers infection control policy and guidance. Shortfalls in staffing hours for cleaning and laundry had been addressed. Arrangements had been put in place to monitor infection control practices and processes on a regular basis.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (last report published 28 November 2020) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Seacroft Court Nursing Home is a care home with nursing providing personal and nursing care to 41 people at the time of the inspection. The service can support up to 50 people. The service provides accommodation for people of two floors.

People’s experience of using this service and what we found

People and staff were not always protected from the risk of contamination because staff did not always follow good infection control practices. Staff did not always receive training around infection control and did not follow the providers infection control policy and guidance. There were shortfalls in staffing hours allocating for cleaning and laundry.

This was a breach of Regulation 12, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Safe Care and Treatment.

Staff had not received training in order to keep their skills up to date and safe. Staff understood their responsibilities to raise any concerns relating to people using the service. During the Covid-19 pandemic, we identified there had been multiple staff absences. Many of these shortfalls were covered using agency staff and support from the management team. However, some shortfalls were unable to be covered in line with the providers staffing guidance. The provider continued to recruit staff and carried out appropriate checks before employment. Medicines were administered and stored safely.

The provider’s quality assurance process was not always effective. Where shortfalls in the service had been identified, action was not always taken and sustained to ensure improvements were made. The process did not identify some of the issues we found on inspection. Despite completion of some works, the environment continued not to be well maintained. There was inconsistent leadership which had affected the improvement in the service. There was no registered manager at the time of inspection. However, there was a home manager who had recently commenced employment.

This was a breach of Regulation 17, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Good Governance.

Since the last inspection there had been some improvement in relation to person centred care. There was evidence some activities had taken place and we observed positive interaction between staff and people. We also observed some people being supported to access the local community, where they had an ice cream near the seafront. However, people, staff and relative told us there was a lack of meaningful activities. During inspection we did not see staff engaging in other meaningful activities with people. However, we did observed people being offered choice around their care.

Staff spoke highly of the new manager and were optimistic about developments for the future. Staff and residents’ meetings had taken place and care plans were reviewed regularly. Staff worked with other agencies to enhance peoples care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement insert (last report published 13 August 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. Although some improvements had been made we found at this inspection not enough improvement had not been made and sustained and the provider was still in breach of some regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Following the inspection the provider sent us an action plan about how they plan to mitigate risks in relation to controlling and preventing infection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified a breach in relation to infection control practices, and a continued breach in monitoring quality of the service at this inspection.

Please see some of the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There were enough care staff to meet people's needs. The cleanliness and internal environment required improvement and would benefit from a review of housekeeping staff hours and duties. The environment was tired, and several areas of the service were unclean. We saw several areas of risk in the grounds and in their current state were not a safe area for people to access.

Staff had access to policies and procedures on safeguarding and whistleblowing and knew how to identify signs of abuse and raise their concerns within the service. People told us that they felt safe.

People received their medicines from staff who were assessed as competent to do so. However, safety measures did not always identify when a medicine was out of date, we acknowledge that the registered manager removed an out of date topical medicine when we brought this to their attention.

People had their care needs assessed, but care was not always delivered in accordance with best practice guidelines.

Staff received training pertinent to their roles. New staff undertook a comprehensive induction.

People were supported by a range of health and social care professionals and records were kept for all visits and consultations.

People were provided with a balanced and nutritious diet. Special diets were catered for and staff supported people who required assistance to eat and drink.

Internal signage and the information shared on notice boards did not always reflect the needs of a person living with dementia. People’s confidential information and personal details were not stored securely. The office door was left open when unoccupied and personal care files were accessible.

People were cared for by kind and caring staff. However, we saw little evidence of staff integrating with people. There was no designated activity time. Most people were not engaged in meaningful activities or social interaction and sat in silence in the lounges. People did not always receive care that met their needs and preferences.

People had access to information advocacy services and the provider’s complaints procedure.

The registered manager is a visible leader, has an open door and is approachable. Staff report that they feel supported.

The registered manager completed regular audits. However, these did not identify or action the failings we found on our inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The provider met the characteristics of Requires Improvement. This has changed from a rating of ‘Good’ at the last inspection in January 2016. More information about this is in the full report.

Rating at last inspection: Seacroft Court Nursing Home was last inspected on 05 January 2016 (report published11 March 2016) and was rated as ‘Good’ overall.

Why we inspected: This was an unannounced planned inspection based on our previous rating.

Follow up: We will continue to monitor intelligence we receive about Seacroft Court Nursing Home until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents. This reduced the risks to people and helped the service to continually improve.

Regular checks were undertaken to ensure that the environment was safe.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Deprivation of Liberty Safeguards are put in place to ensure a person who cannot make decisions for themselves are protected against unlawful restraint.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly. Therefore people were not put at unnecessary risk.

Accurate records were not always maintained which meant that people could be at risk from unsafe and inappropriate care and treatment arising.

Is the service effective?

People's health and care needs were assessed with them verbally but they had not seen the finished plan of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

People's needs were taken into account with signage and the layout of the service enabling people to move around freely and safely.

People told us that they could express their views at meetings, on a one to one basis and by completing surveys.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

People commented, "Staff respect my wishes" and "All my needs are being met."

People who used the service, their relatives, friends and other professionals involved with the service attended meetings throughout the year. Where shortfalls or concerns were raised these were addressed. People told us that they felt their opinions were valued but said that feedback was sometimes slow when they raised issues.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

People received their prescribed medicines.

Is the service responsive?

People told us that they could speak with staff each day and share their concerns. Relatives told us they could speak with staff about their family member's needs, when that person could not make decisions for themselves.

People told us that staff sometimes did not respond to answering call bells very quickly.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed.. As a result the quality of the service was continuously improving.

Staff told us that they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes that were in place. This helped to ensure that people received a good quality service at all times.

Staffing levels dropped at times due to staff leaving, sickness and holidays. The provider was taking a long time to resolve the issues raised and ensuring sufficient staff were on duty at all times to meet peoples needs.