The inspection took place on 30 November 2015 and was unannounced. We last inspected Seymour House (Hartlepool) Limited in August 2014. At that inspection we found the service was meeting all the regulations we inspected.Seymour House (Hartlepool) Limited provides nursing and residential care for up to 20 people. The home provides care and support for people with mental health needs. At the time of this inspection there were 20 people living at Seymour House (Hartlepool) Limited.
The home did not have a registered manager. Although a new manager had been appointed, they had not yet applied to register with the Care Quality Commission to become the 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.
The registered provider had breached regulations 12, 17, 18 and 19 of the Health and Social Care Act 2008. This was because checks to protect the health and safety of people using the service were overdue. The registered provider did not have personalised guidance to support people in an emergency. The registered provider lacked a structured and effective approach to quality assurance to improve the quality of the service. Quality audits had not been completed recently.
Staff had not completed all of the training they needed to effectively carry out their caring role, such safeguarding, Mental Capacity Act and fire safety training. References were not available for some staff to confirm they were suitable to work with vulnerable adults.
You can see what action we told the provider to take at the back of the full version of the report.
People gave us consistently positive feedback about the service. They said they were treated with dignity and respect by staff who knew their needs well. One person told us, “The girls keep looking after me. I have been here a long time so they know me very well.” Another person said, “Staff call me by my name and always knock on my door, they treat me very well.” People confirmed they felt safe.
People were independent and had no restriction placed on them in terms of access to and from the service. Deprivation of Liberty Safeguards (DoLS) authorisations were not required for people currently using the service. People told us they could come and go as they liked, and were not restricted at all.
People told us they were free to make their own choices and decisions. One person said, “I can come and go when I want to, I do my own thing.” Another person told us, “I like it here; I can come and go when I want.” People described how staff had supported them to meet their religious needs by arranging for a local to priest to visit them at the home. Other people described how staff supported them to dress how they chose and to help them lose weight.
Risk assessments were in place to help keep people safe. Assessments identified control measures to help keep people safe, including accessing specialist medical support.
Staff knew how to raise concerns about people’s safety. One staff member said, “I would go straight to my line manager and voice my concerns.” Another staff member said, “I have not seen anything. Concerns would be dealt with very professionally and quickly, straightaway.” Safeguarding concerns had been reported to the local authority for further investigation.
There were enough staff to meet people’s needs in a timely manner. One person told us, “They are always about, in and out of here [lounge area].”
Medicines were managed appropriately. Medicines records confirmed people had received their medicines correctly from trained staff. Medicines were securely stored and locked away.
The registered provider had systems to log and investigate incidents and accidents. Records confirmed action had been taken following falls to help keep people safe.
Staff had a good understanding of how to support people when they displayed behaviours that challenged. Strategies used included distraction and diversion techniques, such as playing games. One staff member said, “We try to stop a situation before it starts.”
People were independent with eating and drinking. They told us they enjoyed their meals. One person told us, “We have lovely homemade meals, I enjoy all my food.”
People were supported to access health care when required, including a range of professionals, such as community nurses, specialist nurses and GPs. One person told us, “I can go to the doctors on my own but someone will go with me if I want it’s no trouble to them. They make sure I get my flu jab.”
People had their needs assessed, including their social needs. There was no record people’s needs assessments had been reviewed, however up to date care plans were in place and had clear goals identified for people to aim towards. The language used within care plans was written from a medical perspective which might be difficult for people to understand. A new format for care plans was to be introduced from January 2016.
People were involved in a range of activities, such as playing games, going to the gym, walking along the seafront and cycling.
People knew how to complain if they were unhappy with the service. One person said, “I have never needed to complain but I know to speak with [manager], and he would listen.” There had been no complaints received about the service.
There were opportunities for people to give their views, through key worker meetings, regular service user meetings and a suggestion box.
We also found two statutory notifications relating to safeguarding concerns had not been submitted to the Care Quality Commission. We are dealing with this outside of the inspection process.
Staff gave us positive feedback about the new manager and said they were approachable. One staff member said, “The manager is approachable and easy to talk to. I can always approach him if I need anything.”
Staff had opportunities to give their views, through attending regular staff meetings. One staff member said, “Staff are listened to, staff get on.” There was a positive atmosphere in the home. One staff member described the atmosphere as, “Nice, a really lovely service.”