24 Seabrook Road

Updated 10 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 21 June 2018 and was announced. We gave the service 24 hours’ notice of the inspection as it is a small service and people are often out. We needed to be sure that they would be in. The inspection was completed by one inspector.

Prior to the inspection, we reviewed information we held about the service, such as any notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law. The provider completed a Provider Information Return (PIR). A PIR is information we require providers to send to us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection, we spoke with a director, the facilitation director, the manager, the deputy manager, four care staff and three people that lived at 24 Seabrook Road. We looked at two care plans and risk assessments, six staff recruitment files, medicine records, quality assurance surveys and audits. After the inspection we spoke with two relatives and received feedback from two healthcare professionals.

We asked the manager to send additional information after the inspection visit. The information we requested was sent in a timely manner.

The service had been registered with us since 8 May 2017. This was the first inspection carried out on the service to check that it was safe, effective, caring, responsive and well led.

Updated 10 August 2018

People and their relatives told us they felt safe at 24 Seabrook Road. One person told us “I am safe here. There’s always someone looking out for me.” A relative told us “The impact the service has had on our lives are parents is huge. We feel confident and comfortable that they are safe.”

People were safeguarded from potential harm and abuse. Staff had received training in safeguarding, and could identify different types of abuse and potential warning signs they would look out for. One member of staff told us “I would look for a change in behaviour for example if they were withdrawn or quiet or declining activities they would normally do.” Another staff told us “If I had any concerns I would go to CQC, the police or safeguarding.” Staff told us they felt confident that any concerns raised would be acted on by the manager and provider. The provider had a safeguarding and whistleblowing policy which staff were aware of and able to refer to should they need to. Safeguarding risks and concerns were discussed during regular staff meetings.

Risks to people had been assessed and mitigated. People’s care plans contained personalised risk assessments which were specific to each individual and their needs. These included risks to people’s mental health care needs, aggression towards others, being in the community, self-harm and making false allegations. Each risk assessment identified potential triggers, known behaviours and how best staff could support the person to reduce the risk or de-escalate the situation in the least restrictive way.

Regular health and safety checks were completed by staff. These included checks of fire extinguishers, infection control checks, control of substances hazardous to health (COSHH) storage and fire doors. Staff and the manager had carried our regular fire drills. People had personal emergency evacuation plans (PEEPs) in place, which included details of how each person responds to the fire alarm, people’s mobility and support needs to evacuate safely. People told us they took part in fire drills and understood how to exit the building in the event of a fire.

People, their relatives and staff told us there were sufficient staff to meet people’s needs and keep people safe. One relative told us “There is always enough staff to give [name] the attention they need.” We reviewed staff rotas, and observed that suitable numbers of staff were deployed at all times. The provider advised us they did not use agency staff, due to the high needs of the people living at the service, and the need for people to have continuity in their care. Should there be a need for temporary cover, the provider had the ability to share staff from one of their other local homes, which staff told us they liked. The service had one staffing vacancy; they were actively recruiting at the time of our inspection. The manager told us “They’re a very good staff team.”

Staff recruitment processes were followed, and recruitment systems were robust. The manager told us that people had been involved in the interviews of staff to ensure they were of the right character to support people with learning disabilities. We reviewed recruitment files for six staff working at the service, and observed that recruitment processes had been followed. Prior to commencing work, the provider had carried out all necessary recruitment checks. Each staff member had a disclosure and barring check (DBS) in place. The DBS helps employers make safe recruitment decisions and helps prevent unsuitable people from working with people who use care services. The provider had sought two references for each staff prior to them starting work, and explored any gaps in the staff members work history.

People’s medicines were administered, stored and disposed of safely. One person was being supported regularly by staff with the administration of medicines. Staff were able to talk through the process of administration medicines with us. Staff would observe the person to confirm they were in the right state of mind to take their medicines, and ask them if they wanted a drink to take them with. We checked the medicines administration records (MAR) and they showed people received their medicines when they should. Some people were prescribed medicines to have on an ‘as and when required’ (PRN) basis. We observed there were clear guidelines in place for staff to follow, detailing how often and the maximum dosage within a 24 hour period. One person had discussed wanting to reduce their prescribed medicines during a care review. We observed staff were working the person and relevant healthcare professionals, to make small changes over a period of time. Staff monitored behaviours that other people may find challenging and told us of the importance of supporting the person in the least restrictive way.

Prior to administering medicines, staff had received effective training in medicines administration. All staff were competency checked by the manager or deputy manager. Staff told us they did not administer medicines unless they and their manager were 100% confident. Staff completed daily stock checks on medicines, and ensured medicines were being stored at the correct temperature. One staff member was responsible for medicines ordering, and they were clear on the expectations of when medicines should be ordered, and who would complete this task if they were not able to.

People were protected by the prevention and control of infection. We observed the service to be clean and tidy on the day of our inspection. People told us staff encouraged them to be involved in the up keep of the service, and staff told us they had a schedule to support them to maintain the property. We observed one person putting their clothes in the washing machine, receiving verbal prompts from staff. Throughout the inspection we observed people washing up following a drink or something to eat. One staff member told us “It’s important we don’t de skill them” and went on to explain they encouraged people to be involved in the upkeep of the house, to cook and make drinks. Staff had received training in infection prevention. There was sufficient personal protective equipment (PPE) available throughout the service, and we observed staff using PPE appropriately.

There were processes and policies in place to learn from accidents and incidents. We reviewed accident and incident documentation and found there were limited incidents. Staff explained to us they worked hard to ensure that incidents were kept to a minimum, and where accidents happened they were clear on the reporting of such events. Records show that the management team had investigated all incidents and put improvement plans in place where any potential issues had been identified. Any learning from such events was shared with staff during handovers and formally during staff meetings.