This inspection took place on the 21 and 22 June 2016 and was unannounced. Seabourne House provides accommodation and support for up to five people who may have a learning disability, autistic spectrum disorder or physical disabilities. At the time of the inspection five people were living at the service. All people had access to a communal lounge/dining area, kitchen, a shared bathroom and well maintained garden. Two people had bedrooms on the ground floor; three people had bedrooms on the first floor.The service did not have a registered manager in post. 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 manager had left the service in January 2016 and was in the process of de-registering with The Commission. The provider had appointed a manager to manage the service. They had submitted an application to register with the Care Quality Commission (CQC) at the time of our inspection. The new manager was present throughout the inspection.
Staffing was insufficient to meet peoples need. There had been numerous occasions when insufficient numbers of staff had been allocated to shifts to ensure people’s assessed needs were met.
Although risk assessments had been completed to support people to remain safe, documentation lacked enough guidance for staff to put safe processes into action.
Recording and auditing of accidents and incidents were not managed well. Reoccurring patterns were not identified and learning from previous events was limited.
People were not supported well to manage their healthcare and referrals had not been made in a prompt or timely way to outside health professionals.
Mental Capacity assessments and best interest decisions had not been completed for less complex decisions to meet the requirements of the Act. One person’s authorisation to deprive them of their liberty had lapsed and an application to renew this had not been submitted which meant they were being restricted in an unlawful way.
Some of the language used in people’s records were not dignified or respectful.
Care plans and other documentation lacked important information and were conflicting. Although staff demonstrated they understood and knew people well, new staff would be unable to support people in the correct way if they relied on the care plans to inform their practice.
The service lacked oversight. The new manager could not demonstrate a good understanding of the needs of the people at the service.
There were safe processes for storing, administering and returning medicines. People had individual assessments around how they liked their medicines to be administered. Some improvements to documentation were required when people required prescribed creams and occasional use medicines.
Appropriate checks were made to keep people safe. Safety checks had been made regularly on equipment and the environment.
Recruitment processes were in place to protect people. People were protected from abuse and staff understood the processes for raising concerns about people’s safety.
People had choice around their food and drink and were encouraged to help staff prepare and cook meals. People could choose alternative meal options when they wished.
Staff demonstrated they understood people well and supported them with their interests. Staff were responsive to people’s requests to communicate with them.
People were helped to complain and staff would support people who were unable to use the easy read complaints policy by understanding what their body language meant if they were unhappy.
The new manager was aware of the key challenges of the service and had made some improvement to the service. People were encouraged to express their views and provide feedback so the service could continuously improve.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.