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 breaches of regulation found at our previous assessment in January 2024 had been met. Improvements had been made to the reporting of incidents and the action taken. Incidents were now used as a learning experience and changes were made to reduce the risk of them happening again. Staff told us they were now involved in decisions within the service and enjoyed supporting people to live a more independent and fulfilling life. Medicines were managed safely and staff had received training and supervision to develop their skills.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they spoke with staff after incidents to reflect on what had happened and how they could respond differently in the future.

Senior leaders explained how they had supported staff, since the last assessment, to understand the incident reporting process and how the information was used. Staff told us they now recorded any incidents and looked for potential triggers. They told us support had been planned to avoid triggers, such as people getting in each others way, and incidents had reduced. Staff told us they were supported to learn lessons and develop if they made a mistake. For example, staff had completed refresher training and their competence had been assessed if they had made a medicines error.

There were now effective processes in place to record incidents, analyse patterns and identify triggers. All this information was now used to develop and update care plans and guidance for staff. The management team now involved staff with the process and worked with them to develop practical measures to reduce the risk of incidents happening again.

People told us about their experience of moving into the service. One person explained how they had visited the service and met the people and staff before they decided to move in. They told us everyone had been friendly and welcoming. They had planned their bedroom décor with staff and it had been decorated before they arrived in the colour of their choice. They had also been able to bring all the things they wanted with them. They told us it had taken time for them to settle in and they now felt at home. They told us, “I’m more independent and feel I have a life now”. A relative told us their loved ones transition into the service had been smooth and the person had been supported to have health checks to make sure they were well.

Senior leaders explained how they met with people to understand their needs and wishes before they offered them a service. They continued to work with other professionals and people who knew the person well after they moved in to ensure they understood the person’s life history and how this may influence them. This information was used to support people to communicate their wishes and achieve their goals. For example, one person had been anxious about attending healthcare appointments, staff had worked with them to reduce their anxiety and they now felt more relaxed. Another person had chosen to continue to have some health checks with professionals they had known for several years, rather than transfer to local health care staff.

A healthcare professional told us they were in contact with the service weekly and there had been no concerns raised. Staff knew people well and they were supported to attend healthcare appointments.

There were effective processes in place to support people to move into the service. A detailed pre-admission assessment was completed and people were invited to spend time at the service to meet the other people. Each person had a 'Grab and go' profile which contained all the relevant information healthcare professionals would need to know to support them safely. This document would be taken to appointments and if people were admitted to hospital.

People told us they felt safe at the service and with staff. They were confident to raise any concerns they had and they would be acted on. A relative told us their loved one trusted the staff and they felt staff were caring, supportive and made an extra effort with people. They told us their loved one was always happy to return to the service after a stay away.

Staff explained to us the signs they may see if someone was at risk of abuse and the action they would take, including telling senior leaders. They were confident concerns would be acted on to keep people safe. Senior leaders explained how staff had immediately raised concerns about a person. The management team had followed the providers processes and informed the local authority safeguarding team and CQC. Action was taken promptly to remove the risk to everyone living at the service.

We observed staff treat people with respect and show a genuine interest in their wellbeing. They listened to any concerns people had and offered reassurance.

There had been improvements since our last assessment. The management team and staff were now following the provider's policies and procedures. Staff had recognised when incidents were potential safeguarding concerns and these had been raised with the local authority and reported to CQC. Following the last assessment, all incidents had been reviewed and some safeguarding concerns had been raised retrospectively. The operations manager had worked with staff to promote an open and transparent culture to support staff to report concerns.

People told us they were now more independent and could do more things for themselves, such as making meals, hot drinks and doing their laundry. One person told us how they made themselves cereal and toast for breakfast each morning. Another person had wanted to cook a steak and kidney pudding and had been supported to do this. People told us staff supported them to do things they wanted to do at home and outside, including going on the train or bus and going on holiday. A relative told us staff knew how to support their relative and looked at “What can I do to help?” rather than doing things for people. Another relative told us their loved one was "Really achieving their potential” and “Spreading their wings”. They also commented their loved one was leading their support and was being supported to make decisions for themselves.

Staff told us they now supported people to achieve their goals by listening to what they wanted to do and looking at how this could be achieved safely. For example, a one cup kettle had been purchased so everyone could safely make themselves a hot drink. Staff explained how they supported people to manage risks related to diabetes. They had worked with healthcare professionals to support people to have regular blood sugar checks. Records showed checks had been completed when people appeared unwell. Staff had taken appropriate action to treat people and the action taken had been effective.

We observed people taking part in household tasks, such as washing up, laundry and food preparation. Staff prompted them where necessary to remain safe, such as when making drinks. Staff supported people to manage any special dietary requirements, to help them stay safe and well. This included helping with portion size or speed of eating when necessary. A staff member asked one person if they needed support making their lunch. The person responded, “I will need help in a minute”. The staff member remained in the kitchen completing other tasks and supported the person when their asked for help.

Improvements had been made since our last assessment. The management team had worked with staff to identify skills people had and how to develop new skills. The culture within the staff team had been changed from 'doing things for people' to 'people can do things'. The management team had brought equipment to enable people to be more independent and supported staff to understand the development of their role and understand managing risk. Care plans and risk assessments had been reviewed since our last assessment. There were now detailed guidelines in place for staff to manage risks to people's health and wellbeing. There were positive behaviour support plans in place to assist staff to support people when they were distressed or anxious including potential triggers. Analysis of incidents showed the plans had been effective as incidents had reduced.

People told us they were happy with their rooms and were able to personalise them as they wished.

Senior leaders explained how they had worked with people and staff to declutter some areas of the building to provide people and staff with additional usable space. This included removing archive records and disposing of items which were no longer needed. Regular checks had been completed and people had worked with staff to complete these. One person had completed the health and safety audit with staff. Another person had been concerned about contractors going into their bedroom to test electrical equipment. Staff had worked with them and the items had been removed and replaced by staff the person trusted to facilitate the testing.

People were able to move around the building without restrictions. The environment had been designed around people’s needs and was homely and welcoming. People used different spaces to watch TV or relax away from their bedrooms. The environment was less cluttered than at our last assessment and a room had been cleared to provide staff with a comfortable space for ‘sleep-in’ shifts. A staff office was now in place which gave staff a place to complete records without interruption. People could use the room for personal meetings, such as with healthcare professionals. This allowed them to maintain the privacy of their bedroom if they wished. One person had moved room since our last assessment. This supported them to be more independent and involved in house activities when they wanted.

There were effective processes in place to make sure the building and the environment were safe.

People told us the staff were “Brilliant”. One person told us they were supported to go to, “All sorts of places” and explained staff supported them to be as independent as possible. Relatives told us the staff were calm and had everything under control. They told us this had a positive impact on their loved one who had coped well with minor changes, such as a late meal, which would have previously caused them some distress.

Staff told us there were always enough staff on duty to support people to go out and about, as well as do things around the house. They explained extra staff were on duty when people wanted to go on a special day trip, such as day out in London, or on holiday.

Staff had positive relationships with people and we observed them chatting in a relaxed way. There were enough staff to provide the support people wanted, when they wanted it. Staff worked as a team to complete essential daily activities and to make sure people could do what they wanted. People and staff worked together in a relaxed way to complete tasks such as cooking. Staff offered prompts when people needed and offered praise and reassurance as people completed activities.

There were effective recruitment processes in place. Robust checks had been completed on new staff to ensure they were of good character and had the skills and experience required for their role. Since our last assessment, senior management had reviewed staff culture, practice and skills. They had followed the providers processes when staff performance did not meet the required standards. Staff had completed additional training and received regular supervision to support their development. New staff had received a comprehensive induction and their competencies had been checked to make sure they had the skills to support people safely.

People told us they worked with staff to keep the service clean. People described how they cleaned their own bedrooms and took part in cleaning around the home. One person enjoyed using the dustpan and brush while another liked to empty the kitchen rubbish bin.

Staff explained to us how they prompted people to complete domestic cleaning tasks around the house.

We observed the service to be clean and odour free. Some people had coughs and colds and were encouraged to cover their mouths when they coughed or sneezed and dispose of tissues immediately. People were encouraged to wash their hands and wear an apron before preparing food. Staff wore personal protective equipment when necessary, such as preparing meals.

There were effective processes in place to make sure the environment remained clean. Staff received training in infection prevention and control.

People explained to us their medicines were now stored in a locked cupboard in their bedroom. They were pleased about this as they no longer had to go to the office and wait for their medicines. People confirmed they received their medicines when they needed them.

Staff explained the change to store the medicines in people’s rooms had reduced the risk of error and gave them more time to spend with people. Some staff told us they had been trained to administer medicines but this had stopped under the previous leadership. They told us they had now completed refresher training and their competencies had been assessed before they administered medicines unsupervised. This had helped them to feel confident around medicines management.

Medicines were stored securely and at a safe temperature. There was detailed guidance in place for staff about when people needed ‘when required’ medicines, such as pain relief or to support people to remain calm. Some people were prescribed emergency medicines to be administered when they had a seizure. Guidelines were in place around their administration and 5 staff had been trained to administer them. Plans were in place for more staff to complete the training shortly after our inspection. People’s medicines had been reviewed, in accordance with national guidance and one person’s mental health medication had been reduced.