Seymour Court Nursing and Care Home (“Seymour Court”) was inspected on the 2 and 3 October 2018 and was unannounced. This is the service’s first inspection since registering with this provider on the 6 October 2017.Seymour Court provides care to older people who require residential support with nursing. The service is registered with us to provide care for 34 people who may be living with dementia, a physical disability and/or a sensory impairment. There were 32 people living at the service when we inspected.
Seymour Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
People’s accommodation was within a converted building spread across three separate floors. There were some double rooms where people were supported to share with someone who was compatible to them. There was a family room for people to stay in should they be needing to be with a relative that was at their end of life.
A registered manager was employed to oversee the service locally. 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. They were supported in this role by a clinical lead and two care managers.
We found external area of the service had not been assessed in respect of security and keeping people safe from falls and trips. Also, not all aspects of people’s medicines were managed safely. These issues had not been identified by the provider’s own quality assurance processes. We raised these concerns with the service who began to take action to address them.
People told us they were safe and happy living at Seymour Court and were looked after by staff who were kind and treated them with respect, compassion and understanding. The provider, registered manager and staff were working towards a high level of improving the experience of people living at the service. All staff expressed a commitment to values of providing only good care and to continue to improve the service.
The service was moving towards specialising in end of life care. We saw compliments from family that demonstrated they were achieving good end of life care for people. An example of the feedback was, “I cannot fault the care the staff gave to my mum during the week she was [at Seymour Court]. Sadly, it was a short time for end of life care; nothing was too much trouble. All her children were able to stay with her and they also looked after us.”
People felt in control of their care. Their care was planned with them or their relative. A detailed personal history was taken to reflect the person; this was used to support people to have their desires met in life so they could pass away having achieved something they always wanted to. If this was not possible, the information was used to enable the person to die having their wishes and feelings met. No everyone was having the Accessible Information Standards applied to ensure they had their communication needs met. The Standard sets out a specific, consistent approach to identifying, recording, flagging, sharing and meeting the information and communication support needs of patients, service users, carers and parents with a disability, impairment or sensory loss.
People could see other health professionals as required. People had risk assessments in place so they could live safely at the service. These were clearly linked to people’s care plans and staff training to ensure care met people’s individual needs.
Staff knew how to keep people safe from harm and abuse. Staff were recruited safely and underwent training to ensure they were able to carry out their role effectively. Staff were trained to meet people’s specific needs. Staff promoted people’s rights to be involved in planning and consenting to their care. Where people were not able to consent to their care, staff followed the Mental Capacity Act 2005. This meant people’s human rights were upheld. Staff maintained safe infection control practices.
Activities were provided that reflected the needs of the individual. Group times were available but the time was mostly one to one. For people at their end of life, the importance of touch, the voice and ensuring the person could sense someone was there were taking place.
People were accepted for who they were regardless of identity, with every effort that everyone, regardless of their sexuality, faith, culture and ability, could end their days in an accepting, open culture where tolerance for all was practiced.
People’s complaints were taken very seriously and every effort made to ensure all concerns had been identified. Reflective practice was a central theme that demonstrated how the service aimed to learn from every event and emotional reaction to it. This meant the service was continually learning from events.
People, relatives and staff were involved in giving feedback on the service. They felt it was easy to approach the registered manager and/or provider. Everyone felt they were listened to and any contribution they made was taken seriously. Regular audits made sure aspects of the service were running well. Where issues were noted, action was taken to put this right.
We found a breach of the regulations. You can see the back of the full report to show what action we have told the provider to take.