CQC report explained · a nursing home
What the CQC found at Seaview Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2023
St Dominic's Nursing Home was rated Requires Improvement; inspectors found risks, staffing shortfalls and weak oversight.
This was an unannounced focused inspection. Inspectors visited on 12, 13 and 16 December 2022. They spoke with people, relatives, staff and health professionals, observed care, and checked care plans, medicine records and quality checks.
The home was not always safe. Inspectors found poor risk assessments, unsafe medicine practices, incomplete food and fluid records, and staffing levels that did not meet people's needs. Some people did not have access to a call bell, and one person waited 20 minutes for staff to respond.
The home was also not well-led. Records did not always describe people's actual needs, and audits had failed to find or fix known problems. The provider remained in breach of Regulations 12, 17 and 18. The overall rating stayed Requires Improvement, partly because the other three areas were not inspected and their previous ratings were carried forward.
Safeguarding awareness
Staff had been recruited and trained to recognise abuse and understood how to report concerns.
“People received care and support from staff who had been appropriately recruited and trained to recognise signs of abuse or risk and understood what to do to safely support people.” from the report
Choice and control
Inspectors found that people were supported to take positive risks, helping them retain choice and control where possible.
“People were supported to take positive risks, to ensure they had as much choice and control of their lives as possible.” from the report
Infection control measures
Inspectors were assured about PPE, visitor arrangements, testing and staff training for infection prevention. Some cleanliness problems were found and immediate action was taken.
“We were assured that the provider was using PPE effectively and safely.” from the report
Recruitment checks
Staff files included employment histories, references and criminal record checks. The home also had a recruitment programme in place.
“All staff files included key documents such as a full employment history, at least 2 references and a DBS check.” from the report
Risks were not managed safely
seriousSome people lacked suitable assessments or clear instructions for choking, dehydration, health conditions and mental health needs. Equipment was not always set correctly, and some people were kept in bed without a documented reason.
“The provider failed to provide safe care and treatment to people, including failing to assess and mitigate risks.” from the report
Medicines were not always available or recorded safely
seriousSome prescribed medicines were out of stock. Staff did not always use the correct recording codes or complete all required checks for medicine records and storage temperatures.
“Medicines were not always being ordered in a timely way, this meant that people did not always receive their prescribed medicines.” from the report
Staffing levels affected care
seriousStaff shortages meant people did not always receive the support they needed. Inspectors found delays in responding to a call bell, limited personal care records and a lack of supervision for some people.
“The provider had not ensured that there were enough numbers of suitably qualified, competent, skilled and experienced persons deployed to meet peoples' needs.” from the report
Weak records and quality checks
seriousCare records did not always reflect people's needs or the care given. Audits and the improvement plan had not reliably identified or resolved repeated problems.
“Quality assurance processes were not effective and did not identify risks to people's safety.” from the report
Personal care was not consistent
needs fixingDuring staff shortages, oral care had not been recorded for five days. Shower records were limited, and people said they were not offered a choice of bath or shower.
“Records for showers were minimal and people told us they weren't offered the choice of a bath or shower.” from the report
Communication needed improvement
needs fixingRelatives and health professionals reported problems getting information and passing information on to staff. Formal surveys for staff and relatives had also not been sent as planned.
“All 4 said that communication needed to be improved.” from the report
- 01How many staff and registered nurses are on duty for each unit today, and how will you cover planned or unexpected absences?
- 02What is your current process for checking that people at risk of falls, choking, dehydration or pressure damage have up-to-date care plans?
- 03How do you make sure prescribed medicines are ordered in time and that medicine records are checked by two staff when needed?
- 04What action has been taken since the inspection to make sure people have access to call bells and are not kept in bed without a clear reason?
- 05How will the new manager and quality assurance lead show that repeated problems with records, oral care and communication have been fixed?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were not inspected and the previous ratings were carried forward. This explanation was written from the published report of 26 January 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2021
St Dominic's Nursing Home was rated Requires Improvement; inspectors found kind care and some progress, but serious gaps in risk records and medicines practice remained.
This was an unannounced focused inspection on 9 and 11 November 2021. Inspectors looked mainly at whether the home was safe and well-led. They reviewed five care records, medicines records, staffing information, training, recruitment and other documents. They also spoke with people, relatives, staff and health professionals.
The home had improved some care plans, risk assessments and quality systems since the previous inspection. People generally said they felt safe and staff were kind. However, records did not always give staff the up-to-date information they needed. Risks linked to high blood sugar, swallowing, hydration, mental health, skin infections and bruising were not always properly assessed or acted on.
Medicines were stored and supplied safely, but staff did not always record administration correctly. Oral care was inconsistent, and many people did not have toothbrushes or toothpaste. Staffing could be stretched at busy times, with agency staff affecting consistency. The overall rating remained Requires Improvement, as did Safe and Well-led, and the home was still breaching Regulations 12 and 17.
Safeguarding awareness
Staff knew how to recognise and report abuse and understood their safeguarding responsibilities.
“Staff were aware of their responsibilities to safeguard people from abuse and any discrimination.” from the report
Recruitment checks
The home carried out the required checks before new staff started work.
“All staff files included key documents such as a full employment history, at least two references and a DBS check.” from the report
Fire and premises safety
Fire assessments, emergency evacuation plans and regular premises safety checks were in place.
“There were detailed fire risk assessments, which covered all areas in the home.” from the report
Some improved care planning
The new computerised care system had improved some care plans and risk assessments, including guidance about equipment for people with mobility needs.
“We saw some improvements had been made to people's care plans and risk assessments since the last inspection.” from the report
Risks were not always managed
seriousSome care plans and risk assessments lacked important information. Inspectors found concerns about blood sugar, swallowing, hydration, mental health, skin infections and bruising.
“The provider failed to provide safe care and treatment to people, including failing to assess and mitigate risks.” from the report
Medicines records
seriousStaff covered errors on medicine records with sticky tape and did not always countersign at the time medicines were given. Some as-required medicine instructions were also not in place.
“Staff were not always countersigning medicines at the time of dispensing and giving.” from the report
Oral care
needs fixingPeople were not consistently offered tooth brushing, and many did not have toothbrushes or toothpaste.
“Many people were not having oral care as they did not have toothbrushes or toothpaste.” from the report
Staffing at busy times
needs fixingThere were enough staff for people's needs overall, but staffing was sometimes stretched. People could receive inconsistent support or be left looking for staff.
“There were times when staffing levels were stretched and resulted in people receiving inconsistent support and people were found searching for staff.” from the report
Incomplete records and oversight
seriousQuality systems had improved but had not been fully embedded. Care records and food and fluid charts were not always complete or up to date.
“The provider had not ensured that there were effective systems to assess and quality assure the service.” from the report
- 01What has been done to make sure every resident has an up-to-date care plan and risk assessment, including for swallowing, diabetes, hydration and mental health?
- 02How do you now check that medicine administration records are completed correctly and that staff countersign at the time medicines are given?
- 03How do you make sure every resident is offered regular oral care and has the toothbrush and toothpaste they need?
- 04What has changed about staffing levels and agency staff use at busy times since this inspection?
- 05How are food and fluid records checked each day, and what action is taken when someone is not meeting their hydration target?
This was a focused inspection of Safe and Well-led, including infection prevention and control under Safe; ratings for Effective, Caring and Responsive were not given in this report. This explanation was written from the published report of 17 December 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Seaview Nursing Home
9 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- September 2020Inspected but not ratedSafe: Inspected but not rated
- June 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- April 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2017Inadequatestayed InadequateSafe: Requires improvement
- November 2016Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- April 2015Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2015Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2014
Report published without a new overall rating.
- August 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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19 live-in carers within about an hour of East Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
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“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
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