Ocean Breeze Residential Home offers accommodation for up to 23 people who require personal care, including those who are living with dementia.

The inspection was unannounced and was carried out on 23 and 24 November 2016.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People, relatives and health professionals told us they felt the home was safe. Staff had received safeguarding training, demonstrated an understanding of the provider’s safeguarding policy and explained the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks. Risk assessments were personalised and provided detailed guidance to staff in how to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development, supervision and appraisal to enable them to meet people’s individual needs. There were sufficient numbers of staff deployed to respond to and meet people’s needs in a timely way.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments.

People were supported to maintain their health and well-being and had access to healthcare services when they needed them.

Staff developed caring and positive relationships with people, were compassionate and reassuring, and sensitive to their individual choices. Staff treated people with dignity and respect and ensured their privacy was maintained.

People were supported to have enough to eat and drink and that met their specific dietary needs. Mealtimes were a social event and staff supported people in a patient and friendly manner.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

The service was responsive to people’s needs and staff listened to what people said. People and, when appropriate, their families or other representatives were involved in discussions about their care planning. Staff identified issues about people’s health promptly and people were referred to health professionals when needed. People were confident they could raise concerns or complaints and that these would be dealt with.

People were encouraged to provide feedback on the service provided both informally and through satisfaction surveys.

Staff felt supported and empowered to raise any issues or concerns with the management team. Quality assurance systems were in place to monitor and assess the standards of care delivered, and actions taken to address any shortfalls. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

Ocean Breeze is registered to provide accommodation and personal care for up to 22 older people. The home had been completely rebuilt and opened in January 2015. It provides accommodation over three floors with bedrooms and communal areas on the ground and first floor. On the second floor is an activities room, the medication room and a staff room. The home has landscaped gardens which were accessible for people.

The service did not have a registered manager in place. 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.

We inspected Ocean Breeze on 17 & 18 March 2016 to check the provider had made improvements required following our inspection in April 2015, and in response to some concerns we had received. This was an unannounced, focussed inspection.

At our unannounced inspection on 29 & 30 April 2015, the provider was in breach of two regulations relating to; safe care and treatment (medicines management) and governance (record keeping). The provider sent us an action plan telling us what they would do to meet the requirements.

We undertook an unannounced focused inspection on 17 & 18 March 2016 to check they had followed their plan and to confirm that they now met legal requirements in relation to the regulations. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ocean Breeze on our website at www.cqc.org.uk. We also wanted to check the provider had appropriate recruitment procedures in place due to some concerns that had been raised with us.

There had been a second change of manager at the home the week before our inspection. The new manager had not yet started the application process to register with the commission.

There were systems in place to manage, record and administer medicines. Medicines were ordered, stored and disposed of safely. People were given their medicines in accordance with instructions.

Recruitment processes were followed to ensure only staff suitable to work in a care setting were appointed. Where standards of staff practice fell short, disciplinary procedures were followed.

The home was mainly well led. However, people’s care records were not always accurate or fit for purpose. This had been identified by an internal audit and the new manager who had an action plan to redesign the care records in addition to implementing other improvements to the home.

We inspected Ocean Breeze on 29 and 30 April 2015 in response to some concerns we had received. This was an unannounced inspection.

The service had a registered manager in place. 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.

Ocean Breeze is registered to provide accommodation and personal care for up to 23 older people. The home had been completely rebuilt and opened in January 2015. It provides accommodation over three floors with bedrooms and communal areas on the ground and first floor. On the second floor is an activities room, the medication room and a staff room. The home has landscaped gardens which were accessible for people.

People and their relatives were all complimentary about the quality of care and the management of the home. Staff said the morale was good. The registered manager promoted a culture of openness and there was a clear management structure, which had recently been reviewed, with systems in place to monitor the quality of care and deliver improvements.

People were protected from possible harm. Staff were able to identify different types of abuse and what signs to look for. They were knowledgeable about the home’s safeguarding processes and procedures and who to contact if they had any concerns. This information was also on display in the reception area for people and relatives if they needed it.

People told us they felt safe and staff treated them with respect and dignity. People’s safety was promoted through individualised risk assessments and effective management of the premises. There were systems in place to manage, record and administer medicines. However, there were some concerns in relation to the administration of medicines.

Staff were caring, compassionate and kind when interacting with people. Staff knew people well and talked with them about topics they were interested in. There was a range of activities on offer throughout the week within the home, such as quizzes, physical and memory games. One to one support was provided for people who needed support to access their community. Staff supported people to make decisions and to have as much control over their lives as much as possible. The home was welcoming and visitors could come and go as they wished.

Medical advice and treatment was sought promptly when people required additional assistance. A range of health professionals were involved in people’s care including GPs, community nurses, dentists and chiropodists.

Meals were prepared in a way that met people’s specific dietary needs. The chef was knowledgeable about people’s specific dietary needs and other important information, such as allergens in food, which was available to people and staff. People could ask for something to eat whenever they were hungry and staff responded to their requests.

The home was mainly well led. However, people’s care records were not always accurate or fit for purpose and these issues had not been identified. Staff understood their responsibility to provide care in the way people wished and worked well as a team. The registered manager operated safe recruitment processes and recruitment was on-going to meet the increasing number of new admissions and staffing ratios were currently high due to the low numbers of people at the home. Staff were deployed to provide care and staff were supported in their roles with training, supervision and appraisals.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The new manager understood this legislation and had submitted DoLS applications for some people living at the home. Staff were aware of their responsibilities under this legislation and under the Mental Capacity Act (2005).

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what we have asked the provider to do at the back of this report.