Sea Gables Residential Home 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. This inspection took place on 1 and 3 October 2018 and was unannounced.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Sea Gables is registered to provide accommodation and personal care for up to seven people and seven people were being accommodated at the time of the inspection. The home is based on two floors and is situated close to local facilities and shops. All bedrooms had en-suite bathrooms and there was a choice of communal areas where people could choose to spend their time.

The home had a registered manager. 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.

At our last inspection, in May 2016, we identified no concerns and rated the service as good. At this inspection, however, we identified some areas for improvement.

CQC were not always notified of significant events. There was a quality assurance process in place, but this was not always used effectively to identifying concerns and bring about improvement.

Best practice guidance was not always followed to ensure medicines were consistently recorded, stored and disposed of safely.

There were clear recruitment procedures in place; however, these were not always followed fully to help ensure only suitable staff were employed.

Arrangements were in place to deal with foreseeable emergencies, although some staff were not clear about the action to take in the event of a fire.

Staff protected people’s rights and acted in their best interests, although they were not always clear about the extent of their role under the Mental Capacity Act 2005. Procedures to use low-level interventions, to support people who could behave in a way that put themselves or others at risk, were not robust.

Most staff had received sufficient training to enable them to support people effectively, although a night support worker had not completed some essential training.

Individual risks to people were usually managed effectively and people were involved in risk-taking decisions. Infection risks were managed appropriately for the size and type of service.

People felt safe living at Sea Gables. Staff used innovative techniques to help people understand safeguarding and protect them from the risk of abuse.

There were enough staff available to meet people’s care needs and support them with activities. Staff were appropriately supported in their role by managers.

People’s nutritional and dietary needs were met consistently. The home had been adapted to meet people’s needs.

Staff supported people to access healthcare services when needed and helped ensure they experienced a smooth transition when they moved into or out of the service.

People were supported by kind, caring and compassionate staff who knew them well. They interacted positively with people and helped boost people’s morale and feelings of self-worth through a ‘Housemate of the month’ scheme.

Staff encouraged people to be as independent as possible, used appropriate techniques to communicate with them and involved them in planning the care and support they received.

Staff respected people’s sexuality, privacy and dignity. They supported people to build and maintain relationships with people im

This inspection took place on 19 and 20 May 2016 and was unannounced. The home provides accommodation for up to seven people with a learning disability. There were seven people living at the home when we visited. The home is a converted house and is based on two floors. There was a choice of communal rooms where people were able to socialise and all bedrooms had en-suite facilities.

A registered manager was not in place at the time of the inspection, although the manager had applied to be registered with CQC and their application was being processed. 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 providers operated an innovative project called “The Land” to provide meaningful outdoor activities for people within a safe environment. This had proved beneficial for people living at Sea Gables by providing opportunities for them to care for animals, grow produce and develop likns with people and organisations in the community.

People were happy living at the home and were supported to work towards individual goals. These were detailed in people’s care plans, together with information about staff should help people achieve them. For one person, working at The Land had acted as a catalyst to developing their independent living skills and achieving their goal of moving to a supported living setting.

People felt safe living at Sea Gables and were protected from the risk of abuse. Individual risks were managed in a way that protected people from harm while promoting their independence.

Staff worked in a flexible way to enable people to lead happy and fulfilled lives. Recruitment practices were safe, people’s medicines were managed safely and there were plans in place to deal with foreseeable emergencies.

Staff were suitably trained and supported in their work and knew how to care for people effectively. They received appropriate induction and supervision.

People received enough to eat and drink and were supported to prepare meals. They had appropriate access to healthcare services when needed. Staff sought consent from people before providing support and followed legislation designed to protect people’s rights and freedom.

People were cared for with kindness and compassion. All interactions we observed between people and staff were positive and it was clear that staff knew people very well. Staff supported people to build and maintain relationships and protected their privacy at all times.

People were involved in developing and reviewing the care and support they received. They could access their care plans on request at any time and staff were responsive to people’s views when they requested changes to the way they were supported.

Sea Gables was well-led. The providers operated their services in a joined up way that complimented one another. There was a positive, open culture. The manager acted in a consultative way. Staff were happy in their work and worked well together.

There was a suitable quality assurance system in place. The manager was aware of the key strengths and areas for improvement at the home and had developed a plan to manage these.

We spoke with four people who used the service. They told us staff sought their consent before they delivered any care. They said they were very happy with the level of care provided and staff understood their needs. One person said “staff help me when I need it. I am helping to do the cooking tonight”. We looked at four care plans and saw they were individualised and included the necessary information to inform staff as to the specific care people required. We saw people had been involved in the development of their plan.

We spoke with three members of staff and the manager, who were all able to demonstrate a clear understanding of peoples’ care and welfare needs. They told us they felt they had enough time to meet people’s needs. We observed care being provided in the communal areas of the home and saw staff were not rushed and had time to interact effectively with people. There was a duty roster system in place, which detailed planned cover and the arrangements to manage short term absence.

We spoke with two families of the people who used the service and a visiting health professional. They all told us they did not have any concerns regarding the quality of the care provided by the home. One family member said “staff are great, they really understand [their relative’s] needs”. They added “I am very, very pleased with how they look after my [relative]”. The visiting health professional said “when I visit, it feels like it is their [the people who used the service’s] home”. They added “My client has grown in confidence since they have been there”.

We spoke to four people who lived at the home. We also spoke to four members of staff including the registered manager. People told us that they felt safe, and that “all the staff were good”. They felt they could make decisions about their care, treatment and support. They said they were supported to take part in a lot of activities, and some had found work in the local community, which they enjoyed.

We observed that staff were friendly and courteous, and respected people’s wishes. For example, people told us that staff always knocked before entering their rooms.

We found that care plans were comprehensive, and showed that people had been involved in decisions about their care. Staff received appropriate training and were supported to deliver care safely. They had a good understanding of how to protect people from abuse, and worked to a policy of non-restraint. One member of staff told us they were “really happy with the way people were treated”.

The provider had an effective system to assess and monitor the quality of service provision, and demonstrated changes that had been made as a result.