This inspection was carried out on the 9 December 2016 and was unannounced.

Seahaven is registered to provide accommodation and personal care for up to 19 people. The service is split over two adjacent houses, with an inter-connecting door between them. One house was called Seahaven and the other house was called Kingsdown Lodge. There were five people living at Kingsdown Lodge and 11 people living at Seahaven. People living in both houses had a range of learning disabilities and mental health needs. Some people were living with autism and some people required support with behaviours that challenged.

The service was located in a rural location, overlooking the sea. Each house had its own kitchen and lounge areas. People were able to move between the two houses whenever they wished, to visit their friends and staff. Each person had their own bedroom.

The service had a registered manager in post. A registered manager is a person who is 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 registered manager also managed a smaller service for three people in Deal, Kent and shared their time between the two services.

Some people’s care plans and risk assessments required updating. The registered manager had already identified this and there was a plan in place to ensure this happened as soon as possible. When people’s care plans and risk assessments had been updated they were detailed and accurate. People told us that they were supported by the same staff, who knew them well and so they always received the support they needed.

Detailed assessments were carried out before people moved into the service. One person had recently moved in and they had visited the service and met staff several times so they were able to get to know everyone.

There were enough staff to keep people safe. Staff were checked before they started working with people to ensure they were of good character and had the necessary skills and experience to support people effectively.

People kept their medicines in a locked safe in their bedrooms and were supported to be as independent as possible when taking their medicines.

People were relaxed in the company of staff and their relatives told us that staff were kind and caring. Staff knew people well and offered people reassurance and support throughout our inspection. People were treated with dignity and respect. Some people needed support with their communication so staff used signs and symbols to help them make their needs known.

The registered manager documented and investigated any complaints.

People and staff told us they thought the service was well led. Staff told us they were well supported by the registered manager and there was an open and inclusive ethos within the service.

Staff completed incident forms when any accident or incident occurred. Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. Regular fire drills were completed.

Staff knew how to recognise and respond to abuse. The registered manager was aware of their responsibilities regarding safeguarding and staff were confident the registered manager would act if any concerns were reported to them.

Staff had an induction and the training needed to carry out their roles. All staff had received training in how to manage people’s behaviours safely, and how to prevent behaviours from occurring. Staff met regularly with their line manager to discuss their training and development needs.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there were any restrictions to their freedom and liber

Our inspection team was made up of one inspector and a specialist clinical advisor. We spoke with some of the people who used the service, the manager, deputy manager and care staff. We spent time with people who had communication difficulties and observed the interactions between people and staff during the day. We considered our inspection findings to answer questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the staff supporting them and from looking at records. We found overall that action had been taken and improvements had been made by management and staff since our last inspection visit.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The service was safe because the manager had a good understanding of the risks and needs of the people using the service and had put appropriate measures in place. Risk assessments had been completed to make sure staff knew how best to support people to minimise potential risks to their wellbeing. People were treated with respect and dignity by the staff. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. People told us that they felt safe. One person said, “My life has improved since I’ve lived here. When I’m having a bad day the staff support me. They listen to me and give me time.” People were protected from infection because the provider had maintained appropriate standards of hygiene and had good systems in place to monitor and assess the quality of service.

Is the service effective?

The service was effective. People’s health and care needs were assessed with them and/or their representatives. Specialists including psychologists and speech and language therapists had been involved in people’s care and to give staff training and advice. Staff had received the training they needed and there was an ongoing training programme to make sure staff had the skills they needed to support people appropriately.

Is the service caring?

The service was caring. Staff spent time with people and assisted them to do what they wanted. Staff had got to know the people using the service well and had developed ways to communicate with them. When people needed support this was given respectfully and in a relaxed way. Staff occupied people with activities and encouraged people to learn new skills.

Is the service responsive?

The service was responsive. People were given choices and staff were responsive to their needs. Sometimes people needed support with their behaviour and there were plans and systems in place to respond to this. The service had a development plan that addressed all areas of improvement needed and they had been responsive to concerns raised at the last inspection.

Is the service well-led?

The service was well-led. The service had a manager who was experienced in working with people with learning disabilities and had been registered as a manager with the Commission at a previous employment. There were systems in place to provide on-going monitoring of the home. This included checks for the environment, health and safety, fire safety and staff training needs. The staff confirmed that they had individual supervision and staff meetings. This enabled them to share ideas and concerns.

We visited Beach House due to concerns that had been raised about the service and in particular with regard to an activity that one of the people who lived at the service had been facilitated to be involved in.

Prior to the visit we contacted other agencies including environmental health, social services and the police regarding the activity that had been reported to us. We were concerned that the activity was not appropriate for this service and that people were at risk of acquiring an infection should it continue. We made an unannounced visit to the service to check that this activity had ceased; which it had six days prior to our visit. People told us that there had been a bad smell for a few days when the activity was being carried out but that it had gone since the activity had ceased. One person told us “That smell has gone, it was bad.”

People had their needs assessed and risks were identified in most cases. However we found that risks relating to an activity had not been identified, assessed and managed to an appropriate standard to ensure the health, safety and welfare of people staff and visitors.

We found that laundry was being separated appropriately and that special waste was being handled, segregated, stored and disposed of suitably.

Concerns had been raised with regard to people not having curtains up in their bedroom and that lights did not work in some of the bedrooms. We found that the curtains were being replaced at the time of our visit and that the lights worked in the rooms that we checked, with the exception of one of the lights in an upstairs bathroom that was not working, this had been reported for replacement.

We saw that the systems that were in place to assess and monitor the service had not been used effectively to ensure people’s welfare and safety and that decisions about people’s care in regard to the activity had not been made by appropriate staff.

Some people living at the service were not able to talk to us directly about their experiences due to their complex needs, so we used a number of different methods to help us understand their experiences. We spoke with staff, spent time with people, read records, looked around the home and made observations of the care and support the people received. People were supported to engage in a variety of activities. People told us that the staff treated them with dignity and respect.

We saw that people were offered choices and their independence was promoted. We saw some positive interactions between staff and the people who live at the service. Staff assisted people in a professional, yet warm manner and explained what they were doing when they supported them.

People we spoke with told us that they liked living in the home and that staff were friendly and caring. We saw that people looked relaxed. The people we spoke with told us that they were satisfied with the care and support received. One person said "I feel safe here, I am very comfortable". Another said "The staff are kind and always find time to chat with me".

We were able to talk with most people but due to communication difficulties with some of the people they were limited in what they could tell us. We spent some time with them and observed their lifestyle and interactions with the staff and other visitors.

People smiled and laughed whilst carrying out their day to day activities. People were participating in a variety of activities and were chatting about the events they were planning.

People told us the home had got much better. A person said, "It's good here." "Yes I have been going out. I went shopping today…"

People said they had meetings with the staff to decide what they wanted to do. They said they found them helpful.

Some people said they liked to be independent and liked the support they were receiving at the home while they needed it. One person said, "Yes, it's alright here, I can do what I want to do." Another person laughed and said "yes, yes, good" and said he was doing lots of different things.

Some of the people had recently booked a holiday and said they were looking forward to it.

People said the home was much cleaner.

People told us they liked the staff. They said they were good and some people referred to their key worker. We saw good interactions between the people living in the home and the staff. People smiled in response to the staff.

People said they talked to the staff if they wanted something changed and said they were happy in the home. People said they were listened to. They talked about some of the changes and improvements in the home.

We were able to talk with most people but due to communication difficulties with some of the people they were limited in what they could tell us. We spent some time with them and observed their lifestyle and interactions with the staff and other visitors.

One person said "there is an inter-joining door upstairs which have no codes on them. [One of the people living in the home] goes up and opens the door and goes into my room and shreds my things. I'd like a lock on the door so that I can save my things." He goes on to say that, "if I wanted to go out I couldn't if there were only two staff. No choice."

One person said "I spend my day on my i-pad. Sometimes I go for a walk when my physiotherapist comes. She used to come once a week. It's now been two weeks since I went out for a walk. " (The physiotherapist was on holiday) "I can't go in the car at the moment. They have found a seatbelt for me so hopefully I can get that and go out. I’d like to go out if the weather was better."

Another person said, "I like it here and I like the staff. …I spend a lot of time in my room watching TV."

One of the people living in the home commented on the staff changes, he said "people don't know who is supporting them from one afternoon to the next."

Not all the people living in the home were able to tell us about their experiences, so we observed the interactions between the people living in the home and the staff.

Some people were smiling as they carried on with their usual daily activities. Some people displayed behaviours that were repetitive and habitual.

People were moving around freely in the home and approaching staff who responded positively to them.

Some people did not have very much structured occupation apart from the routine parts of the day, like meal times. People's opportunities for development of skills and experiences were limited.

People said they liked the home and that it was better since it had been made into two. The downstairs door was open and people were moving freely between the two homes which they said they usually did.

People said they liked their own space. They said they could spend time in their bedroom if they wanted to be on their own or go into the lounge or dining areas if they wanted to be with other people. People said they could get up and go to bed at the time they wanted. They said they helped with some of the cooking and chopping for the meals. People said the new manager was nice and they would go to her if they had a problem.

Not everyone in the home was able to talk to us so we spent time with people in the main areas of the home and observed what was happening so that we could get an idea of their experience.