This inspection took place on 10 and 11 December 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.

Princess House Seaburn is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Princess House Seaburn provides accommodation and personal care for up to 26 people, some of whom may be living with dementia. On the day of our inspection there were 23 people using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Appropriate arrangements were in place for the safe administration and storage of medicines.

Accidents and incidents were appropriately recorded and risk assessments were in place. Staff understood their responsibilities with regard to safeguarding and had been trained in protecting vulnerable adults.

The home was clean and suitably adapted for the people who used the service. Appropriate health and safety checks had been carried out.

There were enough staff on duty to meet the needs of people. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were protected from the risk of poor nutrition. Care records contained evidence of people being supported during visits to and from external health care specialists.

People and visitors were complimentary about the standard of care at Princess House Seaburn.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. Support plans were in place that recorded people’s plans and wishes for their end of life care.

Care records showed that people’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred means ensuring the person is at the centre of any care or support and their individual wishes, needs and choices were considered.

Activities were arranged for people based on their likes and interests, and to help meet their social needs.

The provider had an effective complaints procedure in place, and people were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff said they felt supported by the registered manager. People, visitors and staff were regularly consulted about the quality of the service via meetings and surveys.

At the last inspection on 1 and 2 June 2016 we found a breach of regulation relating to the management of medicines. Following the inspection the provider wrote to us to say what they would do to meet legal requirements in relation to medicines.

We undertook this focused inspection to check that they had met legal requirements and to confirm that they had followed their action plan and made improvements to the service. 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 Princess House Seaburn on our website at www.cqc.org.uk.

Princess House Seaburn is a care home which provides accommodation and personal care for up to 26 people, some of whom may be living with dementia. There were 23 people living there at the time of our inspection. The accommodation is a three storey detached house in its own grounds on the seafront.

The service 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 focused inspection on 14 December 2016 we found medicines were managed safely. Arrangements for administering 'when required' medicines were safe. Medicines were stored securely and at the correct temperature. Prescribed creams were managed and recorded accurately. Appropriate codes had been used on medicine administration records when people did not receive their medicines.

The provider had followed their plan and legal requirements had been met.

The inspection took place on 1 and 2 June 2016. The first visit on 1 June 2016 was unannounced. The second visit on 2 June 2016 was announced. We last inspected the service in June 2014 and found the service met the regulations we inspected against at the time.

Princess House Seaburn is a care home which provides accommodation and personal care for up to 26 people, some of whom may be living with dementia. There were 21 people living there at the time of our inspection. The accommodation is a three storey detached house in its own grounds on the seafront.

The service 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.

We found the provider had breached Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the registered provider did not have accurate records and procedures to support and evidence the safe administration of ‘when required’ medicines and prescribed creams. Medicines were not stored within the recommended limits for safe storage.

You can see what action we told the provider to take at the back of the full version of the report.

People received their routinely prescribed medicines as directed. The arrangements for storing and administering medicines liable to misuse, called controlled drugs, were safe.

People, relatives and staff we spoke with said the service was safe. One person told us, “I’m safe because the home is first class. I have good friends and the home is spotlessly clean.” Another person said, “I’m happy to live here and don’t want to be anywhere else. I’m very happy with the care I receive here.”

People were encouraged and supported to maintain their independence and to pursue their interests and hobbies. Staff interacted with people in a friendly and respectful way. The service was clean, well maintained and contained good quality furnishings.

The service was working within the principles of the Mental Capacity Act 2005. Deprivation of Liberty Safeguards (DoLS) applications had been made appropriately and contained details of people’s individual needs.

People told us they liked the food. One person told us, “The food is good here, can’t fault it.” Another person said, “The food is lovely.”

Thorough recruitment and selection procedures were in place to check new staff were suitable to care for and support vulnerable adults. New staff received a comprehensive induction, which included training in key areas. Staff undertook additional training regularly, and received regular supervisions and appraisals.

There were regular reviews of people's health and care needs and staff responded promptly to any changes. People saw health and social care professionals to ensure they received treatment and support for their specific needs.

People told us staff were kind and they were well cared for. One person told us, “I’m looked after exceptionally well. The staff are kind and give me everything I need.” Another person said, “The staff are wonderful. It’s a great atmosphere here.” Relatives said staff were patient and encouraged people’s independence.

Care plans were detailed and specific to people's individual needs. They were reviewed and updated regularly. When people's needs changed this was acted on promptly.

People knew how to make a complaint and were given information about the service.

People, relatives and staff spoke positively about the registered manager. A person who used the service said, “The manager is marvellous.” A relative said, “The manager is very good. They always know what’s going on.”

We used a number of different methods which included observation to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences.

During our observation we saw people were treated with consideration and respect. We saw staff as they provided care and support to people who used the service. We spoke to six people who lived at the home who told us staff were kind and helpful. One person said;" The staff are very kind" and " they will sit and talk to you." Another person said;" I love the company" and " Princess House is an excellent place." Other comments included there was plenty to do in the way of activities and outings.

All people we spoke with said they were respected by staff. Comments included: "My privacy is respected at all times" and "I'm always involved in any decisions about my care."

There were enough qualified, skilled and experienced staff to meet people's needs. Staff levels were flexible and increased if people's needs changed.

People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. One person said;" I'm very comfortable here. The sea views are magnificent."

Appropriate checks were undertaken before staff began to work with people at the home.

We saw there was an effective complaints system available. The complaints log showed any comments and complaints people made were responded to appropriately.

During our visit, all interactions we observed between the staff and the people living at the home were open, respectful and courteous.

We saw that staff provided whatever was wanted in a way that demonstrated a good knowledge of each individual person.

We observed how the people using the service were being supported and cared for and saw that they were happy, relaxed and comfortable as they went about the home. We saw that there were good relationships between them and the care workers who gave them practical and emotional support.

Care plans were written in a clear and easy to understand way and people's personal preferences were clearly recorded.

There were sufficient staff on duty to support people and to meet their care needs.

People told us they felt able to raise any concerns or comments about the service and that they had no complaints to make.

We spoke to three visitors of people who live here who felt that their relatives received good care and were looked after well. One told us "I am so happy my mum is here. I know she is well cared for." Another relative told us "The staff are cheerful and the atmosphere here is lovely."

We visited the home unannounced on 4 January 2012 from 9.30am to 4.15pm as part of our routine programme of inspections.

We spoke with a number of people who live here, as well as visitors, staff and the registered manager. We also briefly met one of the registered providers, Mrs Young. There were 16 people living in the home at the time of our visit.

Not all people using the service could comment about their care due to their disabilities, but some could. One person said, “You can’t fault it. It’s better than being on your own at home. The staff are good, we get plenty to eat. I’ve got friends here. I know everyone and we all get on”.

Another person also said, “I can’t fault here. They do anything they can for you”. This person told us they were able to live the life they wanted, preferring their own company and having meals in their room. They enjoyed the food and said they received all of the help they needed. Another said, “It’s very nice here” and told us how they enjoyed the keep fit sessions.

We spoke to three visitors of people who live here who felt that their relatives received good care and were looked after well. One told us they were always consulted and kept fully involved in their relative’s care. They felt the home provided good care, good nutrition and a good range of social activities. They described it as “a home from home”. Another said they were, “more than happy with the care provided”. They told us that the home was very supportive of relatives.

Another visitor told us Princess House was “homely and the staff were very good” and that they had “no worries about how (our relative) is being looked after”. They were pleased that the turnover of staff was low which meant greater consistency in the care provided. They told us the food was always good and their relative had made friends here. Other people living here and the other visitors we spoke to also commented on how they had made friends with people living here.

During this inspection we spoke with eight people who used the service and four relatives. Some people who were using the service had dementia care needs which meant they were unable to tell us their views. We used a number of different methods to help us understand their experiences.

We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

Below is a summary of what we found. If you want to see the evidence that supports our summary please read the full report.

Is the service caring?

People described the service they received as “wonderful” and “lovely”. One person told us, “I wouldn’t want to live anywhere else. We’re well looked after and the staff are lovely and kind.”

People were supported by calm and attentive staff. We saw that care workers were respectful and courteous when supporting people. We saw people were able to enjoy their meals at their own pace. We saw staff spent time chatting with people about their interests in a warm and engaging manner.

In discussions staff were knowledgeable about people’s individual needs and preferences and were respectful of their diverse needs. Our observations of the care provided and discussions with people showed us that individual wishes for care and support were taken into account.

Is the service responsive?

There was a visible staff presence throughout the home. Staff spent time with people in the lounges so they could make sure people got support whenever they needed it.

People told us they could join in a range of activities if they wanted. The daily activities included group events and others that met people’s individual interests, for example walks along the seafront and shopping trips.

People and visitors told us they could approach the manager at any time if they wanted to discuss anything and felt they were listened to.

Is the service safe?

People and their relatives said they had “no concerns” about the service. A visiting relative told us, “The staff are very caring. I can leave here and know she’s safe and well cared for.”

People were treated with respect and dignity by the staff. The premises were safe, well maintained and clean.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The manager understood the home’s responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager was aware of the recent court ruling regarding DoLS in care settings, and training from the local authority was planned for the near future. The home had contacted the local authority about the needs of two people who may require applications for deprivation of liberty authorisation.

Is the service effective?

People felt the service met their individual needs and preferences. The care provided was person-centred and individual to meet each person’s needs. For example one person wanted to go out frequently and this was supported by staff who took her for walks several times a day.

A visiting relative told us, “It’s not like a big organisation where everyone gets the same thing. The staff here are really interested in people’s individual like and dislikes.”

Relatives commented positively on the way this home helped people to lead their own lifestyles in a family-type environment whilst supporting them with their care needs.

Is the service well-led?

The home had a registered manager who had been managing the home for several years. People and their visitors told us they had confidence in the management of the home and felt the manager was “approachable” and listened to their views.

The provider had operated this home for many years and visited the home on a daily basis to check the quality of the service it provided. The way the service was run was regularly reviewed.

People had confidence in the way the home was run. One relative commented, “The manager and deputy are smashing and it’s very well run.” Another visitor told us, “The owners are a family and they run this home like a friendly family home.”