This inspection took place on 6 March 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.

Seaton Hall Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Seaton Hall Residential Home accommodates up to 29 older people who require personal care in one adapted building. At the time of our inspection, there were 23 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

Seaton Hall was last inspected by CQC in January 2017 and was rated Requires improvement overall. At the inspection in January 2017 we identified the following breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 17 (Good governance). This was because the provider's governance system had not always been effective in identifying or addressing improvements to the service. At this inspection we found improvements had been made in all the areas identified at the previous inspection.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and described potential risks and the safeguards in place to mitigate these risks.

The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed.

The home was clean and suitable for the people who used the service, and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. Staff were suitably trained and received regular supervisions and appraisals.

The provider carried out relevant vetting checks when they employed staff. However, there was no record of what documents had been checked to confirm the proof of identity of new staff. We have made a recommendation about this.

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 and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Seaton Hall Residential Home. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

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 is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

Activities were arranged for people who used the service based on their likes and interests, and to help meet their social needs. The service had good links with the local community.

People who used the service and family members were aware of how to make a complaint however there had been no formal complaints recorded at the service.

The provider had an effective quality assurance process in place. Staff said they felt supported

We carried out this inspection on 17 January 2017. The inspection was unannounced so the provider and staff did not know we were coming.

The last inspection of this service was carried out in June 2015. That inspection was to check whether the provider had made necessary improvements to assessing and recording the needs of people who stayed at the home for short periods. At that time we found there had been improvements to the way the service set out the support needs of people who were staying for short breaks.

Seaton Hall Residential Home is registered to provide accommodation and personal care for up to 29 older people who have personal or dementia care needs. There were 22 people living at the home when we visited, including four people who were staying for a short period. Seaton Hall Residential Home had been registered as a care home for over 20 years.

At the time of this inspection a former manager was still registered with the Care Quality Commission but was no longer in post. A new manager had commenced the process of applying for registration. 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.

During this inspection we found the provider had breached a regulation about good governance. This was because the provider had not always notified us of events that are required to be sent to us by law. People, relatives and staff said the home's decoration and furnishings was in need of improvement. We found people’s care records did not always include current assessments about potential risks, such as falls, as these had been archived. This meant staff did not have immediate access to information about how to minimise those risks. You can see what action we have told the provider to take at the back of the full version of the report.

We found there were no adaptations to help people who were living with dementia to find their way around. We have made a recommendation about this.

People told us they felt safe and secure in the home. Staff were clear about how to recognise and report any suspicions of abuse. Staff told us they were confident any concerns would be listened to and investigated to make sure people were protected. The provider made sure only suitable staff were employed and used a dependency tool to decide the level of staffing.

People and relatives felt staff were trained and experienced. Staff understood the Mental Capacity Act 2005 for people who lacked capacity to make a decision and asked people’s permission before providing care.

Health and social care professionals said staff cared for people in a competent way and responded appropriately to any changes in people’s well-being. People were supported to eat and drink enough and they said they had choices about their meals.

Staff understood what was important to each person and were familiar with their preferences. There was a friendly atmosphere in the home and there were cheerful interactions between people and staff. People had opportunities to join in activities if they wanted and this was improving with a new activity staff member.

People were asked for their views about the home and felt their views were listened to. People had information about how to make a complaint or comment and these were acted upon. People, relatives and staff felt the manager was approachable and supportive.

Seaton Hall Residential Home provides accommodation and personal care for up to 29 older people who have personal or dementia care needs. There were 19 people living at the home when we visited.

At the last inspection of this care home, which was carried out on 23 July 2014, we found some people’s care records did not always reflect their primary care needs. This was a breach of regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

After the inspection the provider wrote to us to say what they would do to meet legal requirements. We carried out an unannounced focused inspection to check whether the provider had followed their plan and to confirm that they now met the legal requirement. This report only covers our findings in relation to that requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Seaton Hall Care Home on our website at www.cqc.org.uk.

During this inspection we found that care records included clear explanations of people’s needs and the actions staff should take to support them with those needs. The care plans were personalised and detailed. This meant the provider had met the assurances they had given in their action plan and were no longer in breach of the regulation.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

Seaton Hall Residential Home provides accommodation and personal care for up to 29 older people who have personal or dementia care needs. There were 13 people living at the home when we visited. Seaton Hall Residential Home had been registered as a care home for over 20 years.

This was an unannounced inspection. At the time of this visit the home did not have a registered manager because the previous registered manager had left in March 2014. The new manager was in the process of submitting an application for registration to CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

During this inspection we found two of the 13 people living at the home did not have adequate records about their main areas of care needs. Although staff on duty had a good understanding of how to support those people, there were insufficient records to guide all staff to provide assistance in a consistent way or to review any changes in their needs.

People were positive about the service they received. People felt safe and felt included in decisions about their care. Staff understood the Mental Capacity Act 2005 for people who lacked capacity to make a decision and deprivation of liberty safeguards to make sure they were not restricted unnecessarily. People’s safety was protected without compromising their rights to lead an independent lifestyle.

Staff were clear about how to recognise and report any suspicions of abuse. Staff told us they were confident that any concerns would be listened to and investigated to make sure people were protected.

There were sufficient staff to meet people’s needs. Staff spent time with people and saw this as an important part of their role. Staff received the training and support they needed to be competent in their roles.

People were supported to eat and drink enough to meet their nutrition and hydration needs. People had choices about what, where and when they ate their meals. There was a warm, friendly atmosphere in the home and there were positive interactions between staff and the people who lived there.

People were treated with kindness and dignity. People told us their privacy and independence were respected and they were able to make their own decisions about their day to day lives. Staff were respectful of people’s diverse needs.

People who used the service and their relatives told us they felt well cared for in the home. People said any changes in their health needs were referred to the relevant health care agencies. The health care professionals we spoke with felt the home responded quickly to any changes in people’s needs.

People and their relatives were asked for their views about the home and their suggestions were used to improve the service. People had information about how to make a complaint or comment. Although this information was out of date, people and visitors felt any comments were acted upon. The provider and manager monitored the quality and safety of the care service.

We found a breach of regulation relating to the maintenance of accurate care records. You can see what action we told the provider to take at the back of the full version of the report.

We spoke with four people who used the service and two visitors. The people we spoke with were extremely satisfied with the service and very complimentary about the staff who supported them. They felt the staff understood their needs and that they continued to lead independent lifestyles.

One relative told us, “The staff are superb and I have always found the care to be of a high standard”.” People also said, “I find that the owner and the staff care a great deal about us,” and “Staff know what they are doing and it is a good place to live in.”

We found that people's care was planned and delivered in line with their needs. The staff were very knowledgeable about people’s care needs and how to meet them. We noted that the staff team had been very stable and all of the staff had been in post for a number of years. We found that the manager made sure the home provided effective care and encouraged staff development.

The home was well-maintained and the provider had an on-going programme of redecoration which ensured it was kept to a high standard,

We found that effective procedures were in place should people wish to complain.

On the day of our inspection there were eleven people living at the home. We found that people who used the service we protected from unsafe care and treatment because records contained detailed up to date information about the needs of people who used the service. The records were also updated and reviewed regularly.

We spoke with three people at Seaton Hall Residential Home. One person told us; “The staff are here for me, I have nothing to complain about. I’m quite happy here.” They also told us “The food is good here and I get choices.”

Another person told us; “I’ve been here a couple of months, the food is OK and I get what I fancy.” They also added; “We help each other, nobody’s ever nasty and there is nothing to be concerned about.” Additionally, one person told us that they had been able to choose the room they wanted. The third person told us; “I’m happy with my care here. The activities aren’t always to my taste but that’s ok as I enjoy being in my room anyway.”

People told us that the “Staff do a heck of a lot”, “It’s lovely here, I get well looked after”, “The staff are good.”, “Don’t get me wrong, I’d rather be at home, anyone would, but I’ve no complaints.”, “I like to spend time in my room” and “I’m a sports man, I’ve been watching the cricket this morning.”