Archived: Haven Social Care Limited

Updated 10 February 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 9 and 16 November 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

The inspection was completed by two inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert had experience in caring for someone who used a domiciliary care service.

Before the inspection we reviewed the information we already held about the provider including feedback from people and staff we had received since the last inspection and notifications the provider had submitted to us. We sought feedback from the local authorities who commissioned the service and the local Healthwatch.

During the inspection we spoke with seven people who used the service and two relatives. We spoke with six members of staff including the registered manager and five care workers. We reviewed the care records of six people who used the service including care plans, risk assessments, medicines and care records. We reviewed 13 staff files including recruitment, training and supervision records. We also reviewed policies and other documents relevant to the management of the service.

Updated 10 February 2017

This inspection took place on 9 and 16 November 2016 and was announced. The provider was given 48 hours’ notice as they provide a domiciliary care service and we needed to be sure people would be available to speak with us.

Haven Social Care Limited provides personal care to adults living in their own homes. At the time of our inspection they were supporting 24 people.

The service had a registered manager in post. 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 service was last inspected in January and February 2016 when we found breaches of two regulations and made one recommendation. These issues had not been addressed.

Staff were not recruited in a safe way as interviews and skills audits were not assessed by the provider. People told us there were not enough staff and this meant they had to wait for care, particularly at weekends. The provider did not maintain sufficient records to ensure that staff identities were known. Staff did not receive sufficient training or support to perform their roles.

People told us, and records confirmed, care plans were reviewed and updated every six months. Care plans were task focussed and did not contain information about people’s preferences for care, food or staffing. There was limited information about people’s pasts, cultures and identity. We have made recommendations about recording people’s dietary preferences, cultural and identity needs.

People receiving care lived with a range of long term health conditions. The support they required to maintain their health and the impact their health conditions had on their support was not recorded. We have made a recommendation about recording people’s health needs.

Risk assessments were in place for some identified risks. However, the measures in place to mitigate risk were not robust and did not contain enough information for staff to use to keep people safe. Some risks had not been properly identified and there were no measures in place to mitigate them.

People were supported to take their medicines. There was insufficient information in care plans to ensure this was managed in a safe way. Records of medicines were unclear and did not show they were administered as prescribed. The service did not check medicines records to ensure medicines were managed safely.

People told us they were offered choices and care workers asked their permission before providing care. Records of consent were not in line with legislation and guidance as friends and relatives without appropriate legal authority had signed consent forms of people’s behalf.

The provider had a complaints policy in place and had not received any formal complaints since our last inspection. Records showed that feedback had not always been responded to. We have made a recommendation about responding to feedback.

Feedback about the management and leadership of the service was mixed. People and some staff told us the registered manager was kind and supportive. Other staff told us the service was disorganised and the registered manager did not respond when they requested support.

There were no effective systems in place to monitor the quality and safety of the service. Records were not routinely checked and some could not be located during the inspection.

People told us staff had a caring attitude and treated them with dignity and respect. Care workers spoke about the people they supported with kindness and affection.

We found breaches of six regulations. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures.’

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.