The Haven

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

We expect providers to understand and work within the right support, right care, right culture statutory guidance when they provide support to autistic people and people with a learning disability. The service is providing support to one person with a learning disability diagnosis. When asked the registered manager told us they were not aware of the statutory guidance and therefore have not assessed the persons care and support using the correct guidance.

A stakeholder said, “I think the shape of the home makes supervision tricky at times- they have rooms tucked away and some upstairs rooms. They appear to make reasonable decisions about who is appropriate for each room and will move residents if need be.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Records did not consistently demonstrate that care was delivered in line with care planning guidance. We found examples where people’s dietary needs for modified foods were not consistently recorded across all documentation. Some people’s care plans stated they need support with behaviours that challenge, however there was no evidence to demonstrate effective monitoring or analysing of behaviours to identify key triggers and evaluate the effectiveness of support. This limited the provider's ability to demonstrate that people consistently received care and treatment that reflected their assessed needs and planned outcomes.
 

The provider did not always work well across teams and services to support people.

Specialist involvement from external professionals was not always clear in care plan records, for example we reviewed the care plan for a person with a mental health diagnosis that impacted on their mental wellbeing and perception of reality. The care plan states the person is under the mental health team, however there was no information about professional visits or reviews.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control.

Due to the limitations of the building layout, there was no quiet area for people to sit and socialise away from the noise of activities going on in the main lounges. This impacts on people who would choose to sit in communal areas but like their own space. People told us this impacted on their quality time with families because there was nowhere to sit privately.

A family member said, “There is a good selection of food, good selection sandwiches, sausage rolls, hot or cold, fruit corner, cakes etc at teatime. Meals from what I have seen are good and my [relative] has gained a healthy amount of weight since being here.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Care plans stated areas that staff needed to monitor for example, effects of medication, behaviours and for one person hand care. However, care plans did not include how these were being monitored. As a result, the provider could not always demonstrate that monitoring information was being used to drive improvement and support better outcomes for people.

People had a wide range to mental capacity assessments however the provider was not proactive in applying for people’s Deprivation of Liberty authorisations, there were a number of people’s who DoLS orders had expired before the provider had sent for new authorisation.