The Haven

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.
At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care not working within the right support, right care, right culture is the statutory guidance that CQC expects providers to work within when supporting people with a learning disability and/or autistic people.

This service scored 61 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

One person’s care plan stated they can become frustrated and self-harm and were prescribed PRN medication to help them calm when needed. We reviewed the medication records for this person and we could see no evidence of medication being prescribed as PRN to help them manage their mental health.
The same care plan stated suicidal tendencies however there was no risk assessment in place for how staff should approach or deescalate this. Information was lacking in their care plan for how staff should support the person to stay safe at times of distress when declining the assistance of staff for personal care. Additionally, staff have not received mental health training.

We also found the provider was not working within the statutory framework; Right support, right care, right culture is the statutory guidance which supports the Care Quality Commission (CQC) to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. The registered manager told us they had not heard of the framework. Providers not working within this framework can have a negative impact on people and there is also an increased safety risk.

The provider did not fully understand the diverse health and care needs of people or of the local community, as a result care was not always joined-up, flexible or supportive of choice and continuity.

The service worked in partnership with the local doctor and district nurse team. One person told us they attend a health clinic weekly and the staff ensure the transport for appointments is always booked.

Records showed that referrals to specialist services were not always actively followed up, and recommendations from healthcare professionals were not consistently implemented, reviewed or reflected within care planning documentation. For example, to support to the speech and language team for dysphagia assessments.

We also found limited evidence of regular multi-agency reviews of people's mental health review. As a result, the provider could not consistently demonstrate that people's changing needs were being reviewed and coordinated effectively across health and social care services.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

There were a lot of information boards around the service that contained information about how to report concerns and safeguarding’s, information about infection prevention and the recent heat waves. However, it was not always clear who this information was aimed at and if it was all needed in corridors.

The registered manager told us they have created posters to help 1 person understand the importance of taking their medicines.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Visitors have the opportunity to leave feedback and rate their experience at The Haven each time they sign out. The registered manager reviews and analyses the information at the end of the month, looking for themes and trends. The manager had an action to speak with one family member who had consistently rated a lower satisfaction level than expected.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The registered manager told us regular reviews and good communication with staff and relatives meant any appropriate referrals would be made in a timely way. However, some improvement was needed to ensure referrals were followed up and changes in people’s needs were reflected in all documentation.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

A person who lived at the service and was subject to a local authority guardianship order sadly passed away. As the individual had no appropriate person available to make decisions on their behalf, they were under a guardianship arrangement which ensured that their rights, welfare, and financial interests were protected.

Following their death, initial arrangements were for a local authority-funded funeral, with no one able to attend. Through effective partnership working between the service, the local authority, and the persons extended family members, arrangements were made to enable the family and people important to the person to attend and pay their respects. This promoted equity of experience and outcomes by ensuring the person was afforded dignity, respect, and meaningful involvement from those who knew them, despite the complexities of their circumstances.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Care plans did not always evidence how people were actively involved in planning for or discussing their future care needs, including end of life. Improvements were needed, including holding difficult conversations with people or their representatives to discuss their views, preferences, and wishes for care, ensuring these are respected if they later cannot make decisions or if unexpected situations arise. For example, one person’s care plan stated they have a pre-paid funeral plan in place but also states manager to talk with [name] and family regarding end of life wishes. There is a goal for this person to maintain their end of life wishes, however staff can not know the end of life wishes if a discussion has not taken place.