Haviland House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Assessments were completed before people moved into the service and included information from people, their relatives and healthcare professionals. There were ‘households’ at Haviland House which were designed to meet people’s needs through their dementia journey. A staff member told us, “It would be unusual to not meet people's needs here, we have households and people can move up through different households. If someone becomes more dependent and needs to move, we talk to the families and usually there is an in-house move.” Summaries of people’s care records were available should they move to another service or require hospital admission which promoted continuity of care.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Assessments were completed before people moved into the service and included information from people, their relatives and healthcare professionals. There were ‘households’ at Haviland House which were designed to meet people’s needs through their dementia journey. A staff member told us, “It would be unusual to not meet people's needs here, we have households and people can move up through different households. If someone becomes more dependent and needs to move, we talk to the families and usually there is an in-house move.” Summaries of people’s care records were available should they move to another service or require hospital admission which promoted continuity of care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People and their relatives told us they felt safe and comfortable with staff, a person told us, “Yes I do feel safe here and am not worried about anything, no complaints and no concerns.” A relative said, “[Person] definitely feels safe there. Staff are absolutely brilliant.” Staff were trained to prevent the risk of harm or abuse of people and knew who to raise concerns with. A staff member told us, “I would escalate to the management and check if they were aware. If needed I would come straight to CQC or West Sussex Safeguarding.” Safeguarding concerns were responded to appropriately and logged to establish if there were any trends or patterns.

Staff and management worked within the principles of the Mental Capacity Act 2005 (MCA). Where people had a Deprivation of Liberty Safeguards (DoLS) in place, the management oversaw authorisations to ensure they were in date and any imposed conditions were being met. Information about any DoLS conditions were recorded in people’s care records and included on a tracker.
 

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff assessed where people had a specific health risk, such as Parkinson’s disease, diabetes or experienced seizures, care plans detailed how staff could support them safely and included signs of deterioration to watch out for. People were enabled to take positive risks, for example, one person had a preference to lock their bedroom door, this was achieved through risk and contingency planning. A relative told us, “[Person] needs more help now to get up and is less mobile. They have had falls and I’m happy that staff tell me. At nighttime [person] has an alarm mat by the bed and an alarm pendant around their neck.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Regular health and safety checks of the environment and any required equipment had been completed and were overseen by the facilities team. Technology and equipment were in place to support the safety and wellbeing of people. People had access to call bells and those who were unable to use their bells had other measures in place to keep them safe, these included bed rails, crash mats, beds which could be raised and lowered and sensors to alert staff if people had stood and required assistance. There was also an acoustic monitoring system which allowed staff to check the safety of people without needing to disturb them. The management team had identified areas of the service to develop and create additional social space for people.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. We observed enough staff to safely meet people’s needs and spend social time with them. A relative commented, “In our opinion, there’s more than enough staff.” A person spoke about staff and said, “They (staff) see what people need and they do their best to do it, you don’t have to wait long for them to do things.” Recruitment checks were completed before staff were employed. Where agency staff were required, their credentials were checked and they were provided an induction prior to deployment, the management team requested consistent agency staff to support people. Staff received supervision from their line managers and told us supervisions were helpful to their ongoing development. Staff spoke about mandatory training as well as additional training which was offered in areas which interested them. Staff received enhanced training on how to support people living with dementia. One staff member told us about an ‘immersive dementia experience’ they had attended and said, “I learned how it would be to be in their (people’s) shoes and understand although we are helping we are understanding. We can get to know more why they react like they do. Some of the things I learned was how to manage if someone was agitated how to react and I want to help them feel calmer. I feel now I have more experience and confidence.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The service was clean without any malodour. Staff followed the provider’s infection prevention and control policies to keep people safe. Personal protective equipment (PPE) was available which staff used and disposed of appropriately. Audits and checks were completed by the infection prevention and control lead, observations of staff handwashing and putting on/taking off PPE were conducted to ensure staff followed good practices. A relative commented, “It’s spotless. Absolutely spotless. There’s no problems and [person’s] room is cleaned daily.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people and, where appropriate, their relatives in planning, including when changes happened. However, we identified some areas where documentation required closer monitoring. Staff did not always consistently document where they had applied people’s prescribed cream on the topical medication administration record (TMAR) chart, although they had recorded the application in progress notes. Some people were prescribed when required (PRN) medicines. However, staff did not always record in the progress notes about people’s presentation prior to PRN medicines being administered. We discussed this with the management team who put immediate measures in place to address the recording issue. Medicines were administered by registered nurses and team leaders who had completed medicine training; their competencies were regularly assessed. People who were prescribed time sensitive medicines received them as prescribed. People and their relatives were involved in medicine reviews, a relative told us, “The GP sees [person] regularly. The GP phoned me about a change in medication. I got a follow up call from Haviland to check the GP had been in touch. I get a monthly report on health and any medicine changes written on it.”