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Haven Care Home Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 August 2018

This inspection took place on the 8 and 10 May 2018 and was unannounced.

This was the first inspection of Haven Care Home following the change of provider to HC – One on 15 December 2017.

Haven Care 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.

The home is registered to provide nursing and personal care and accommodation for up to 40 older people and people with disabilities. At the time of the inspection there were 27 people living at Haven Care Home. People had different health care needs. Some required continual nursing care due to complex health care needs; including end of life care. Other people needed support with personal care and assistance to move around the home safely due to frailty or medical conditions and some people were living with dementia.

The registered manager was present during the inspection. 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.

There were not enough permanent staff working in the home, which meant there was a reliance on agency staff, particularly agency nurses. This had a negative impact on the support and care provided; medicines were not given out as prescribed, there had been errors and safeguarding referrals had not been made in line with current guidance. This meant people may have been at risk of harm or injury.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The management and staff had attended training in the Mental Capacity Act 2005, Deprivation of Liberty Safeguards and safeguarding. They said they were aware of current guidance to ensure people were protected. However, not all staff had demonstrated a clear understanding of protecting people from harm and had restricted a person without following current guidelines. For example, a best interest meeting with appropriate health and social care professionals.

Care plans had been personalised, they identified people’s specific needs and included guidance for staff to follow and provide the care and support people needed. However, the information recorded was not consistent and had not been effectively reviewed by the nurses, due to the lack of permanent staff. Records showing the support and care staff offered daily had not been completed and did not accurately reflect the actual care provided.

HC - One quality assurance and monitoring system had not been set up at the time of the inspection and staff were unable to access policies and procedure at the home. Policies requested were available after the inspection and were sent to CQC. Following the inspection an improvement plan had been completed that identified areas where improvements were needed and what action would be taken to address them. These improvements would take time to implement and embed into practice.

Risk had been assessed and people were encouraged to be independent in a safe way, with the provision of walking aids and assistance from staff as required. Emergency procedures had been developed to support people if they had to leave the building; there were regular checks of the environment and staff followed the providers infection control policies with a cleaning schedule that ensured people were protected.

From August 2016 all organisations that provide NHS care or adult social care are legally required to follow the Accessible Information Standard. The standard aims to make sure that people who have a disability, impairment or sensory loss are provided with information that they can

Inspection areas

Safe

Requires improvement

Updated 7 August 2018

The service was not always safe.

There was a reliance on agency staff which meant there were not enough staff working in the home with the skills and understanding to meet people’s needs.

Medicines were not managed safely, which meant people were at risk of not receiving their prescribed medicines.

Staff had attended safeguarding training; but had not made referrals to the local authority in line with current guidance and people were not consistently safe.

Recruitment procedures were in place to ensure only suitable people were employed at the home.

Records showed regular checks had been completed to ensure the environment was safe.

Effective

Good

Updated 7 August 2018

The service was effective.

Staff said they had attended relevant training and management provided support through supervision and appraisals to ensure their practice was up to date.

Staff had completed training on the Mental Capacity Act and Deprivation of Liberty Safeguards and people were supported to make decisions about the care provided.

People were encouraged to have enough to eat and drink; choices were offered and people chose where they wanted to have their meals.

People were supported to maintain their health and wellbeing and referrals were made to health and social care professionals when needed.

Caring

Good

Updated 7 August 2018

The service was caring.

People were treated with respect and their privacy and dignity was protected.

Staff provided support based on people’s preferences and choices and asked for their consent before providing assistance in a kind and caring way.

People could have visitors at any time and relatives and friends were made to feel very welcome.

Responsive

Requires improvement

Updated 7 August 2018

The service was not consistently responsive.

Care plans contained personalised information about people’s needs and guidance for staff so that they understood them. However, the information was not consistent and care plans had not been reviewed and updated when required. Daily records did not reflect the care and support provided.

People’s needs had been assessed to ensure their needs could be met and people and their relatives were involved in planning and reviewing the care provided.

Activities were provided based on people’s preferences and staff respected people’s choices if they chose not to participate.

The complaints procedure was available to people and their relatives to use if they wished.

Well-led

Requires improvement

Updated 7 August 2018

The service was not consistently well-led.

The quality assurance and monitoring system had not assessed all of the services provided, additional work was needed to identify areas where improvements were needed and drive improvement.

Feedback about the service provided was consistently sought from people, relatives and staff.

Staff meetings had taken place to inform of any changes and encourage staff to put forward suggestions for improvement.

The provider had informed CQC of any incidents that may affected the provisions of services.