Haven Care Home

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 Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The culture of the service was positive and one where learning was part of everyday practice. The registered manager and management team were available and approachable to staff, people and families. A relative said, “Excellent communication from the manager and team.”

Staff explained that the registered manager and their colleagues helped them learn and improve practice when things went wrong. For example, lessons learnt were discussed in staff meetings, supervisions and daily handovers.

The management team told us they investigated accidents/incident events and had learnt from these. They gave an example of improvements they had made around people who experienced repeated falls, such as, sensor mats. One person had an unwitnessed fall despite the use of a sensor, so it was discussed with all staff to review whether the sensor mat is still the most effective intervention or whether additional measures were needed. They also demonstrated how they used root cause analysis to monitor skin tears and pressure damage to prevent re-occurrences. An example of this was monitoring pressure relieving equipment and mobility aids, such as hoist slings to ensure they were the correct size and in good working repair.

Safety concerns and events were thoroughly investigated and reported on, and lessons were learned to embed good practices. The provider told us they used learning from accidents/incidents at other services within the group to improve oversight of care and ensure people's continued safety. The service had a service improvement plan in place which detailed plans for ongoing improvements.

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.

The management team worked with other health and social care professionals to make sure that people transitioned into the service smoothly. People moved on from the service only when they themselves chose to move, sometimes to be closer to loved ones or if the service could no longer meet their needs.

The registered manager told us they held meetings to discuss people’s changing support needs with the appropriate health professional and where appropriate the hospice team. People were only moved if they could not continue to be supported safely at the service. Staff told us of meetings that took place when there were concerns about needs being met or a person became unhappy or anxious. These meetings involved relatives and all necessary professionals and made sure that the best outcomes were achieved for people.

People told us they were supported with transitions and moves. A person said, “Staff came to see me, and it went ahead.” A visitor told us, “Amazing staff, 10/10, so supportive, things changed for my loved ones and the staff worked with us so that coming to Haven was done smoothly, took so much stress off us, it also helped with the grieving and not having to worry about my loved alone at home.”

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.

There were organisational procedures for safeguarding people. These provided guidance about the action to take if staff had concerns about the welfare of people. Training records showed staff had completed safeguarding training. There was a system in place for recording safeguarding concerns which helped management have oversight over this. The registered manager had appropriately made safeguarding referrals to the local authority when required.

Our observations found that people were comfortable with staff, we saw positive interactions, that assured us they felt safe and could approach staff. People and their relatives told us that Haven Care Home was safe. One person said, "I like it here, everybody is lovely, they look after me.” Relatives' comments included, “I really don’t have any worries, I visit regularly, at least twice a week, I feel I can approach any of the staff for help or to answer any queries.”

Staff were aware of the signs of abuse and how to report safeguarding concerns. Staff confirmed that they had read the policies as part of their induction and refreshed at yearly safeguarding training. They were confident the management team would address any concerns regarding people’s safety and well-being and make the required referrals to the local authority. Staff had a good knowledge of whistleblowing procedures and would use them if they felt their concerns had been ignored.

One staff member said," I would discuss with my team and take it to management, we get training, the training is very good, informative.” Another said, "Direct communication with my team, inform the senior, and they will communicate with manager and record on the care plan."

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. The documentation supported that each DoLS application was decision specific for that person. For example, regarding restrictive practices such as bed rails, sensor mats and locked doors. We saw that the conditions of the DoLS had been met.

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.

There were organisational procedures for safeguarding people. These provided guidance about the action to take if staff had concerns about the welfare of people. Training records showed staff had completed safeguarding training. There was a system in place for recording safeguarding concerns which helped management have oversight over this. The registered manager had appropriately made safeguarding referrals to the local authority when required.

Our observations found that people were comfortable with staff, we saw positive interactions, that assured us they felt safe and could approach staff. People and their relatives told us that Haven Care Home was safe. One person said, "I like it here, everybody is lovely, they look after me.” Relatives' comments included, “I really don’t have any worries, I visit regularly, at least twice a week, I feel I can approach any of the staff for help or to answer any queries.”

Staff were aware of the signs of abuse and how to report safeguarding concerns. Staff confirmed that they had read the policies as part of their induction and refreshed at yearly safeguarding training. They were confident the management team would address any concerns regarding people’s safety and well-being and make the required referrals to the local authority. Staff had a good knowledge of whistleblowing procedures and would use them if they felt their concerns had been ignored. One staff member said," I would discuss with my team and take it to management, we get training, the training is very good, informative.” Another said, "Direct communication with my team, inform the senior, and they will communicate with manager and record on the care plan."

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. The documentation supported that each DoLS application was decision specific for that person. For example, regarding restrictive practices such as bed rails, sensor mats and locked doors. We saw that the conditions of the DoLS had been met.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care. Before admission, consideration was given to peoples’ mobility and mobility aids required to ensure they could meet people’s needs safety. People had easy access to both internal and external spaces which were safe and promoted independence.

The environment was safe and well cared for. Care equipment was in good working order and documentation to support regular servicing was seen. There was no clutter, and the home was accessible for people with mobility needs and safe for those who like to walk.
Processes had ensured the environment was safe and well kept. Health and safety checks had been undertaken to ensure safe management of the home. There was a business continuity plan which instructed staff on what to do in the event of the service not being able to function normally, such as a loss of power or evacuation of the property. There were detailed fire risk assessments, which covered all areas in the home and each person had a personal emergency evacuation plan in place. Premises risk assessments and health and safety assessments were reviewed on an annual basis.

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.

The staffing levels were based on peoples’ needs and regularly reviewed. We looked at 3 months of rotas, and the staffing levels were consistent and supported by relief staff to cover vacant positions, sickness and holidays. Staff numbers and the deployment of staff had ensured people’s needs were met in a way that met their preferences. Care delivery was supported by records that evidenced that people’s care needs were being met.

Our observations showed us that staff were visible and available to support people’s requests for help and took the time to sit with people, to assist them with food and drink if necessary. People received timely care, and call bells were mostly answered promptly. People did not have any concerns regarding staff numbers. People told us, “Always quick to respond, sometimes breakfast is slow, but it’s always hot,” and “The staff are quick to answer my bell, I get supported and they don’t rush me, so I think the staffing levels are good.”
Staff were recruited safely. The provider undertook checks on new staff before they started work. This included checking their identity, their eligibility to work in the UK, obtaining at least two references from previous employers and Disclosure and Barring Service (DBS) checks. The DBS helps employers make safer recruitment decisions and prevent unsuitable people from working with people. Registered nurses have a unique registration code called a PIN. This tells the provider that they are fit to practice as nurses. Before employment, checks were made to ensure the PIN was current with no restrictions.

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 premises provided people with a clean, and well-maintained environment. People’s rooms were cleaned regularly by housekeeping staff and people commented positively, with no-one reporting any problems with the standard of cleanliness of the environment and equipment.

People told us, “Always clean, never any odours,” and “They (housekeepers) are good.” Visitors told us the home was clean and well maintained. A visitor said, "Well-kept, clean and welcoming." Staff told us they are well resourced for cleaning and infection control was well managed. One said, “Personal protective equipment (PPE) is not an issue, we have enough and also cleaning products and equipment.”

We saw housekeeping staff undertaking cleaning in all parts of the home. People’s laundry was managed well. The laundry room was clean and well organised, and people were well dressed.
Housekeeping staff understood their role and followed appropriate procedures to keep the home clean. All staff understood their responsibility to reduce the risk of infection and followed infection control guidance. There were posters and training to assist staff in keeping up to date with any changes to infection control measures. Audits were completed to ensure compliance with the procedures and policies of the home. Staff were trained in the use of PPE and of the importance of good hygiene practice.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

The service made sure that medicines and treatments were safe and met people’s needs, and preferences. Staff supported and involved people to manage their medicines and followed best practice for administering medicines. One person told us, “I manage my medicine, staff support me by ordering and storing it in the fridge, but I do the rest, my choice.” Staff documented medicines clearly in care plans and made sure medicines accompanied the person between healthcare settings.

Not everyone could share their experiences regarding medication, but one person said, “I rely on the staff to give me my medicine and trust them to keep me informed of changes.” One family member we spoke with said, “I don’t have any worries, he gets all his medicines”

The management of medicines were organised, with minimal extra stock and all medicines no longer required were managed safely and returned as per their policies.

Staff who gave medicines had the relevant knowledge, training and competency that ensured medicines were handled safely. We observed staff giving medicines safely and that they were recorded accurately on the electronic medicine administration record . All discrepancies and medicine errors were recorded and investigated and action taken as required. Daily and monthly audits were carried out, and any shortfalls were addressed. Protocols for ‘as required’ (PRN) medicines such as pain relief medicines were in place however, some lacked personalisation and not everybody had a pain chart that could track effectiveness of the PRN medication, this included just in case medicines used for end-of-life care. This was fully discussed during the assessment. The registered manager has confirmed that the GP will be working with the staff regarding PRN directives