About the service:

Haven Residential Care Home is a registered care home providing the regulated activity ‘Accommodation for people who require personal care or nursing care’. Haven Residential Care Home was registered to carry out the regulated activity to 30 people. During our inspection 29 people lived at Haven Residential Home.

What life is like for people using this service:

• There was a friendly, welcoming and homely atmosphere throughout the home. People had developed positive, trusting relationships with staff to help them feel safe. Robust systems ensured the safe management of medicines. Risk assessments were person centred and developed together with people.

• Support provided focused on people maximising choice and control over their lives. People were encouraged and supported to meet their identified goals and aspirations.

• People were supported by skilled and knowledgeable staff, who were committed to making a positive difference and impact every day to all people.

• Staff communicated well with others and we saw many positive examples of collaborative working with other professionals.

• Care was focused upon each person as an individual, with meaningful and purposeful activities based upon people's interests, goals and outcomes. People and their families felt listened to, involved, valued and empowered to change things. Technology was used extensively and individually to maintain and gain greater independence.

• The management team valued and inspired the staff. There was a clear set of values in the service and these formed the focus of shared purpose. There was shared professional admiration and respect for people, whatever their role in the service and a clear commitment to driving and improving quality.

• Leaders and managers of the home were clearly visible, fair, open and transparent and formed a sound basis for ensuring people's needs were met in an individualised and person-centred ethos.

• More information is in the full report

Rating at last inspection:

Good. The last report was published on 12 July 2016.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated as Good.

This inspection took place on 5 May 2016 and was unannounced. Haven Residential Care Home is a care home without nursing. The home is owned and operated by Sanctuary Care Limited. Haven Residential Care Home is registered to provide accommodation and care for up to thirty older people who may also have dementia. The home has a dementia unit.

At our last inspection on 9 September 2014 the service met the regulations inspected. There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People and their relatives informed us that they were satisfied with the care and services provided. On the day of our inspection we observed that people were well cared for and appropriately dressed. People using the service said that they felt safe in the home and around staff.

Relatives of people who used the service told us that they were confident that people were safe in the home.

Systems and processes were in place to help protect people from the risk of harm and staff demonstrated that they were aware of these. Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

Comprehensive risk assessments had been carried out and staff were aware of potential risks to people and how to protect people from harm. People's care needs and potential risks to them were assessed.

Staff prepared appropriate care plans to ensure that people received safe and appropriate care. Their healthcare needs were closely monitored and attended to. Staff were caring and knowledgeable regarding the individual choices and preferences of people.

On the day of the inspection we observed that there were sufficient numbers of staff to meet people's individual care needs. Staff did not appear to be rushed and were able to complete their tasks. However some people and relatives we spoke with told us that there was not enough staff in the home. We spoke with the registered manager and were informed that the staffing levels were reviewed using the organisation's dependency assessment tool and the home had sufficient staff deployed to meet the needs of people. The registered manager also told us they had bank staff who knew the home and people well and were able to help if needed. The registered manager was also on call at all times.

Systems were in place to make sure people received their medicines safely. Arrangements were in place for the recording of medicines received into the home and for their storage, administration and disposal.

We found the premises were clean and tidy and there were no unpleasant odours. There was a record of essential inspections and maintenance carried out. The service had an infection control policy and measures were in place for infection control.

Staff had been carefully recruited and provided with induction and training to enable them to care effectively for people. They had the necessary support, supervision and appraisals from management.

People's health and social care needs had been appropriately assessed. Care plans were person-centred, detailed and specific to each person and their needs. Care preferences were documented and staff we spoke with were aware of people's likes and dislikes.

People told us that they received care, support and treatment when they required it. Care plans were reviewed monthly by staff and were updated when people's needs changed.

Staff we spoke with had an understanding of the principles of the Mental Capacity Act (MCA 2005). Capacity to make specific decisions was recorded in people's care plans.

The CQC is required by law to monitor the operation of the Deprivation of Liberty

We carried out an inspection on the 12th and 13th November 2013 and found the provider in breach of Regulation 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The registered person had not demonstrated that they had taken appropriate steps to ensure that at all times there were sufficient qualified, skilled and experienced staff on duty to safeguard the health, safety and welfare of people who used the service.

The purpose of our inspection on the 9th September 2014 was to assess compliance with Regulation 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We found from checking records, talking to seven people who used the service, two team leaders, six care staff and the registered manager that the registered person had taken appropriate steps to ensure that there were sufficient staff with appropriate skills to meet the needs and safeguard the health, safety and welfare of people who used the service.

During our inspection, we spoke with four people who used the service, one relative and six members of staff.

Overall, people who used the service were positive about the care provided. One person said ‘the home is pleasant and staff are helpful’.

We observed that people who used the service appeared to be happy and comfortable and the atmosphere at the home was relaxed.

Care records contained information about people’s healthcare needs and documented their preferences.

During our inspection we observed that there was a lack of dementia specific activities for people.

Staff demonstrated that they were aware of what action to take when responding to allegations or incidents of abuse and they had received training in safeguarding people.

We observed that the home was clean and welcoming. People’s bedrooms had been individually personalised.

We noted that the staff rota was not accurate and did not correctly reflect all the staff on duty during both days of our inspection. Staff we spoke with also indicated that they felt that there were not sufficient numbers of staff on duty during the day.

We observed that the majority of records were accurate and up to date. However, we saw that risk assessments had not recently been reviewed and also noted that activity logs were incomplete.