About the service:

Haven Rose Residential Care Home is situated in a residential area of Southampton and provides accommodation and care for up to 16 people living with dementia or enduring mental health needs. At the time of our inspection there were 14 people living at the home.

People’s experience of using this service:

People received safe care and support living at Haven Rose. This was because the staff had received training in safeguarding adults and the service worked with health care professionals in meeting goals agreed and developed with people. The registered manager had also taken steps to maintain a safe environment for people.

The service employed sufficient numbers of staff to meet people’s assessed needs and the staff employed had been subject to robust recruitment procedures. Staff received appropriate training and supervision to support them in working with people living at the home.

Medicines were managed safely with staff receiving appropriate training.

People’s needs had been assessed and care plans developed with people’s consent.

The service was working within and meeting the requirements of the Mental Capacity Act 2005 . People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s dietary needs were met and people were encouraged to lead healthy lives.

People told us the staff were supportive, kind and respectful of their right to privacy and dignity. Many of the people had lived at Haven Rose for many years and had built positive relationships not only with the staff but with each other .

People were encouraged to go out and be involved in the local community.

The home was well led with good leadership from the registered manager.

Rating at last inspection:

The home was last inspected in August 2016, when it was rated as good .

Why we inspected:

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This unannounced inspection was carried out on the 05 July 2016. Haven Rose provides accommodation and support for up to 16 older people with mental health needs or living with dementia. At the time of our inspection there were 13 people living at the home.

The home had a registered manager who has been registered since December 2010. 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.

People felt safe living at Haven Rose and they were very much at the heart of the service. The risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies.

Relevant recruitment checks were conducted before staff started working at Haven Rose to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.

People were supported to take their medicines safely from suitably trained staff. People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and went out of their way to provide people with what they wanted.

Staff received regular support and one to one sessions of supervision to discuss areas of development. They completed a wide range of training and felt it supported them in their job role.

Staff sought consent from people before providing care and support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully.

People were cared for with kindness, compassion and sensitivity. Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

People were supported and encouraged to make choices and had access to a range of activities. Staff knew what was important to people and encouraged them to be as independent as possible. ‘Residents meetings’ and surveys allowed people to provide feedback, which was used to improve the service.

A complaints procedure was in place. There were appropriate management arrangements in place and staff felt supported. Regular audits of the service were carried out to assess and monitor the quality of the service.

An adult social care inspector carried out the inspection. We considered all the evidence we had gathered under the outcomes we inspected. We looked at consents, care and welfare of people, safeguarding adults, medicines management, staffing and assessing the quality of the service. We spoke with seven people, four staff and the manager. We used the information to answer the five questions we always ask ;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led

This is a summary of what we found.

Is the service safe?

The service was providing safe care. People told us they received help when they needed it and the staff treated them with “kindness “and were “very caring” whenever they needed help. A person said the staff “are very good to you and help you”. Another person told us they felt “very safe” and they had lived at the home for a number of years. Staff told us they had adequate time to provide care and they were supported to attend training and updates. The staff were knowledgeable about the people’s needs and support they required.

We found the service had systems in place to ensure people were protected from the risk of abuse. Staff had completed training in safeguarding vulnerable adults as part of their induction. The home was clean and staff followed their procedure for the control of infection. There were arrangements in place to manage people’s medicines and to ensure these were administered safely.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The manager told us there was no one under this safeguard who was receiving care at the time of our inspection. Staff were aware of people’s rights to make choices and people were supported to be involved in their care.

Is the service effective?

The service was effective. We found care plans included risk assessments were completed and these were relevant to the person. We saw specific action required was developed to manage risks. People we spoke with were complimentary about the care and support they received. Support plans showed people’s needs were assessed and clear information was provided for the staff. This included appropriate support with food and fluids and pressure risks management. Specific equipment was in place to support people and to maintain their independence.

Is the service caring?

We noted people were supported in a caring and compassionate way. Staff and people using the service had developed good relationship and people were treated with respect. People were complimentary about the staff and the manager who was involved in their care.

Is the service responsive?

The service was responsive to people’s changing needs and took appropriate actions. People said they were “very satisfied” with the care and support they were receiving. We saw people were able to access external healthcare facilities as needed. People had opportunities to express their views and a person told us the manager “listens to what we have to say”.

Is the service well-led?

Systems were in place to regularly assess and monitor the quality of service provided. Risks were assessed and appropriate action plans were in place. People’s views were sought through satisfaction surveys and action plan developed to address any issues as needed.

People who use the service were sat in different areas of the home. There was one lounge, a conservatory and a dining area where people were sat during our visit. The home also had a designated area for residents to sit and smoke if they wished. We talked to three residents about some of the outcomes we looked at during the inspection visit. People told us that the home was ok, ‘better than some places’. One person told us that they were able to go out most days on their own for a walk.

People we spoke to told us they were well looked after and the food was good. They told us that they did not have any concerns or complaints but would raise these with the staff or the manager if they did.

All the people who use the service we spoke with enjoyed the food and felt they had plenty of choice. One person told us that if they did not like what was on the menu that day they could request something else and it would be provided for them.

One person told us that they could go to bed when they liked and could have a ‘lie in’ in the mornings.

This inspection took place on 14 and 15 May 2015 and was unannounced. Haven Rose provides accommodation and care for up to 16 older people with mental health needs or people living with dementia. At the time of our inspection there were 15 people living at the home.

The home had a registered manager who has been registered since December 2010. 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.

We found people’s safety was compromised in some areas. Infection control guidance issued by the Department of Health (DoH) was not followed and the risks of cross infection were not managed effectively. There was no hand washing sink available in the staff toilet or the laundry. The recommended process for dealing with soiled linen, using soluble bags, was not used.

Risk assessments had been completed for the environment and safety checks were conducted regularly of gas and electrical equipment. However, three windows on the first floor of the home did not have restrictors in place and could be opened fully. The risks with respect to the windows had not been assessed. They could be accessed easily and presented a potential risk to people.

People felt safe. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. Incidents of potential conflict between people were dealt with effectively and recorded appropriately. However, we had not been informed of two incidents where a person had had physical altercations with two other people living at the home.

People were supported to receive their medicines safely from suitably trained staff. There were enough staff to meet people’s needs. They were well organised and attended to people quickly. Relevant checks were conducted before staff started working at Haven Rose to make sure staff were of good character and had the necessary skills. Staff received regular supervision and support where they could discuss their training and development needs.

Staff sought consent from people before providing care or support. The ability of people to make decisions was assessed in line with legal requirements to ensure their liberty was not restricted unlawfully. Decisions were taken in the best interests of people.

People received varied and nutritious meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and offered alternatives if people did not want the menu of the day.

People were cared for with kindness, compassion and sensitivity. We observed positive interactions between people and staff. Staff members knew about people’s lives and backgrounds and used this information to support them effectively.

People and their families were involved in assessing, planning and agreeing the care and support they received. People were encouraged to remain as independent as possible. Their privacy and dignity was protected.

Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

People were supported and encouraged to make choices and had access to a wide range of activities tailored to their specific interests. ‘Residents meetings’ and surveys allowed people to provide feedback, which was used to improve the service.

People liked living at the home and felt it was well-led. There was an open and transparent culture with people able to access the community as part of their daily activities. There were appropriate management arrangements in place and staff and people told us they were encouraged to talk to the manager about any concerns. Regular audits of the service were carried out to assess and monitor the quality of the service.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and one breach of the Care Quality Commission (Registration) Regulations 2009.

You can see what action we have told the provider to take at the back of the full version of the report.