Haviland House is a purpose-built nursing home registered to provide accommodation and nursing care for up to 63 people with a range of care and nursing needs This includes people living with dementia. At the time of our inspection, 59 people were accommodated at the home. Haviland House is divided into five suites (known as ‘households’): Angmering, Bramber, Clapham, Durrington and Elmer. Angmering, Bramber and Durrington households cater for up to 13 people and Clapham and Elmer for up to 12 people. Each household caters for a different stage of the dementia journey. Each suite has a separate sitting room, dining area/room and kitchenette. There is a variety of communal areas within the home for people to access, including gardens. All bedrooms have en-suite facilities.

Staff have different roles such as ‘house leaders’ who are in charge of the shift, management of care plans and risk assessment reviews. Staff who are ‘home makers’ ensure that people’s care and support needs are met in a personalised way, together with other care staff. People are known as ‘family members’.

At our last inspection we rated the service as ‘Good’ overall. We made a Recommendation in relation to staff supervisions and appraisals. We rated the key question of ‘Effective’ as ‘Requires Improvement’. At this inspection, we found that improvements had been made and this key question has improved to ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained ‘Good’.

People received an exceptional standard and quality of care that was personalised to meet their individual needs. The ethos of the home was one that put people at the heart of the service. The provider had sought advice from a number of professionals and organisations who were expert in the field of dementia. They had looked at the advice and applied it to all areas of the home, thus improving the lives of people living with dementia. People’s care was based on what was proved to be best practice in the field by these professionals and organisations resulting in an outstanding level of care. Great care and time had been taken with activities that were organised specifically around people’s interests, rather than being structured. Staff knew people extremely well and went out of their way to ensure that people led meaningful lives. End of life care supported people’s individual needs and preferences in a person-centred way.

People said they felt safe living at the home and relatives commented on the safe environment. Staff had been trained to recognise the signs of potential abuse and knew what action to take if they had any concerns. There were sufficient numbers of staff on duty to meet people’s needs. New staff were recruited safely. Medicines were managed appropriately and in line with good practice. The home was clean and odour-free. Lessons were learned by staff and improvements made when things went wrong.

Staff had completed essential training and received regular supervisions to enable them to provide care and support to people effectively. People were offered a choice of food at mealtimes and specialist diets were catered for. People had access to a range of healthcare professionals and services. An environment had been created that people living with dementia could understand and access easily. 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 were cared for by kind and friendly staff who were empathic to their needs. People were encouraged t

The inspection took place on 12 September 2017 and was unannounced.

The last inspection took place on 9 August 2016. As a result of this inspection, we found the provider in breach of Rregulation 18 (Staffing). We asked the provider to submit an action plan on how they would address this breach. An action plan was submitted by the provider which identified the steps that would be taken. At this inspection, we found the provider and registered manager had taken appropriate action and this regulation had been met. As a result, the overall rating for this service has improved from 'Requires Improvement’ to ‘Good’.

Haviland house is a purpose-built nursing home registered to provide accommodation and nursing care for up to 60 people with a range of care and nursing needs, including people living with dementia. At the time of our inspection, 58 people were living at the home. Haviland House is divided into five suites (known as ‘households’): Angmering, Bramber, Clapham, Durrington and Elmer. Each suite caters for up to 12 people who are at different stages on their dementia journey. For example, people accommodated in Clapham are living with more advanced dementia and are less able to communicate verbally. Staff have different roles such as ‘house leaders’ who are in charge of the shift, management of care plans and risk assessment reviews. Staff who are ‘home makers’ ensure that people’s care and support needs are met in a personalised way, together with other care staff. People are known as ‘family members’. Each suite has a separate sitting room, dining area/room and kitchenette. There is a variety of communal areas within the home for people to access, including gardens. All bedrooms have en-suite facilities.

A registered manager was in post. 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.

Staffing levels were assessed based on people’s care and support needs. Following the last inspection, the provider put plans in place to ensure that staff were allocated to each suite based on people's assessed care and support needs. Staff were on duty within each suite of the home and two registered nurses were on duty during the day and one at night. At the time of our inspection, agency staff were employed to cover any gaps in staffing. Staffing levels were sufficient and people’s needs were met promptly. Safe recruitment practices were in place. People felt safe living at the home. Staff had been trained to recognise the signs of abuse and knew what action to take. People’s risks had been identified and assessed appropriately and guidance was in place for staff on how to mitigate risks. Premises and equipment were checked regularly and emergency evacuation plans were in place should people need to leave the building in the event of an emergency. Medicines were managed safely.

We have made a recommendation to the provider about staff supervisions. Not all staff had received regular supervisions in 2017 and the registered manager looked into this issue following our inspection. Some valid reasons had been provided where supervisions had not taken place, however, 13 staff had not completed supervisions recently. This had not impacted on the care people received. Staff meetings took place and some were used as group supervisions for staff. Staff had completed a range of training considered essential to carry out their responsibilities in line with their job role. Staff had also completed training on mental capacity and associated legislation and put what they had learned into practice. Catering at the home was managed by an external contractor which the provider had employed. People had a choice of what to eat at meal

The inspection took place on 9 and 10 August 2016 and was unannounced.

Haviland House is a home registered to provide nursing and residential care for up to 60 people with a variety of health needs, including people living with dementia. At the time of our inspection, 57 people were living at the home. Haviland House is a modern, purpose-built nursing home situated within a residential estate to the west of Worthing. The home comprises five x 12 bedded suites housed on the ground, first and second floors: Angmering, Bramber, Clapham, Durrington and Elmer. Each suite has two separate living rooms, a dining room with kitchenette, assisted bathroom and all rooms are of single occupancy with en suite facilities. Gardens are well maintained and provide seats and shady areas for people to enjoy.

At the time of our inspection, there was no registered manager in post. The acting manager was due to be replaced by a permanent manager when their employment commenced on 5 September 2016. 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.

At times, staff were not deployed flexibly to meet people’s needs in some parts of the home which placed people at potential risk. Gaps within staffing rotas were filled by agency staff. Staff felt that staffing levels were an issue and the management team was aware of this; new staff were being recruited. Only a small number of staff had received training on the Mental Capacity Act 2005. We have made a recommendation to the provider that all care staff should be trained to understand their responsibilities under this legislation. Staff had been trained in all essential areas and received supervision as needed, although the regularity of 1:1 meetings had slipped recently. Group supervisions and staff meetings took place. New staff studied for the Care Certificate, a universally recognised qualification.

People were supported to have sufficient to eat and drink and their risk of malnourishment had been assessed. Catering was provided by an external organisation. Some staff were not always sensitive to people’s assessed needs and risks during the lunchtime periods we observed at inspection. Some staff displayed a lack of empathy when discussing people’s needs with other staff. However, the majority of staff were kind, understanding and supportive of people and treated them with dignity and respect. People had access to healthcare services and professionals. Care plans were detailed and provided comprehensive advice and guidance to staff on how to meet people’s needs and preferences.

People’s risks had been identified, assessed and were managed appropriately. Arrangements were in place, and staff were trained on the action to take, in the event of an emergency such as fire. People’s medicines were managed so they received them safely. A number of safeguarding concerns had been raised recently and the provider was working collaboratively with the local safeguarding authority to ensure these were investigated thoroughly and managed appropriately.

The environment at Haviland House had been designed to meet the needs of people living with dementia and to provide stimulation and a homely atmosphere. However, we observed one area of the home which the provider had also identified as an area for improvement in a corridor on one suite. Some activities had been organised for people in parts of the home, but overall, during the inspection period, there was a lack of regular, inspiring activities to engage with people. The provider was in the process of recruiting staff who would oversee people’s health and well-being and who would provide a person-centred approach, based on people’s preferences, hobbie