Little Haven provides accommodation, personal care and nursing treatment for up to 43 older people. There were 39 people living in the home at the time of this inspection.

This inspection took place on 6 July 2017 and was unannounced.

At the last inspection on 3 and 4 February 2016 the service was rated Good. At this inspection we found the service remained Good.

This inspection was brought forward from the planned date due to concerns about how the registered provider was monitoring the safe management of medicines.

There were systems and processes in place to protect people from harm. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team.

Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.

Following concerns we had received since the last inspection, the medicines management procedures had recently been improved through increased monitoring and staff vigilance.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people in a patient and friendly manner.

Staff developed caring and positive relationships with people, were sensitive to their individual choices and treated them with dignity and respect. People and their families were supported to express their views and be involved in making decisions about their care and support.

The service was responsive to people’s needs and staff listened to what they said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People were confident that any concerns or complaints they raised would be dealt with.

People living in the home and staff spoke positively about how the service was managed. There was an open and inclusive culture within the service. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate care and support.

Further information is in the detailed findings below.

During this follow up inspection we found that the provider had completed the actions it had planned to meet essential standards.

Records were securely stored and were up to date and accurately maintained in relation to the care and treatment provided.

There were sufficient numbers of suitably qualified, skilled and experienced persons employed.

We visited this service because we had been made aware of some concerns about staffing levels. People that we spoke with were very complimentary about staff and about the care that they received. Staff we spoke with all demonstrated a very strong commitment to providing a good service and said that they worked well as a team. However, we found that there were not always sufficient staff on duty with suitable experience to meet peoples' collective needs.We also found that some records did not accurately reflect people's care and treatment.

During the visit we spoke with eight people who used the service. People told us they were well treated by members of staff and said they were polite and respectful. We asked six people about their care plans which they were not aware of. However, people said staff provided care in the way that they requested such as with mobility, personal care, and choosing where to spend time. None of the people we spoke with raised any concerns about the way they were treated. Comments included that the service was “perfect”, that help was available when “needed” and there were “no complaints.”

Most people we spoke with said they thought there were sufficient numbers of staff available when they needed them. People gave examples of staff usually responding promptly when they used their call bell. People told us that members of staff would explain if they were busy and they would return to help later. Comments from staff however, indicated that staffing levels sometimes meant they could not always spend the time needed to talk with people.

This inspection took place on 3 and 4 February 2016 and was unannounced.

At the last inspection on 2 May 2013 we found the service complied with all of the regulations we inspected.

Little Haven provides accommodation, personal care and nursing treatment for up to 43 older people. There were 37 people using the service at the time of this inspection.

The service did not have a registered manager. 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. The registered manager had resigned a short time before this inspection and an interim manager was overseeing the day to day management of the service.

The provider had made significant improvements to the governance arrangements in place. A range of audits were undertaken to assess and monitor the quality and safety of the service. These needed to be embedded and sustained to ensure that they continued to drive improvements.

There were systems and processes in place to protect people from harm. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns.

Medicines were managed safely as the staff responsible for administering people’s medicines were suitably trained and competent.

There were sufficient numbers of staff to meet people’s needs. Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home.

Staff were supported to carry out their roles and received an induction and ongoing training and supervision. Staff were kind and caring and worked in a manner that respected people’s privacy and protected their dignity.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations were in place or had been applied for.

People received on-going health checks and support to access healthcare services. They were supported to eat and drink enough to meet their needs.

People were confident they could raise concerns or complaints and that these would be dealt with.

There was a positive and open culture within the service, which encouraged people’s involvement and their feedback was used to drive improvements.