A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. We also spoke to a Community Psychiatric Nurse and a Care Manager.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. The accommodation had been well maintained and was clean. A member of the management team was available on call in case of emergencies.

Staff training records showed that staff had undertaken training relevant to their role. This meant the provider could demonstrate that the staff employed to work at the home were suitable and had the skills and experience needed to support the people living in the home.

Staff demonstrated an extensive knowledge of the policies and procedures of the home and how they would respond to different emergencies. There was an effective security system installed which meant that staff were able to monitor people coming and going from the building.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people’s care and support needs and that they had developed a trusting relationship with them. One person who used the service told us “I have the Haven to thank for getting me to focus on recovery. Without their help, I would be done in.” Staff had received training to meet the needs of the people living at the home and were equipped to deal with the complexities of behaviours presented. A Care Manager whom we spoke to told us “They do a fine job supporting my client who is very challenging. Their family is also very happy with the service as staff are always so accommodating.”

Is the service caring?

People were supported by dedicated and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. We observed how staff engaged with those who used the service and treated them with respect. We noted that at lunchtime, support workers moved from table to table, engaging in conversation with those who used the service. A volunteer told us “It is a very positive experience being here. It is obvious to me that people are treated with a lot of respect.” We saw in one record of a person who used the service who had severe memory impairment how special efforts were made to ensure that they did not forget to attend medical appointments. A person who used the service told us how “The staff always have a kind word. I can have a good laugh with them.”

Is the service responsive?

People’s needs had been assessed before they moved into the home. People told us they met with their key workers once a month to discuss what was important to them. We were also told that “My keyworker will meet with me in-between times if I need to see them. They will always do what they say they will do, for example help me to buy equipment for my room.” Records confirmed people’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their needs. People had access to activities that were important to them and had been supported to maintain relationships where possible. A member of staff told us that “Re-establishing family contact is a big thing here.” The registered manager told us “It is all about small steps at the Haven, according to each individual’s ability and wish.”

Is the service well-led?

Staff had a good understanding of the ethos of the home and robust quality assurance processes were in place. People told us they were asked for their views on the service they received and that they had also filled in a customer satisfaction survey, with support from a person who was not a member of staff. They confirmed they had been listened to and as a result of the survey changes to the menu had been made and increased activities had been introduced. Staff told us they were clear about their roles and responsibilities. They attributed this to "a good induction schedule, a robust training programme and a management team that was always available to lend support and advice.” They said someone from the senior management team was always on call and that the manager was very “hands-on and approachable.”

The home was clean, warm and had a relaxed and friendly atmosphere. There were three members of staff and the manager on duty when we arrived for this inspection. All the people living at the home and the cook were also present.

We talked to three people using the service and observed many others in the lounge and dining room. We also observed and spoke to staff, a visitor, and examined the records kept at the home. We noted that staff treated people using the service with respect and dignity. We saw that people could make drinks and snacks when they needed. Each person using the service had a programmed ‘fob’ (key) which the used for accessing communal areas and their bedrooms.

People told us they were happy living at the home. They said they could talk to staff and they felt staff listened to them. They said they were treated with respect and they could choose meals that reflected their individual, cultural and dietary needs.

We do not currently rate independent standalone substance misuse services.

We found we found the following areas of good practice:

• With the exception of the clinic room, the environment was visibly clean and well maintained. Housekeeping staff attended the service on a daily basis and cleaned clients' rooms during the week.

• The risk assessments we reviewed were detailed and informative. The service mitigated and recorded risk well.

• Staff received feedback from incidents and attended reflective practice sessions. A psychologist facilitated the sessions externally.

• Assessments we reviewed were detailed and comprehensive. Information included the clients’ social history, family history, drinking history, previous contact with alcohol services, history of drug use, previous convictions and criminal proceedings.

• Care plans were comprehensive and personalised.

• Staff attended in-house training sessions and externally facilitated training at team away days. Examples of training included working with change resistant drinkers and assertiveness skills.

• Staff had access to specialist training. One member of staff was about to begin cognitive behavioural therapy (CBT) training.

• We observed staff to be caring and thoughtful in their approach with clients.

• The care plans we reviewed demonstrated attempts by staff to engage clients with their families.

• The service had clear admission criteria.

However we found the following issues that the service provider needs to improve:

• Medicines were not stored at a safe temperature and staff were unaware of recommended temperature ranges for fridges. Instructions for administration of medication on some medical administration records were unclear and staff did not demonstrate a good understanding of directions.

• The service did not have efficient governance processes to ensure the management of medication was safe.

• Staff were not up to date in two modules of mandatory training. Twenty five percent of staff had not completed training in food hygiene training and in managing challenging behaviour.

• Staff did not demonstrate a sound understanding of safeguarding adults. Safeguarding training was not mandatory and some staff said they had not received any safeguarding training since beginning employment. The service did not offer safeguarding children training to staff. The manager told us children were not allowed on the premises unless supervised, however, clients may have contact with children either through family and friends or in the community.

• When asked about the risks of alcohol intoxication to clients, staff highlighted the risk of withdrawal. Staff described signs that would indicate a resident was experiencing alcohol withdrawal. However staff did not demonstrate how they would monitor or manage the risk.