Haven Care Wirral Limited

Updated 14 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place because the service had been inspected in October 2016 and was rated as ‘Requires Improvement’. This inspection was to check that the issues identified in the 2016 inspection had been addressed. The inspection team consisted of an adult social care inspector and an ‘Expert by Experience’. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service,

The first day of this inspection took place on 06 and 07 December 2017 and was unannounced we rang relatives after the inspection. We made telephone calls to some of the people who used Haven Care support services and to some of the staff who supported following these visits. These calls had been agreed with the recipients, previously. We also visited several people who lived in the supported living service and the extra care service where Haven Care provided staff to support individuals within those settings.

Prior to the inspection, we checked with the local authority and also looked at our own records to see if there was any information we should consider during this inspection. We looked at the information the service had sent to us as ‘statutory notifications’. We had requested that the service submit a ‘Provider Information Return’ (PIR) which had been completed and sent to us in August 2017. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at the local Healthwatch website to see if they had recorded any concerns about the home.

During the inspection we visited and spoke with seven people who used the service in their own homes in all settings, with six people and eight relatives by telephone and with eight staff members face to face, including support staff, care coordinators, the registered manager/provider and the deputy manager. We also contacted and spoke with a further nine support staff by telephone. We looked at six people’s care records either as paper files or electronic files. We looked at the training and recruitment files for two recently recruited staff and two longer serving staff. We also checked records relating to the day-to-day running of the service, for example audit records and staff supervision files.

Updated 14 February 2018

The inspection was announced and site visits to the office and to people’s homes, were carried out on the 6 and 7 December 2017. We made telephone calls to some of the people who used Haven Care support services and to some of the staff who supported following these visits.

At our last inspection in October and November 2016, we found a breach of the Health and Social Care Act 2008 (Regulated Activities) 2014, relating to the use of systems and processes to assess, monitor and improve the quality and safety of care. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve the key question, ‘is the service well-led’, to at least good. At this inspection we found that the issues we had identified had been addressed and rectified.

However, at this inspection, we found that some statutory notifications had not been made to us in relation to some safeguarding concerns, which is a ratings limiter to the ‘well-led’ question. These concerns had though, been notified to the local authority.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community and supports people with a range of needs. The people whom it supports range from older to younger adults all of whom live in their own homes in either an individual domestic setting or in supported or extra care housing. Haven Care employs approximately 144 staff and supports approximately 130 people in these various settings in the community. These figures vary according to the needs of people needing support.

Supported housing provides care and support to people living in a ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support services.

Recently, some other providers had reduced or ceased trading and some of the people they were supporting were transferred to Haven Care. These were the people who lived in the supported living and extra care accommodation. Some of the usual staff who supported them had also transferred to Haven Care, which enabled continuity. The process is colloquially known as TUPE (or Transfer of Undertakings Protection of Employment). The new services which Haven Care provided were to a group supported living community and a service in an extra care housing service. The service to their original service users who lived in their own homes in an individual domestic setting in the community continued to be delivered.

The service requires a registered manager and there were two in post who had been there for several years. 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. One of the registered manager’s for Haven Care is also the provider of the service. The other registered manager was not available for the inspection.

At our previous inspection we found that audit and quality assurance systems were not robust. At this inspection we saw that improvements had been made in relation to these. The provider’s managers had completed spot checks on staff and care record and medication record audits. We found that the auditing and quality assurance processes had improved. The provider was also a registered manager of the service and there was another registered manager who was on long term leave at the time of our inspection. The provider and the other managers of the service (the deputy managers and the care coordinators of the teams) who we talked with, had an open, supportive, accountable and transparent relationship with people who used the service, and the staff. They also had a similar relationship and had had good partnership working, with various organisations.

Recruitment processes were robust which ensured the safe employment of suitable staff. There were sufficient staff to meet people’s needs but recruitment was continual, although the service had a good staff retention record.

Staff were being bought up to date with training although all had had either their previous employers training or that provided by Haven Care; supervisions had been increased and appraisals completed and planned. A schedule of training and supervision dates had been completed for the following year.

People were protected from the risk of abuse. All staff had completed training in safeguarding vulnerable adults, but some needed to be updated. They all knew how and to whom to report any concerns they may have This helped to ensure people’s safety.

People told us that positive relationships had been developed between them and staff. They told us staff were, “Lovely” and “Helpful”. One family member had written in a satisfaction survey, that staff made their relative laugh and other people told us they felt relaxed and at ease whilst being supported by staff.

People told us and we saw, that they were treated with dignity and respect. People told us that staff conducted themselves respectfully and left their homes clean and tidy.

People’s care records contained accurate and up-to-date information about their needs. People were involved in their care planning and their preferences and choices respected. Risk assessments were in place and provided information to staff around how to manage those risks presented to people. This helped ensure that staff had access to information about supporting people and how to keep them safe.

There were sufficient numbers of staff in post. People commented that staff usually arrived on time, or within an acceptable time frame. People confirmed that staff always turned up for their care call. Staff told us they had enough time to spend with people in order to support them and chat with them and did not feel stretched. They told us that travelling time was built in to their schedules and was separate from the call times.

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. This ensured that people’s rights were protected under the Mental Capacity Act 2005. At the time of this inspection there were no people subject to any restrictions.