The Haven Rest Home

Updated 15 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 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.

Service and service type

The Haven Rest Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Haven Rest Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 30 January 2023 and ended on 10 February 2023. We visited the service on 30 January and 3 February 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people and 6 relatives and we received written feedback from a further 4 relatives. We spoke with 12 staff members including; the registered manager, deputy manager and head of care, 5 care staff, 2 domestic staff the chef/maintenance staff member an administrator and the provider’s representative. We spoke with 1 external healthcare professional. We observed interactions between staff and people to help us understand the experience of people who could not talk with us.

We looked at the care records of 5 people and multiple medication records. We looked at 2 staff files in relation to recruitment and a variety of records relating to the management of the service. These included policies and procedures, records of accidents or incidents and quality assurance records. Following the inspection, the registered manager provided us with information to show the actions they had taken and other documents to support our inspection.

Updated 15 March 2023

About the service

The Haven Rest Home is a residential care home providing accommodation for up to 20 people in one adapted building. The service provides support to older people who may be living with dementia and/or a physical or sensory impairment. At the time of our inspection there were 18 people using the service.

People’s experience of using this service and what we found

People told us they were safely cared for. We found improvements were required to ensure risks to people had been assessed and plans were in place and followed to mitigate those risks. Not all safeguarding incidents had been referred to the local authority or notified to CQC. Not all recruitment checks were fully completed. Information to support the administration of ‘as required’ medicines’ was not always person centred with safe administration guidance for staff. The registered manager acted promptly on the concerns we raised during and following the inspection.

Consent for decisions about people’s care and treatment did not always follow guidance and the law. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not always support this practice.

A quality assurance system was in place; however, this had not been effective in identifying all the concerns we found. The registered person had failed to notify CQC without delay of all incidents as required in the regulations.

There were enough skilled and knowledgeable staff to support people safely. Procedures were in place to prevent and control the spread of infections.

People’s needs were assessed and reviewed, and they received the healthcare and nutritional support they required. The provider had made improvements to the environment which took account of the needs of people living with dementia.

People and relatives told us they would recommend the home to others. We saw the service had received compliments from people and relatives about the care they had received. The registered manager had made improvements at the service and this was acknowledged by staff, people and relatives.

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

Rating at last inspection

The last rating for this service was requires improvement (published 15 May 2019). At our last inspection we recommended the provider sought advice and guidance on checking the environment supported people living with dementia. At this inspection we found the provider had made some improvements. The service remains rated requires improvement.

Why we inspected

This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which were rated requires improvement at the last inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified breaches in relation to the need for consent in line with law and guidance and the notification of incidents to CQC.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.