Haviland House

Updated 13 January 2022

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 Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by three inspectors, one of whom was a medicines inspector.

Service and service type

Haviland House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service which included concerns raised. We looked at statutory notifications which the registered manager is required to send to us by law. We sought feedback from the local authority and professionals who work with the service, including safeguarding investigations which were in progress. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with six people and two relatives about their experience of the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the chief executive of the provider who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the registered manager, the director of quality and care home operations, five care staff and the housekeeping manager.

We reviewed a range of records including ten care plans and multiple medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 13 January 2022

About the service

Haviland House is a residential care home providing personal and nursing care to 35 people living with dementia and other health conditions at the time of the inspection. The service can support up to 67 people.

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

Risks to people, including management of particular health conditions, had not always been fully assessed with guidance and information for staff on how to support people safely. There were gaps in the recording of the application of topical creams in some of the medication records reviewed.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policy and systems in the service did not always ensure consent was gained lawfully. The use of recliner chairs for some people was a form of restraint, but people had either not been asked for their consent or best interests decisions had not been taken in the use of these chairs. We have made a recommendation to the provider with regard to gaining consent.

Some improvements had been made since the last inspection, but further work was required such as the review of people’s care plans and risk assessments. Issues we found at inspection had not been identified by the provider’s auditing systems.

People told us they felt safe living at Haviland House. One person said, “Oh yes, I do feel safe and secure. I’m lucky. I have a beautiful view from my room and I do feel safe”. There were sufficient staff on duty to meet people’s needs and to provide support in line with their choices and preferences.

Dietary needs were catered for and advice sought from healthcare professionals as required. People were positive about the food on offer. One person commented, “I like cooking, but the chefs are fantastic. Today’s lunch was very nice; I can’t complain”.

Haviland House is a purpose-built nursing care home and the premises have been designed to support people living with dementia.

People were treated with dignity and respect by kind and caring staff. One person said, “Staff know me well, we have a good laugh”. People were encouraged to be as independent as possible, and their diverse needs were acknowledged and catered for.

People received personalised care that met their needs. The risk of social isolation was mitigated with visits from relatives and friends; social media also enabled people to stay in touch with those that mattered to them. A range of activities was on offer and people enjoyed participating in various events around the home.

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

Rating at last inspection and update

The last rating for this service was Requires Improvement (report published 5 August 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found some improvements had been made and the provider was no longer in breach of one regulation. However, the provider was found to be in continued breach of one regulation and to be in breach of another regulation.

Why we inspected

This was a planned inspection based on the previous 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.

We have found evidence that the provider needs to make improvement. Please see the Safe, Effective and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Haviland House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good governance.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.