Haven Rose Residential Care Home Limited

Haven Rose Residential Care Home is a residential care home providing personal care and accommodation for up to 16 people. The service provides support to older people and those who may be living with dementia or a mental health condition. At the time of our inspection there were 11 people using the service. Accommodation was spread over three floors accessible via stairs.

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

People told us they were happy and safe living at Haven Rose Residential Care Home. We were told by people living in the service and their relatives that they felt included, safe and well cared for. Although the service was clean, ongoing refurbishment was still in progress. Risks related to legionella had not been fully mitigated.

Risks to individuals were assessed when they moved into the service, reviewed by the registered manager and reflective of their current needs. The registered manager worked well with other healthcare professionals to ensure that learning took place and necessary changes were made to continually improve.

People were supported safely and appropriately by sufficient staff who knew people well. However, not all staff had full work history with gaps explained. Staff training was not always complete or up to date although we did not observe any evidence of poor care during the inspection.

Processes and procedures were in place to store and administer medicines safely. We were somewhat assured appropriate infection prevention and control measures were in place to protect people against the risk of COVID-19 and other infections.

The registered manager did not have 1 to 1 meetings or appraisals with staff although due to the size of the home they were in regular contact with staff. The staff team told us they felt supported by the registered manager. People who used the service and other stakeholders were involved in how the service was managed. The registered manager had processes in place to monitor and improve the quality of the service people received and had been well supported by local authority quality teams.

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 good (published 10 May 2019).

Why we inspected

This inspection was prompted by a review of the information we held about the service.

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.

This report only covers our findings in relation to the key questions safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Haven Rose Residential Care Home 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 monitor the service and will take further action if needed.

We have identified breaches of regulation in relation to managing the risk of legionella, staff recruitment practice and training at this inspection. We found the two areas reviewed were now rated as requires improvement.

Follow up

We have requested 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.

Haven Rose Residential Care Home is situated in a residential area of Southampton and provides accommodation and care for up to 16 people living with dementia or enduring mental health needs. At the time of our inspection there were 14 people living at the home.

People’s experience of using this service:

People received safe care and support living at Haven Rose. This was because the staff had received training in safeguarding adults and the service worked with health care professionals in meeting goals agreed and developed with people. The registered manager had also taken steps to maintain a safe environment for people.

The service employed sufficient numbers of staff to meet people’s assessed needs and the staff employed had been subject to robust recruitment procedures. Staff received appropriate training and supervision to support them in working with people living at the home.

Medicines were managed safely with staff receiving appropriate training.

People’s needs had been assessed and care plans developed with people’s consent.

The service was working within and meeting the requirements of the Mental Capacity Act 2005 . 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.

People’s dietary needs were met and people were encouraged to lead healthy lives.

People told us the staff were supportive, kind and respectful of their right to privacy and dignity. Many of the people had lived at Haven Rose for many years and had built positive relationships not only with the staff but with each other .

People were encouraged to go out and be involved in the local community.

The home was well led with good leadership from the registered manager.

Rating at last inspection:

The home was last inspected in August 2016, when it was rated as good .

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

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

The home had a registered manager who has been registered since December 2010. 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.

People felt safe living at Haven Rose and they were very much at the heart of the service. The risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies.

Relevant recruitment checks were conducted before staff started working at Haven Rose to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.

People were supported to take their medicines safely from suitably trained staff. People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and went out of their way to provide people with what they wanted.

Staff received regular support and one to one sessions of supervision to discuss areas of development. They completed a wide range of training and felt it supported them in their job role.

Staff sought consent from people before providing care and support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully.

People were cared for with kindness, compassion and sensitivity. Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

People were supported and encouraged to make choices and had access to a range of activities. Staff knew what was important to people and encouraged them to be as independent as possible. ‘Residents meetings’ and surveys allowed people to provide feedback, which was used to improve the service.

A complaints procedure was in place. There were appropriate management arrangements in place and staff felt supported. Regular audits of the service were carried out to assess and monitor the quality of the service.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led

This is a summary of what we found.

Is the service safe?

The service was providing safe care. People told us they received help when they needed it and the staff treated them with 'kindness 'and were 'very caring' whenever they needed help. A person said the staff 'are very good to you and help you'. Another person told us they felt 'very safe' and they had lived at the home for a number of years. Staff told us they had adequate time to provide care and they were supported to attend training and updates. The staff were knowledgeable about the people's needs and support they required.

We found the service had systems in place to ensure people were protected from the risk of abuse. Staff had completed training in safeguarding vulnerable adults as part of their induction. The home was clean and staff followed their procedure for the control of infection. There were arrangements in place to manage people's medicines and to ensure these were administered safely.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The manager told us there was no one under this safeguard who was receiving care at the time of our inspection. Staff were aware of people's rights to make choices and people were supported to be involved in their care.

Is the service effective?

The service was effective. We found care plans included risk assessments were completed and these were relevant to the person. We saw specific action required was developed to manage risks. People we spoke with were complimentary about the care and support they received. Support plans showed people's needs were assessed and clear information was provided for the staff. This included appropriate support with food and fluids and pressure risks management. Specific equipment was in place to support people and to maintain their independence.

Is the service caring?

We noted people were supported in a caring and compassionate way. Staff and people using the service had developed good relationship and people were treated with respect. People were complimentary about the staff and the manager who was involved in their care.

Is the service responsive?

The service was responsive to people's changing needs and took appropriate actions. People said they were 'very satisfied' with the care and support they were receiving. We saw people were able to access external healthcare facilities as needed. People had opportunities to express their views and a person told us the manager 'listens to what we have to say'.

Is the service well-led?

Systems were in place to regularly assess and monitor the quality of service provided. Risks were assessed and appropriate action plans were in place. People's views were sought through satisfaction surveys and action plan developed to address any issues as needed.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People experienced care, treatment and support that met their needs and protected their rights. They were protected from the risk of infection because appropriate guidance had been followed. People were cared for, or supported by, suitably qualified, skilled and experienced staff. There were sufficient systems in place to enable the quality of service provided to be regularly assessed and the provider monitored the quality of service that people received.