Havencare Cornwall

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People’s accommodation did not always meet their needs, when this was identified managers looked for alternative arrangements. Staff knew how to raise a safeguarding within the organisation and received training in this area. However, they told us they were not always confident doing this. Managers were keen to drive improvements and there was a culture of driving improvement. Risks associated with people’s care were identified and acted on. People received their medicines as prescribed.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

When things went wrong managers discussed how things could be made better in the future. A report showed this included reflecting on how people could be more involved when considering how to drive improvements.

Complaints were investigated according to organisational policies and procedures, and action taken to address people’s concerns.

There were systems and processes to reflect on practice at an organisational level. For example, the use of medicines to manage behaviour was analysed annually in line with Stop the Over Medication of People with a Learning Disability (STOMP) principles.

Relatives told us people had been well supported when they started using the service. One commented: “We managed to have a month’s transition period. They kept taking [X] out in the car because they knew [X] loves that. We also bought some furniture over from the old house and that helped too.”

Managers told us they tried to match people with the service before they moved in. This had not always been successful; when this occurred staff and managers worked with people to find alternative arrangements.

An external professional told us of an example when multi-disciplinary team meetings had been held prior to a person moving into the service. A compliments record contained feedback from a professional which read; “They (staff) have worked really effectively to help settle the client into their, still relatively new, home.”

Following a transition into the service for 2 people managers had attended a ‘learning from significant events’ meeting to reflect on how the process could be improved in the future.

People and most relatives told us they had no concerns about safety. Some relatives of people in one particular setting, were concerned staffing arrangements and the way the service was organised did not always ensure people’s safety. We discussed this with managers who told us they continually reviewed the situation to help meet the person’s needs. In other settings relatives felt staff had the necessary skills to support people safely.

Staff told us they knew how to raise safeguarding concerns within the organisation. However, during our conversations with staff we were told they were not always confident or comfortable doing this. There was an organisational safeguarding lead who supported training needs and collated data to help identify any trends.

Policies supported and underpinned safe practice. When people lacked capacity to make certain decisions the correct legal processes had been followed to ensure any decisions were in people’s best interest.

We saw staff supporting people and talking with them if they were worried about things. They helped people think about how they could manage their worries and what they might do to help them feel safe. People were involved in developing risk assessments.

Sometimes people acted in a way which could put them, and others, at risk. Staff told us they were confident supporting people at these times.

Risk assessments identified when people were at risk and how staff should support them at these times. These were regularly reviewed.

Some relatives had concerns about the suitability of the environment for people. This included difficulties staffing at night due to the layout of accommodation, where the accommodation was situated and risks within the accommodation.

People’s living arrangements did not always meet their needs. This had been recognised by managers and, where necessary, alternative accommodation was being sought.

In one of the hubs, scaffolding had been erected in a narrow passageway leading from the main property to some individual dwellings. The passageway was used by two people who used walking aids and had some restrictions to their mobility. No risk assessments had been completed to identify if any protective measures needed to be put in place.

Feedback from relatives was mixed. Some relatives of people living in the hub models raised concerns about the use of agency staff who they felt were not as knowledgeable about their family member’s needs. Rotas showed there was a high use of agency staff, particularly at weekends. Managers told us, where possible they used agency staff who were familiar with the service to deliver a consistent approach. Relatives at other settings were positive about staffing levels. One commented; “I pop in from time to time and there’s always enough staff around.”

One of the hub settings was staffed by more than one provider. Staff told us that, if another provider was short staffed, or if people wanted support outside of their allocated hours, they were often required to stand in for them without notice which put a strain on their own staffing arrangements. Following our visit the provider told us they had raised concerns about the model of support at the hub with commissioners.

Staff received regular training. Staff supporting people whose behaviour could be unpredictable, putting themselves and others at risk, undertook extended training in de-escalation techniques. In one of the hub settings staff supervisions were not up to date and there had not been a staff meeting for several months. Pre-employment checks were completed prior to staff starting work.

Some people needed support to keep their homes clean and tidy. Staff encouraged people to be involved in this where possible.

Staff confirmed they had completed infection prevention and control training. Some staff raised concerns about the cleanliness of one person’s home. One member of staff said they worried about the best way to support the person to keep their environment clean. Following the inspection the registered manager told us additional support had been put in place to address the concerns.

An annual infection control statement was produced for the organisation.

No-one raised any concerns about the management and administration of medicines. People told us staff supported them with medicines. Some people needed very little support in this area, staff encouraged them to maintain their independence.

Staff confirmed they completed medicine administration training and had their competency checked. They were able to describe the process to follow if there was a medication error in order to mitigate any associated risks.

People’s care plans contained information about the medicines prescribed and the support they would need to take these. Medicines audits were completed.