Care Home: The Haven Residential Home

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What the care home does well The Haven provides a comfortable, homely environment with pleasant communal areas and bedrooms that reflect individual tastes. In particular the bright, modern kitchen diner has been renovated to a high standard. People living in the home and their relatives are complimentary about the environment and the care provided. One person said, "It`s a wonderful environment". People living in The Haven are cared for by staff who value and respect them as individuals and who actively promote their independence. Their care plans are developed from a comprehensive assessment of the person`s individual needs and wishes, which leads to person centred care. A relative who completed a survey stated, "The care home has greatly improved my [relative`s] quality of life. The staff do everything in their power to meet [my relative`s] needs". The Haven is well managed by a competent person who is committed to providing the people who live there with a good quality service. One relative stated, "I can`t praise the owners and staff enough, for my [relative] it`s more like living at home and not in a home". The menu in The Haven provides people with a well-balanced and varied diet. Staff provide good home cooked food that is enjoyed by people living there. Everyone spoken with on the day of the inspection were complimentary about the food. Staff treat people living in the home with dignity and respect. A healthcare professional who completed a survey stated, "I have always been able to meet privately with service users" and another, "My observations of [service users`] interactions with staff [at clinic appointments] has shown mutual respect". What has improved since the last inspection? This is the first inspection of the service since the new owners took over and registered with us at the Commission. CARE HOME ADULTS 18-65 The Haven Residential Home 27 Penfold Road Clacton on Sea Essex CO15 1JN Lead Inspector Ray Finney Unannounced Inspection 25th September 2008 09:00 The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Haven Residential Home Address 27 Penfold Road Clacton on Sea Essex CO15 1JN 01255436403 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) havenclacton@aol.com The Haven Residential Care Home Ltd Joyce Sihwa Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is 3 This is the first inspection since the new provider took over the home. 2. Date of last inspection Brief Description of the Service: The Haven is a small residential care home, registered to provide personal care and accommodation to three people who require care by reason of a mental health problem excluding dementia or a learning disability. It is a pleasant, semi-detached house situated in Clacton-on-Sea, close to the seafront promenade and within walking distance of the town centre shops. Accommodation is in single rooms, one of which is on the ground floor and the remaining two on the first floor. There is a small lounge and kitchen diner on the ground floor and another lounge on the first floor. The Haven provides a clean, homely environment and furnishings are of a good standard. The home is owned and managed by Mrs Joyce Sihwa, who takes a ‘hands on’ approach to managing the home and has private accommodation on the premises. Some parking is available to the front of the property and there is a ‘pay and display’ car park nearby. The home charges between £628.00 and £958.00 a week for the service they provide. This information was given to us in September 2008. Information about the home, including the Statement of Purpose and Service User Guide, can be obtained by contacting the manager. Inspection reports are available from the home and from the CSCI website. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. A range of evidence was looked at when compiling this report. Documentary evidence was examined, such as care plans and personnel files. An Annual Quality Assurance Assessment with information about the home was completed by the manager and sent to us when requested. Throughout the report this document will be referred to as the AQAA. A visit to the home took place on 25th September 2008 and included a tour of the premises, discussions with people living in the home, the manager, members of staff and a visitor. Completed surveys were received from people living in the home, healthcare professionals, members of staff and a relative. Observations of how members of staff interact and communicate with people living in the home have also been taken into account. On the day of the inspection the atmosphere in the home was relaxed. were given every assistance from the manager and staff on duty. We What the service does well: The Haven provides a comfortable, homely environment with pleasant communal areas and bedrooms that reflect individual tastes. In particular the bright, modern kitchen diner has been renovated to a high standard. People living in the home and their relatives are complimentary about the environment and the care provided. One person said, Its a wonderful environment. People living in The Haven are cared for by staff who value and respect them as individuals and who actively promote their independence. Their care plans are developed from a comprehensive assessment of the person’s individual needs and wishes, which leads to person centred care. A relative who completed a survey stated, The care home has greatly improved my [relatives] quality of life. The staff do everything in their power to meet [my relatives] needs. The Haven is well managed by a competent person who is committed to providing the people who live there with a good quality service. One relative stated, I cant praise the owners and staff enough, for my [relative] its more like living at home and not in a home. The menu in The Haven provides people with a well-balanced and varied diet. Staff provide good home cooked food that is enjoyed by people living there. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 6 Everyone spoken with on the day of the inspection were complimentary about the food. Staff treat people living in the home with dignity and respect. A healthcare professional who completed a survey stated, I have always been able to meet privately with service users and another, My observations of [service users’] interactions with staff [at clinic appointments] has shown mutual respect. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Through the comprehensive admission process, people choosing to live at The Haven can be confident that their needs will be met. EVIDENCE: The new providers were registered with the Commission in May 2008. As part of the registration process, the service’s Statement of Purpose and Service User Guide were examined. Both documents met the required standard and contained appropriate information to ensure people wishing to move in to the home and their representatives have sufficient information about the service to decide if it would meet their needs. Records examined on the day of the inspection confirm that the three people living in the home each have their own copy of the homes Service user Guide and the Statement of Purpose. They also have a Charter of Rights that the manager has discussed with them. All three people living in the home have been there for a number of years and there are no vacancies. However, through discussion with the manager, she was able to demonstrate a good awareness of the importance of a thorough assessment process. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 9 The manager stated in the AQAA, “If the opportunity arises to recruit a new service user, the home has a comprehensive assessment tool which enables the identification of mental , physical, social, psychological and spiritual needs. The prospective service user will be invited to test drive the home for a day and join current service users for meals and activities, ask questions and move in on a trial basis before making a decision whether to make The Haven their permanent home or not”. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Haven receive good quality care, which is based on their assessed and identified needs. EVIDENCE: The manager states in the AQAA, “We have integrated service user files that contain care plans which form the basis of all care delivery in the home” and that, “The care plans are not written in a tablet of stone but are meant to be dynamic so as to respond to the changing needs of service users”. Care plans for all of the people living in the home were examined on the day of the inspection. Each care plan identifies the person’s individual needs, what interventions are in place to meet the need, and what the expected outcome is for the individual. Records examined confirm that care plans are evaluated monthly. Through discussion with the manager, she was able to demonstrate that it is important for people living in the home to be involved in formulating their care plans and also in evaluating how their needs are being met by the The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 11 care plans in place. The manager stated that “care plans are subject to monthly reviews involving the service user” and “service users are encouraged to assess their own progress or lack of it”. People spoken with said that they talk about their care with the manager and staff. Care plans examined cover a range of issues including mental health, the need to promote personal hygiene, choking, family relationships, reducing smoking, intellectual stimulation, constipation, restlessness, diet controlled diabetes, pernicious anaemia, high cholesterol, visual impairment, falls, dental care, asthma, nutrition and socialising. Staff spoken with had a good knowledge of people’s needs and said they are familiar with care plans and are kept informed of any changes. One member of staff who completed a survey stated, At the beginning of each shift I have a handover meeting with the manager in which she will update me on any changes that have occurred or that I need to be aware of as well as how the service users are and what their plans are. I am expected to read the daily diary and have access to the care plans. People spoken with on the day of the inspection all made positive comments about how they can choose what they want to do and how they conduct their lives. One person living in the home who completed a survey stated, When I want to lie in on Sundays, I get to do that. Records examined also contained evidence of the service’s commitment to giving people opportunities to voice their opinions and make choices. House meetings and service user meetings are held every one to two months. The minutes of the meetings examined showed that issues discussed included trips out, leisure activities, food choice and menus. There are a comprehensive range of risk assessments in place, which the manager is in the process of updating. Through discussion with the manager, she was able to demonstrate that people’s quality of life can be improved if risks are identified and measures put in place to minimise the risk without undue restrictions on what the person wants to do. The manager states in the AQAA, “Risk assessments are utilised in conjunction with care plans”. A healthcare professional who completed a survey said that what the home does well is, Providing a safe, friendly and supportive environment for vulnerable people with mental health needs. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in The Haven can expect to enjoy a lifestyle that meets their wishes and interests. EVIDENCE: The manager states in the AQAA, “All service users have an individual activity plan which they were instrumental in drawing up”. People’s individual files each contain a ‘Leisure and Activity’ plan which record a wide range of activities that people participate in, including going for walks, singing, playing scrabble, shopping. People living in the home talked to us about the activities that they like to do including reading poetry and novels, video shows, chatting with staff, exercises, reading newspapers and listening to ‘talking books’. A person living in the home who completed a survey stated, I like it when carers read a chapter from a story book to me. One person is currently enjoying taking The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 13 lessons in maths with a tutor who comes to the home, and the person hopes eventually to take a GCSE examination in the subject. They told us they are also interested in economics and have asked the manager to organise economics home tuition. The manager said she is at present looking into the funding for this. The manager stated in the AQAA, “Formal house meetings are held bi-monthly and informal house meetings are held weekly. At the formal house meetings, service users agree what activities they would like to participate in together. At one of the formal meetings, the service users decided to go on a trip together. They went to Dedham Vale and thoroughly enjoyed themselves”. People spoken with explained how they like to go out and about in the local community. One person said they go to a social club and use the library. One person visits Colchester twice a week independently on the train; they told us they enjoy doing this. The manager states in the AQAA, “Service users are encouraged to integrate with the community and to also participate in activities in the home”. Records examined contain evidence that people are supported to keep in touch with family and friends. One person keeps in touch with family members who live abroad by telephone and text messages. They also send photographs by email and the manager downloads them and prints them out. The person told us that the photographs are very important to them. The manager states in the AQAA, “We have a service user charter of rights. The service users have this in their service user guides. One to one sessions have been held with each service user to ensure they are clear about the rights we are promoting in the home”. People spoken with were confident that they understood their rights. The manager states in the AQAA, “Informal house meetings are held on Sunday after lunch to decide what food the service users would like to eat the following week”. Records examined all contained information relating to people’s individual nutritional and dietary needs including a low cholesterol/low iron diet, a high fibre/high iron diet and a low cholesterol and weight reducing diet. All those living in the home made complimentary comments about the food. One person said they like plantain and curries and said, I like my curry dishes. When I ask for them they make them for me. Someone else said they choose to follow a vegetarian diet. The kitchen is a very pleasant room and people living in the home are encouraged to participate in cooking. One person enjoys preparing food and regularly goes to the shops to buy ingredients for their favourite chicken casserole and they cook it regularly, including for a relative who recently The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 14 visited. The manager said they are encouraging this interest and a member of staff has bought the person a cookery cook to introduce them to new recipes. The manager explained that social services have ‘showcased’ the kitchen by sending someone to take photographs and video recording of people using the kitchen. This record is to be shown at a conference later in the year and one of the people living in the home is to attend the conference. All the people living in the home were spoken with at length on the day of the inspection. All were happy with their lifestyle and complimentary about the way the manager and staff team help and support them. There is ample evidence that each person is encouraged and enabled to take part in activities and access facilities of their choice. A member of staff who completed a survey stated, I think The Haven provides a very tailored service and one that is very quick to adapt to changing needs and wants. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can expect their personal and healthcare needs to be identified and provided with the support to ensure these needs are met as they would wish. EVIDENCE: People spoken with on the day of the inspection said they get whatever help they need with their personal care. The manager was able to demonstrate a good awareness of people’s needs and other staff spoken with had a good understanding of people’s care plans. Relatives who completed surveys made positive comments about the standard of care provided by the home. One relative said, All aspects of care are done exceedingly well and another The Haven is undoubtedly the best place my [relative] has lived in since [their illness]. [They] are well cared and catered for. A completed survey from a healthcare professional said, I have been attending the home for many years with two different owners and the care has always been second to none; another said, the new manager appears The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 16 proactive and actively interested in the service users health and social care needs. There is ample evidence in people’s individual files of input from a range of healthcare professionals including dental appointments, community nursing services and hospital appointments. A healthcare professional who completed a survey said, Staff always accompany service users to appointments and actively engage in discussion about [their] care. One person visited the GP on the day of the inspection and chose to do this independently, then discussed the outcome with staff. Care plans examined cover a range of issues relating to people’s healthcare needs including mental health, constipation, diet controlled diabetes, pernicious anaemia, high cholesterol and asthma. Health promotion is also addressed. One person said they wanted to smoke less so they discussed it with the manager and put together a care plan around supporting them to reduce smoking. Through discussion the manager was able to demonstrate a commitment to ensuring they have a robust process in place for supporting people with medication. There is currently no-one in the home who manages their own medication but the manager is supporting people to have a greater awareness of their needs around prescribed medication. She is encouraging people to take more responsibility as a first step in working towards self-medicating where possible. There are information sheets in individual files about people’s prescribed medication and copies of these are also in people’s own rooms. The information is designed to give people an understanding of their medication, how to recognise it, when it should be taken, what the medicine does and any side effects. On the day of the inspection, the storage for medication was examined and found to be secure. Medicine Administration Record (MAR) sheets were completed clearly and appropriately. A healthcare professional who completed a survey said, The home has always managed medication effectively. The manager and staff spoken with understand their responsibilities around the safe storage, administration and recording of medication. There were no controlled drugs in use at the time of the inspection but the manager was able to demonstrate an awareness of their responsibilities around appropriate storage and recording of controlled drugs. The home did not have a cupboard designed for the storage of controlled drugs. Legislation states that care homes must store controlled drugs in a controlled drugs cupboard, including care homes registered for personal care. Thought should be given how they would meet the requirements of recent changes to legislation should anyone be prescribed medication that requires this level of secure storage. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that their concerns about how they are treated are listened to and acted upon as stated in the complaints and safeguarding procedures. EVIDENCE: Records examined show that there have been no formal complaints recorded, but there is a process in place for recording complaints when necessary. The process for dealing with concerns and complaints records the date when the issue was reported, what the concern was about, what action needed to be taken to address the issue, who was responsible for ‘problem solving’, the date the issue was resolved and the outcome and review date if necessary. People spoken with were all confident that if they had any concerns they would be listened to. All said that they have never had to make a complaint. When asked if they would know what to do if they needed to complain about something, one person said, I understand I approach a carer and/or my social worker or Joyce, the manageress and another, I speak to the carers. I have never had to make a complaint. The manager states in the AQAA, “At the Haven we take our service users concerns very seriously no matter how trivial these may seem. Staff are encouraged to listen to service users and take their views and opinions on board”. The home’s complaints log was examined and documents all concerns no matter how minor they may appear. Through discussion the manager was The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 18 able to give a number of examples of how they have addressed minor concerns. She said that all concerns are taken seriously and dealt with appropriately. One person had raised the issue of creaking floorboards in one of the bedrooms that they found particularly intrusive at night. The manager contracted a builder to realign the floor boards and insulate the floor in the room where the noise was coming from. The manager states in the AQAA, “The Haven Service User Guide contains a Charter of Rights” which documents people’s right to complain “within a framework of unconditional positive regard” and assures them that the quality of care will not be compromised in any way just because they have raised concerns. The manager said, “since the introduction of the Service User Charter of Rights, The Haven service users have not been shy in coming forward with concerns”. Through discussion, the manager was able to demonstrate a range of processes they have in place to ensure people have plenty of opportunities to discuss concerns. These include daily chats with the manager who lives on the premises, bi-monthly formal house meetings, weekly informal house meetings and family meetings. Personnel records examined contain evidence that staff have received training in issues around safeguarding people (previously called Protection of Vulnerable Adults or POVA). Staff spoken with have a good understanding of their responsibilities around keeping people safe. Personnel records contain evidence that all staff undergo Criminal Record Bureau (CRB) checks before commencing employment in the home. The manager states in the AQAA, “Service users are instrumental in eliciting their care needs. For example what foods they would like to eat and what activities they would like to participate in. This process empowers them. The staffs responsibility is to facilitate the service users needs. This shift in balance of power minimises the risk of abuse”. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can enjoy living in an environment that suits their lifestyle and which is homely, well maintained and clean. EVIDENCE: A tour of the premises showed the furnishings in The Haven to be domestic and comfortable and people living there benefit from the homely surroundings. Furnishings are in keeping with the style and age of the property and are well maintained. The manager has recently had new carpets laid in the hallway. There are two bedrooms upstairs and a separate lounge. The large downstairs bedroom has an en-suite ‘wet room’ that is accessible for a wheelchair user. There is also a small downstairs lounge if people wish to entertain visitors privately. People’s bedrooms contain ample evidence of personal possessions, ornaments and photographs. One person who showed us their room said they “really like it”. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 20 The kitchen/diner has been refurbished to a high standard and is clean, bright and cheerful. It is a pleasant room that people living in The Haven enjoy using. The manager stated in the AQAA, “Our kitchen is being show cased by Essex Council at their next conference in October 2008. They have filmed the service users cooking in the kitchen”. On the day of the inspection people spoken with said they like the home. A member of staff who completed a survey stated, The Haven provides a home rather than a care home. Because it is a small home, it has more the feel of a family home as is possible. The standard of cleanliness throughout the home is high and there are no unpleasant odours. On the day of the inspection a sample of records relating to the maintenance of the home were examined and were found to be in order. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Haven can be confident they are cared for by a competent, well trained staff team who can meet their needs and have been employed following thorough recruitment checks to ensure they are protected. EVIDENCE: In addition to the manager who lives on the premises and takes a hands on role in caring for the people who live there, The Haven has a very small staff team of two carers. One person has achieved a National Vocational Qualification (NVQ) in care and the other is in the process of completing the award. Although the staff team is not large, we observed on the day of the inspection that people’s needs and requests were being met promptly. A member of staff who completed a survey stated, The ratio of staff to service users varies between 3:3 and 1:3 which amply provides for [people’s] individual and group needs. Through discussion the manager was able to demonstrate a good awareness of the importance of having a robust recruitment process and thoroughly vetting prospective carers to ensure that people living there are supported by staff The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 22 who are fit to work with vulnerable people. Personnel records were examined and were well organised. Records contained all the documentation required by regulations, including two written references, relevant proofs of identity with photographs, Criminal Record Bureau (CRB) enhanced disclosures and an appropriately completed application form with a declaration of the person’s fitness to carry out their role. People spoken with on the day of the inspection were complimentary about the staff and one person who completed a survey stated, The staff are caring. When asked what the home does well, a healthcare professional who submitted a survey stated, Staff support for service users is good. Although there have been no new staff since the new owner took over the home, she was able to demonstrate the process that will be followed to ensure new staff receive a thorough induction. A member of staff who completed a survey stated, I had an induction when I started work, this was carried out by the previous owner. When the new owner/manager took over she went through this again to check my knowledge base and as a useful refresher for me. On the day of the inspection all staff files were examined and were found to be well organised. Personnel records contain individual development plans to record a range of training that staff have completed. The manager stated in the AQAA, “Individual development plans have been formulated to provide a clear focus and direction [for staff]”. Training includes Health and Safety, Fire Management and Prevention, Food Hygiene and diabetes awareness. The manager and another member of staff have recently completed training on the Mental Capacity Act and Deprivation of Liberty. Staff also have had training around safeguarding (previously called the Protection of Vulnerable Adults or POVA) and all have received the Essex Vulnerable Adults Protection Committee guidance booklet. The manager stated in the AQAA, “Whilst all staff have sufficient knowledge and skill to support service users with mental health issues, ongoing training is provided to ensure staff remain competent in their work”. Staff spoken with on the day of the inspection were enthusiastic about their jobs and were knowledgeable about the needs of the people they support. They were also complimentary about the training provided. One person who completed a survey said, Since the new owner/manager took over I have had several updates in previous training courses in Fire Safety and Food Handling. Additionally I have attended a Deprivation of Liberty course relating to the Mental Capacity Act. Also, I now have an individual development programme which will help me focus on my future training needs and interests. The manager states in the AQAA, “Informal supervisions occur almost on a weekly basis. Each member of staff has had formal supervision with the manager”. Personnel records examined contain supervision handbooks and individual development plans. Staff spoken with on the day of the inspection The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 23 felt well supported. The minutes of staff meetings which are held every two months were examined. A member of staff who completed a survey stated, We do have regular meetings, but as it is a small home and all the staff work closely together, I have the opportunity to discuss any issues with my manager on a daily basis. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately managed in the best interests of people living there. EVIDENCE: The new proprietor of The Haven also manages the home and, as stated previously in this report, she lives on the premises and takes a hands on approach working alongside the staff team. She has completed NVQ level 4 in care and management and is appropriately qualified to run the home. Through discussions with the manager she was able to demonstrate an excellent understanding of people’s needs and of her responsibilities around managing the home. Records examined were well organised and completed to a high standard. Information requested by us at the Commission, the Annual Quality Assurance Assessment document, was sent in promptly and completed in good detail. The manager stated in the AQAA that she has, “sound The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 25 knowledge of the statutes and regulations underpinning the management of care homes”. Staff spoken with were complimentary about the way the home is managed and a survey completed by a healthcare professional stated, [the] manager is proactive in service user CPA [Care Programme Approach] reviews. On the day of the inspection the home’s Quality Assurance system was discussed with the manager, who was able to demonstrate how they seek the opinion of people living in the home and other interested parties. People living in the home are consulted through daily chats with the manager, weekly informal house meetings, bi-monthly formal house meetings and service user and family meetings. Similarly staff are able to give their opinions through regular staff meetings. People spoken with, including members of staff and people living in The Haven, confirm that they are consulted on matters relating to the way the home is run. Information obtained through the home’s processes for dealing with concerns and complaints also contributes to their Quality Assurance process. Overall the manager of The Haven was able to demonstrate that the service responds to people’s views and wishes. Records examined show that appropriate maintenance checks are carried out and a range of certificates relating to Health and Safety were examined, including gas installations, smoke detectors and temperature checks on fridge, freezer, water outlets and rooms. Fire drills are carried out regularly and recorded. The health and safety folder contains COSHH (Control of Substances Hazardous to Health) assessments on products used in the home. A recent unannounced environmental health premises inspection was carried out by Tendring District Council Environmental Services and no contraventions were found. As reported in the staffing section of this report, staff receive training around issues relating to the health, safety and welfare of people living in the home. On the day of the inspection staff were observed to follow good practices that promote infection control, such as effective hand washing. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations An appropriate facility for the storage of controlled drugs should be available in the event someone in the home may be prescribed medication that requires this type of secure storage. The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Haven Residential Home DS0000071643.V371610.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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