This inspection took place on 5 May 2016 and was unannounced. Haven Residential Care Home is a care home without nursing. The home is owned and operated by Sanctuary Care Limited. Haven Residential Care Home is registered to provide accommodation and care for up to thirty older people who may also have dementia. The home has a dementia unit.At our last inspection on 9 September 2014 the service met the regulations inspected. There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and their relatives informed us that they were satisfied with the care and services provided. On the day of our inspection we observed that people were well cared for and appropriately dressed. People using the service said that they felt safe in the home and around staff.
Relatives of people who used the service told us that they were confident that people were safe in the home.
Systems and processes were in place to help protect people from the risk of harm and staff demonstrated that they were aware of these. Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.
Comprehensive risk assessments had been carried out and staff were aware of potential risks to people and how to protect people from harm. People's care needs and potential risks to them were assessed.
Staff prepared appropriate care plans to ensure that people received safe and appropriate care. Their healthcare needs were closely monitored and attended to. Staff were caring and knowledgeable regarding the individual choices and preferences of people.
On the day of the inspection we observed that there were sufficient numbers of staff to meet people's individual care needs. Staff did not appear to be rushed and were able to complete their tasks. However some people and relatives we spoke with told us that there was not enough staff in the home. We spoke with the registered manager and were informed that the staffing levels were reviewed using the organisation's dependency assessment tool and the home had sufficient staff deployed to meet the needs of people. The registered manager also told us they had bank staff who knew the home and people well and were able to help if needed. The registered manager was also on call at all times.
Systems were in place to make sure people received their medicines safely. Arrangements were in place for the recording of medicines received into the home and for their storage, administration and disposal.
We found the premises were clean and tidy and there were no unpleasant odours. There was a record of essential inspections and maintenance carried out. The service had an infection control policy and measures were in place for infection control.
Staff had been carefully recruited and provided with induction and training to enable them to care effectively for people. They had the necessary support, supervision and appraisals from management.
People's health and social care needs had been appropriately assessed. Care plans were person-centred, detailed and specific to each person and their needs. Care preferences were documented and staff we spoke with were aware of people's likes and dislikes.
People told us that they received care, support and treatment when they required it. Care plans were reviewed monthly by staff and were updated when people's needs changed.
Staff we spoke with had an understanding of the principles of the Mental Capacity Act (MCA 2005). Capacity to make specific decisions was recorded in people's care plans.
The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person's best interests. The home had made necessary applications for DoLS and we saw evidence that authorisations had been granted.
There were suitable arrangements for the provision of food to ensure that people's dietary needs were met. People were mostly satisfied with the meals provided. Food was freshly prepared and presented well. Details of special diets people required either as a result of a clinical need were clearly documented.
People and relatives spoke positively about the atmosphere in the home. Bedrooms had been personalised with people's belongings to assist people to feel at home.
People who used the service and relatives we spoke with told us there were activities available for them to participate in. The home employed two half-time activities co-ordinators. During the inspection, we observed a volunteer do a quiz and a letter game with people which involved a good deal of discussion and engagement from people using the service.
Staff were informed of changes occurring within the home through daily staff meetings as well as quarterly staff meetings. Staff told us that they received up to date information about the service and had an opportunity to share good practice and any concerns they had at these meetings.
The home had carried out an annual resident's satisfaction survey in 2015 and the results from the survey was positive.
The home had a clear management structure in place with a team of care workers, team leaders, deputy manager, the registered manager and the provider. Staff told us that the morale within the home was good and that staff worked well with one another. Staff spoke positively about working at the home. They told us management was approachable and the service had an open and transparent culture. They said that they did not hesitate about bringing any concerns to the registered manager.
There was a comprehensive quality assurance audit process in place The service undertook a range of checks and audits of the quality of the service and took action to improve the service as a result.
Relatives spoke positively about management in the home and staff. They said that the registered manager was approachable and willing to listen. Complaints had been appropriately responded to in accordance with the home’s policy.