CQC report explained · a nursing home
What the CQC found at Haviland House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2022
Haviland House was rated Requires Improvement; inspectors found kind, personalised care, but gaps in risk records, consent and quality checks put people at risk.
Inspectors visited the home without notice on 16 and 17 November 2021. They spoke with people, relatives, staff and managers, observed care, and reviewed care plans, medicines records, staff files and management records.
The home was caring and responsive. People were treated with dignity, supported to make choices and given personalised care. Food, activities, visits and communication were generally well managed. Staff numbers were sufficient and infection control arrangements were considered satisfactory.
However, some health risks were not fully assessed or explained for staff. There were gaps in topical cream records. Some people were using reclining chairs that counted as restraint without the required consent or best-interests decisions. Audits had not found these problems. The home remained in breach of Regulation 12 and was also in breach of Regulation 17.
Kind and respectful staff
People were treated with dignity and respect. Inspectors observed staff being patient, kind and caring.
“Staff were patient, kind and caring in their approach.” from the report
Personalised care
Care was tailored to people's needs, preferences, interests and communication styles. Staff knew people well.
“People received personalised care that met their needs and was in line with their choices and preferences.” from the report
Enough staff
Inspectors found there were sufficient staff to meet people's needs and provide support in line with their choices.
“Staffing levels were sufficient to meet people's needs.” from the report
Activities and contact
People had access to activities and were supported to keep in touch with relatives and friends, including through visits and social media.
“A range of activities was available for people. Staff supported people to stay in touch with friends and relatives.” from the report
Risk information was incomplete
seriousCare plans did not always explain how to manage conditions such as diabetes and seizures. Records of some day-to-day health monitoring were inconsistent, which placed people at risk.
“Care plans lacked information on how risks were managed and there was a lack of guidance for staff.” from the report
Gaps in medicines records
seriousSix of eight medication care plans reviewed had gaps in recording whether topical creams had been applied as prescribed.
“Out of eight medication care plans we reviewed, six showed gaps in recording, so it was unclear whether staff were applying people's topical creams as prescribed.” from the report
Consent and restraint
seriousSome reclining chairs restricted people's ability to get up. The required consent, capacity assessments or best-interests decisions were not recorded.
“There were no records or assessments to show how people's consent had been obtained or to reflect that a decision to use the chairs had been taken in their best interests.” from the report
Weak quality checks
seriousThe provider's audits had not identified problems in care plans, risk assessments and consent records. Some records were inconsistent, unclear or copied from another person's plan.
“The provider had failed to ensure that auditing systems were sufficiently robust to monitor and measure all aspects of the service effectively.” from the report
- 01How are you now recording and checking the application of topical creams and other medicines?
- 02What steps have you taken to assess risks linked to diabetes, seizures, falls and bowel management?
- 03How do you make sure reclining chairs and other equipment are used only with lawful consent or a recorded best-interests decision?
- 04How are you checking that care plans and risk assessments are accurate, consistent and about the right person?
- 05What progress has been made on the action plan required after the Regulation 12 and Regulation 17 breaches?
This was an unannounced planned inspection covering all five key questions and infection prevention and control, following the home's previous Requires Improvement rating. This explanation was written from the published report of 13 January 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2021
Rated Requires Improvement; inspectors found kind staff and safe medicines, but risks and personalised care were not always managed well.
This was an unannounced inspection on 27 May 2021. Inspectors reviewed care plans, medicine records, staff files and management records. They spoke with people, staff and a visiting health professional, and observed care.
Inspectors found problems with some risk assessments and guidance for staff. This included incorrect diet advice, missing diabetes guidance and incomplete information about the exact timing of Parkinson's medicines. Medicines were managed safely during the inspection, but some senior staff were unclear about what to do after a medicine error.
Staff were described as kind and staffing levels were sufficient. However, care was sometimes task-led rather than personal. Inspectors also found poor hand hygiene on one occasion, incomplete safeguarding training for some staff, and weaknesses in management oversight.
The overall rating fell from Good to Requires Improvement. Safe, Responsive and Well-led were rated Requires Improvement. Effective and Caring were not inspected at this visit, so their previous ratings were used in the overall rating.
Enough staff
Inspectors found staffing levels sufficient to meet people's needs. They saw staff respond promptly when people needed help.
“Staffing levels were sufficient to meet people's needs.” from the report
Medicines managed safely
Medicines were managed safely during the inspection. Staff administering medicines had training and regular competency checks.
“At inspection, we found medicines were managed safely.” from the report
Kind and caring staff
Staff were generally kind and caring, although inspectors also saw occasions when care became task-focused.
“People were supported by kind and caring staff” from the report
Activities and contact
Staff organised activities such as quizzes, and social media and arranged visits helped people keep in touch with important people.
“Staff had organised activities for people in the home.” from the report
Health risks not fully assessed
seriousSome care plans gave unsuitable diet advice or lacked important guidance about diabetes and the exact timing of medicines. The report says this created an increased risk that people could be harmed.
“Some people's risks were not always identified and assessed accurately to prevent them from harm.” from the report
Care was not always personal
seriousInspectors saw limited communication during a meal, disrespectful talk about one person and food that was cold. Care was sometimes driven by tasks rather than by people's preferences.
“People did not always receive personalised care that met their needs and preferences.” from the report
Management oversight
needs fixingThe provider's checks had not identified all the problems found by inspectors. The home had also experienced changes in its management team, with a new manager still applying to register.
“Shortfalls we found at this inspection had not been identified by the provider so actions could be taken and improvements made.” from the report
Infection control practice
needs fixingInspectors were not fully assured that staff followed good hygiene practices. One staff member moved between handling used items and serving food without effectively washing or sanitising their hands.
“We were not fully assured that good hygiene practices were followed by staff.” from the report
Training and confidentiality
minorNot all staff had updated safeguarding training. Personal dates of birth were also displayed in a corridor, although management agreed this information should be removed.
“However, not all staff had updated this training as required.” from the report
- 01What changes have been made to the care plans for people with diabetes, Parkinson's disease and the health condition affected by diet?
- 02How do you make sure staff know what to do after a medicine error, and how do you check that this is followed?
- 03How are you ensuring that meals are served at the right temperature and that staff provide respectful, personalised support during meals?
- 04What action has been taken to improve hand hygiene and complete overdue safeguarding training?
- 05Has the manager now registered with the CQC, and what progress has been made against the action plan?
This was a focused inspection prompted by concerns about medicines, risk management and management oversight; Safe, Responsive and Well-led were inspected, while Effective and Caring were not and their previous ratings carried over. This explanation was written from the published report of 5 August 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Haviland House
5 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- January 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2021Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- December 2020Inspected but not ratedSafe: Inspected but not rated
- January 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- December 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2014
Registered with the Care Quality Commission on 10 December 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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