CQC report explained · a residential care home
What the CQC found at The Haven
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Care plans and risk assessments still contained some inconsistencies. Medicines were given safely, but some as-required medicine protocols needed more detail, and parts of the building needed renovation for infection control.
- Effective?
- Good
- This question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Systems for governance and oversight were in place, and the new management team had identified areas for improvement. Inspectors recommended a service development plan because it was too early to show that all changes were embedded and sustained.
What inspectors found, August 2023
Rated Good overall, but Safe Requires Improvement while refurbishment and care-plan updates were still in progress.
This was an unannounced focused inspection on 25 and 28 July 2023. Inspectors looked only at Safe and Well-led because of concerns about organisational safeguarding. They spoke with people, relatives, staff and other professionals, observed care, and checked care plans, medicines records and management documents.
The home was rated Good overall. Safe was rated Requires Improvement. Inspectors found that medicines were given safely, staffing and recruitment were safe, and safeguarding systems were in place. However, some care plans and risk assessments were not yet fully updated, some medicine protocols needed more detail, and parts of the building needed renovation to support infection control.
Well-led was rated Good. A new management team had identified problems and was making improvements, but it was too early to show that all changes had been fully embedded and sustained. The overall Good rating includes ratings from the previous inspection for the three questions that were not inspected this time.
Safe medicines practice
Medicines were given safely and as prescribed. The management team carried out regular audits and followed up errors or omissions.
“Medicines were given safely and as prescribed.” from the report
Staffing and recruitment
Inspectors found enough care staff on duty during their visits, and recruitment checks were completed for new staff.
“Our observations showed there were sufficient care staff on duty to meet people's needs in a timely fashion.” from the report
Caring staff
Feedback from relatives and professionals described staff as caring, helpful and positive. People and relatives also reported improvements.
“The care staff are great, and notably very sincerely caring.” from the report
Open to improvement
The new management team acted promptly on issues raised during the inspection and had plans for further improvements.
“The management team were open to feedback and acted promptly when any issues were raised during the inspection process.” from the report
Care plans and risk assessments
needs fixingSome care plans and risk assessments were still inconsistent and had not been fully reviewed, updated and embedded. Inspectors said there was no evidence of harm because regular staff knew people's needs well.
“At this inspection, we also identified some inconsistencies. However, there was no evidence people had been harmed, as regular staff knew people's care needs well.” from the report
Infection control and renovations
needs fixingSome parts of the building made it harder to maintain infection prevention and control. Items including toilet brushes, bins, taps and flooring needed replacing, although refurbishment was under way.
“At the time of inspection, some areas of the service required renovation to ensure good IPC practice could be maintained.” from the report
As-required medicines
needs fixingProtocols for PRN medicines did not always explain clearly what staff should do to support someone with distress before giving the medicine.
“Protocols for 'as required' (PRN) medicines required some further detail to show the steps staff should take to support people with distress before administering medication.” from the report
Management changes not yet embedded
minorThe new management team had identified improvements, but had not yet had enough time to show that changes were consistently working. There was also no registered manager in post during the inspection.
“However, more time was still required for these changes to be made, embedded, and sustained.” from the report
- 01Have all care plans and risk assessments now been reviewed and updated, and how do you check that staff follow them?
- 02Have the PRN medicine protocols been rewritten to explain what staff should do before giving as-required medicine?
- 03Which refurbishment work has been completed, including replacement of flooring, taps, bins and toilet brushes?
- 04How are you tracking the service development plan and checking that improvements remain in place?
- 05Has the manager's application to become registered been completed?
This was an unannounced focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings used for the overall rating carried over from the previous inspection. This explanation was written from the published report of 31 August 2023 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, March 2020
Rated Good overall, but Safe was Requires Improvement because some risks and care records were not always managed properly.
This was an unannounced inspection on 13 and 14 February 2020. Inspectors spoke with eight people, four relatives, 11 staff and two visiting professionals. They reviewed care records, medicine records, staff files and management records.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. Inspectors found kind staff, suitable training, enough staff in practice, good support with food and health, meaningful activities and thoughtful end of life care.
Safe was rated Requires Improvement. Some environmental risks, emergency evacuation plans, risk assessments and care plans were not up to date. Inspectors also found that some fire safety concerns had not been dealt with quickly enough. The home took immediate action on several issues during the inspection, but inspectors said there was limited assurance about safety and an increased risk that people could be harmed.
The overall Good rating means inspectors found the service consistently met people's needs in most areas. It does not remove the need to check how the home has kept safety records up to date since this inspection.
Kind and respectful care
Inspectors observed positive and meaningful interactions. People said staff listened to them and respected their choices, privacy and independence.
“Staff responded to people in a kind and caring manner and people were comfortable with staff.” from the report
Good staff training
Staff received induction, ongoing training and opportunities for additional qualifications and specialist responsibilities.
“Training records showed that 100% of staff had completed all training, regardless of role.” from the report
Meaningful activities
People were supported to take part in activities linked to their interests, both inside and outside the home. The Sparkle initiative helped people pursue important wishes.
“People enjoyed a range of social activities which were meaningful and gave them purpose.” from the report
Safety risks were not always controlled
seriousSome emergency evacuation plans did not reflect people's current abilities. Fire safety concerns had also been identified before and were not dealt with quickly enough. The report says these issues had been addressed by the inspection, but a legionella risk assessment was still being arranged.
“Environmental risks were not always managed or mitigated to ensure people were safe.” from the report
Care plans and risk assessments were out of date
seriousSome records did not match people's changing needs, including needs linked to moving, medicines and pressure care. This could affect new or agency staff who did not know people well.
“Risk assessments in people's care plans did not always provide staff with guidance on providing safe care.” from the report
Quality checks missed problems
needs fixingAudits did not identify all the issues found by inspectors. The manager had not delegated enough work, and concerns about night staff duties and falls had not been acted on promptly.
“Other audits in the service had not picked up issues raised by the inspection as set out in the safe key question.” from the report
Some legal safeguards needed updating
needs fixingThe local authority had not always been told when extra restrictions had been added to people's care. The manager updated the authority during the inspection.
“We recommend the home reviews DoLS to ensure they include all deprivations of liberty.” from the report
- 01How have you kept each person's care plan and risk assessments up to date since the inspection?
- 02What action was taken after the fire safety concerns and the planned legionella risk assessment?
- 03How do you now check that emergency evacuation plans reflect people's current mobility, vision and support needs?
- 04What changes have been made to delegation and quality audits so that safety problems are found earlier?
- 05How do you make sure any new restrictions on a person's freedom are properly reviewed and reported to the local authority?
This was an unannounced inspection covering all five key questions, with care, accommodation, records, medicines, staffing and management reviewed; the previous overall rating was Outstanding, published on 17 August 2017. This explanation was written from the published report of 5 March 2020 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 The Haven
5 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- August 2023Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2020Gooddown from OutstandingSafe: Requires improvementWell-led: Good
- August 2017Outstandingup from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- March 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 20 December 2010.
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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