This unannounced inspection took place on over two days on 16 October and 21 October 2014 and was unannounced. At our last inspection in August 2013 the service was meeting the regulations inspected.
Havenmere is a care home that provides nursing and residential care to younger adults. The home is registered to accommodate 40 people. The home is purpose built and provides easy access for people with mobility problems. Havenmere aims to provide a service for people with complex physical and/or mental health needs who may need permanent, rehabilitation or respite care. This may include Dementia related impairments, Huntington’s disease, Acquired brain injury, Learning disability and other mental or physical illness requiring support. Havenmere is located in Immingham, in North East Lincolnshire. There are shops close by and the home is close to transport routes. There is a car park at the property for visitors and staff.
There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission 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.
Staff demonstrated a clear understanding of their role in keeping people safe and were able to describe different forms of abuse. Staff had received training about safeguarding vulnerable people from harm or abuse. People’s care records contained details and techniques staff should follow to ensure known risks to people were minimised and avoided where possible.
A variety of training was regularly provided to enable staff to have the right skills to carry out their roles and support people who used the service. Staff received regular supervision and appraisals to enable them to develop their careers.
Staff demonstrated a good understanding of the principles of the Mental Capacity Act 2005 (MCA) and the use of Deprivation of Liberty Safeguards (DoLS). People were supported to make informed decisions and choices that were in their best interests. Assessments used by the registered provider to determine people’s capacity to consent to making specific informed decisions were not fully in line with the principles underlying the MCA and were global in detail. We recommend that the service considers the Department of Health guidance on the Mental Capacity Act and the Mental Capacity Act Code of Practice
.
Checks had been carried out of new staff to ensure they were safe to work with vulnerable adults. Staff were deployed in sufficient numbers to make sure they were able to support people’s needs.
People were involved in decisions about their support and staff respected their right to make choices. Staff demonstrated compassion and consideration for people, many of whom experience difficulties in expressing their needs and adapting to their medical conditions. Staff responded to people’s differing individual needs with kindness and sensitivity, providing positive encouragement and giving explanations to help them understand what was being said.
People were able to contribute their views about the service and how it was run and could make complaints to enable their concerns to be addressed and where possible resolved.
The registered manager carried out regular checks to make sure the health and wellbeing of people who used the service were promoted.
Medicines, including controlled drugs were stored securely and administered to people in a safe way. A medication error had led to a safeguarding investigation being carried out by the local authority. The provider took prompt action about this to ensure this issue was minimised in the future, with additional medication training provided and regular audits of medication carried out.
People who used the service were provided with a diet that was wholesome and nutritious. Assessments about people’s nutritional needs and associated risks were recorded, with details about their personal preferences and dislikes. Staff monitored people’s weight and diet and involved specialist health care professionals where required. A safeguarding concern about a person experiencing a deterioration in their ability to swallow had been recently raised. An up to date care plan about this had not yet been developed despite a decision about this being made the previous week, which is a breach of Regulation 9 of the Health and Social Care Act 2008. You can see what action we told the provider to take at the back of the full version of the report.