12 February 2016
During a routine inspection
The Haven provides care and accommodation to up to four adults with a learning disability. People had a variety of complex needs including mental and physical health needs and behaviours that may challenge. There were three people using the service at the time of our inspection. The registered provider DGSM Your Choice, a charity which had recently become a subsidiary of MCCH. We found that changes in documentation was taking place as MCCH systems were being adopted.
People had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy in their home by showing warmth to the staff that were supporting them. Staff were attentive and communicated with people in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for care and support. We observed staff supporting people with their daily activities.
A registered manager was not employed 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. A registered manager from another service owned by the registered provider assisted with the inspection process on the day of the inspection. They had been the registered manager. They had recently de-registered to register with another service owned by the registered provider, but were still overseeing the service. They told us that a registered manager of another service owned by the registered provider was due to start work at The Haven on the 1 April 2016.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The manager assisting the inspection understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.
Staff had been trained to recognise and respond to the signs of abuse. Discussions with them confirmed that they knew the action to take in the event of any suspicion of abuse. Staff understood the whistle blowing policy and how to use it. They were confident they could raise any concerns with the registered provider or outside agencies if this was needed.
There were enough staff with the skills required to meet people’s needs. Staff were recruited using procedures designed to protect people from the employment of unsuitable staff. Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.
Staff respected people in the way they addressed them and helped them to move around the service. Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served and at other times during the day.
Staff were knowledgeable about the needs and requirements of people using the service. Staff involved people in planning their own care in formats that they were able to understand, for example pictorial formats. Staff supported them in making arrangements to meet their health needs.
Medicines were managed, stored, disposed of and administered safely. People received their medicines when they needed them and as prescribed.
People were provided with food and fluids that met their needs and preferences. Menus offered variety and choice.
There were risk assessments in place for the environment, and for each individual person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. People were involved in making decisions about their care and treatment.
There were systems in place to review accidents and incidents and make any relevant improvements as a result.
Management investigated and responded to people’s complaints and relatives/advocates said they felt able to raise any concerns with staff.
People were given individual support to take part in their preferred hobbies and interests.
There were systems in place to obtain people’s views about the quality of the service and the care they received. People were listened to and their views were taken into account in the way the service was run.