30 November 2022
During an inspection looking at part of the service
New Haven Care Home is a residential care home providing accommodation for up to 50 people, who require personal care. The service provides support to people who have physical health needs and conditions such as dementia. At the time of our inspection there were 37 people using the service, this increased to 39 by the end of the inspection.
The home is set out across 3 floors, one floor was dedicated to providing care for people living with dementia. Two floors contain communal areas and each bedroom has an en-suite. There is also a hairdressers and beauty space available for people.
People’s experience of using this service and what we found
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We found people being deprived of their liberty without the principles of the Mental Capacity Act being followed. This practice was addressed by the registered manager during our inspection.
We found people were at risk of harm as medicines and risks associated with people’s care were not safely managed. Risk assessments and care records for people were either not in place or not reflective of people’s needs. We found staff and the management team were not always assessing risks and reporting incidents appropriately.
The provider was not actively involved in the running of the service and we found no evidence of provider audits. The provider hired a consultancy firm to complete periodic reviews and provide support at the service, however the provider had not acted on concerns raised by the consultancy. The head of the consultancy firm was the nominated individual of the service and was not completing audits on behalf of the provider.
The shortfalls from previous inspections had not been adequately addressed. There was a new registered manager in post at the service who had identified multiple concerns with poor care and was actively working to improve people’s experience. The governance processes in place had been implemented by the new registered manager but needed embedding in practice.
We found staff were not knowledgeable about mental capacity, consent and dementia care. The consultancy firm confirmed they would provide additional training after the inspection.
We found staff were not always reporting safeguarding concerns to the management team and potential safeguarding concerns were not always appropriately reviewed by the management team.
People, relatives and staff raised concerns about staffing levels. We saw some positive interactions between staff and people; however, people were not always supported in a timely manner and staffing was not calculated in line with people’s needs. The registered manager was actively working to improve the dining experience for people.
Feedback from staff was mostly negative about the culture of the service and the support they received.
People and their relatives told us they felt people were safe. Recruitment was managed safely. Staff were trained in safeguarding and some staff could give examples of different types of abuse. The service was well maintained providing a spacious and hygienic environment. People and relatives spoke positively about the care provided by care staff. We saw evidence of and gained positive feedback from visiting professionals around good partnership working to meet the needs of people living at the service.
The registered manager and consultancy firm were responsive to our inspection findings and responded during the inspection. We received updates about what actions they were taking to address concerns.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 04 March 2020) and there were breaches of regulation. At this inspection we found the provider remained in breach of regulations and found new breaches of regulation. This service has been rated requires improvement for the last 2 consecutive inspections and is now rated inadequate.
Why we inspected
This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part due to concerns received in relation to the management team at the service. As a result, we undertook a focused inspection to review the key questions safe, effective and well-led. The provider has taken action to mitigate some of the risk identified at this inspection. Please see the safe, effective and well-led sections of this full report.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for New Haven Care Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, need for consent, staffing and good governance. Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.