The inspection took place on 8 August 2017 and was unannounced.

Hatfield Haven provides accommodation and personal care for up to 22 older people some who may be living with dementia. Care is provided on two floors. At the time of our visit there were 21 people living in the service.

Since the last inspection a new manager has been appointed. They told us that they had applied to CQC to be registered. 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.

When we last visited the service in 2015 we found that improvements needed to be made. During this inspection we found the provider and registered manager management team had made improvements.

People spoke positively about the service and the care that was provided. They told us they were listened to and staff were kind and caring.

People told us that they felt safe. Staff were clear about what was abuse and the steps that they should take to protect people. The likelihood of harm was reduced as risks to people’s health and welfare was assessed. Risk assessments guided staff in how to reduce the risks and keep people safe.

Checks were undertaken on staff suitability for the role and there were sufficient numbers of staff available to meet the needs of the people living in the service.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow. Their competency was checked regularly.

New staff received induction training to provide them with the skills to care for people. Staff files showed staff had undertaken sufficient training to meet the needs of people and they were supervised regularly to check their competence. However, staff needed to improve their knowledge and understanding around supporting people living with dementia. Staff were supported and supervision sessions gave staff the opportunity to discuss their work and identify any necessary training.

People who lived in the home were positive about the quality of the food and our observations were that people enjoyed their meals.

People had access to healthcare professionals and appointments were documented with outcomes implemented in care plans. We found staff had responded promptly when people had experienced health problems.

Quality assurance systems were in place however, they were not yet fully effective as they had not identified some of the areas that we found where improvements needed to be made. People and relatives were encouraged to give their views about the service. A complaints procedure was available and people knew who to speak to if they had a concern.

The new manager was approachable and promoted an open culture.

The inspection took place on 28 July 2016 and was unannounced.

Hatfield Haven provides accommodation and personal care for up to 22 older people some who may be living with dementia. Care is provided on two floors. At the time of our visit there were 19 people living in the service.

Since the last inspection a new manager has been appointed and has taken up post. They told us that they had applied to CQC to be registered. 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.

People spoke positively about the service and the care that was provided. They told us they were listened to and staff were kind.

People told us that they felt safe. Staff were clear about what was abuse and the steps that they should take to protect people. The likelihood of harm was reduced as risks to people’s health and welfare was assessed. Risk assessments guided staff in how to reduce the risks and keep people safe but could be more detailed.

Checks were undertaken on staff suitability for the role and there were sufficient numbers of staff available to meet the needs of the people living in the service.

Medication was generally managed safely but did not always follow the recommended professional guidance.

Staff received an induction to prepare them for their role and additional training was provided to support their learning and development. Staff had limited understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Staff supervisions and competencies had not been carried out on a regular basis.

People who lived in the home were positive about the quality of the food and our observations were that people enjoyed their meals.

The environment did not promote people’s independence.

Care plans documented people’s needs but varied in quality which meant that some people were at risk of receiving inconsistent care.

The manager was approachable and promoted an open culture.

Complaints were taken seriously and investigated. Staff knew what was expected of them.

There was no formal way of gaining people’s views.

There were systems in place to drive improvement but these would benefit from a greater focus on people’s experiences.

We considered all the evidence we had gathered under the outcomes we had inspected to answer the questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Is the service safe?

Each person had a support plan which identified their individual needs and contained a range of risk assessments with actions to reduce the risks identified and keep them safe. We saw equipment was in place where necessary to prevent the development of pressure ulcers. As a result people were protected from the risk of inappropriate or unsafe care..

Appropriate systems were in place for obtaining medicines and for their safe storage, administration and disposal.

Training in the safeguarding of vulnerable adults from the risk of abuse was provided to all staff and they were clear about the action they would take if they had concerns about the safety and welfare of a person who used the service. There was a whistle blowing policy in place and this was available to staff and people who used the service. Staff had received training in the Mental Capacity Act and Deprivation of Liberty Safeguards and understood the implications of these in relation to the people who used the service. Capacity assessments had been completed in relation to people’s ability to make decisions about their care and treatment and involve others as appropriate This meant steps had been taken to safeguard the people using the service.

Is the service effective?

Full assessments of each person were undertaken prior to agreeing their admission to the service. Care plans were reviewed regularly and updated as necessary to ensure the care provided was appropriate to each person’s individual needs.

We saw there was involvement of a range of professionals in the care of each person to ensure care was effective and specialist input obtained where necessary.

Staff were provided with the training and support necessary to provide safe and effective care.

Is the service caring?

People told us staff were kind and one person said, “They will do anything for you.” People appeared happy and relaxed and were engaged in activities they clearly enjoyed.

We saw staff interacting with people in a very positive way. They showed respect for people as individuals and protected their dignity. The relatives we talked with told us they were always made welcome and were able to visit at any time.

We saw staff took care to consider people’s preferences in order to cater for their individual wishes and provide choice. For example one resident liked to have Chinese food twice a week and this was provided in addition to the normal menu choice.

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Is the service responsive?

The views of the people who used the service were sought and used to improve the service.

There was a complaints procedure in place with timescales for response. The procedure was accessible to the people who used the service, their relatives and advocates.

There were systems in place to learn from incidents such as falls, thus reducing risks to people using the service

Is the service well led?

The manager was actively engaged in activities within the service and available for advice and support to people who used the service and to staff.

Staff were provided with appropriate training and support when they joined the service and there were systems in place to ensure they received regular updates and additional training during their employment. Staff received annual appraisals and regular supervision.

Quality assurance processes were in place to monitor and assess the quality of the service provided and introduce improvements.

During our inspection we spoke with six people and two relatives of people who lived at the home. People told us that the care workers always knocked on their door before entering their room and asked for their permission before any personal care was carried out. One person said, "They always ask, not that they need to."

People told us that they were very happy with the care that they or their relative received. One person told us, "The staff are nice to us. They are caring and considerate." People told us that there were plenty of activities in which they could participate. One person told us, "It is never boring or anything." People also said that they liked the food that was provided. One person told us, "The cooking is lovely. We get nice puddings and lovely meals." During the lunch time period we observed care workers assisting people to eat their meal in a caring and sensitive manner.

The home looked clean and smelled fresh. We saw that all the rooms were thoroughly cleaned on a daily basis. The en-suite facilities of the rooms we looked at were clean and rooms were dust free.

We saw that each new staff member was required to complete an induction programme relevant to their individual role over a twelve weeks period.

We saw that people's care plans were kept in a secure cupboard on the ground floor and were therefore protected from access by unauthorised people.

We spoke with four people who used the service and we looked at the results of the last relatives' feedback survey in September 2011.

A person who uses the service said, "It's absolutely brilliant here" and, "There's plenty to do" in respect of activities available at the service. They went on to explain that their relative had chosen the service for them as it was, "The best one" they saw.

Another person explained, "I am happy here. They look after me very well."