About the service:

Haven Lodge is a residential care home that was providing accommodation and personal care to people who have learning disabilities and or mental health needs and were aged 65 and over at the time of the inspection.

People’s experience of using this service:

People told us they were happy living at Haven Lodge and were happy with the service they received. People visiting the service said the home had a friendly family atmosphere and told us they all got on well together and felt safe at the service.

Processes were in place to protect people from avoidable harm and abuse. Staff were aware of their responsibilities in relation to this and were clear about the way to escalate any concerns they identified. When accidents or incidents occurred, learning was identified to reduce the risk of them happening again. Sufficient staff were available to provide a timely response to people and provide safe care. People received their medicines as prescribed and medicines were managed safely.

People continued to receive effective care. Staff were well trained and were given regular opportunities to review their work and identify their learning and development needs. Staff supported people to access healthcare services when needed and liaised well with other professionals to provide coordinated care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and systems supported this practice. Consent to care was obtained in line with legislation.

People were treated with kindness and sensitivity. Staff knew people well and used this knowledge to provide reassurance when people were anxious or distressed. They were responsive to people's individual needs and wishes and the service was provided flexibly. People were involved as much as possible in decisions about their care. People were supported to access services outside the home and links with the local community were well developed.

The service continued to be well led. Roles and responsibilities were clear, and staff were proud of the service they provided. Systems were in place to monitor and improve the quality of care. People were encouraged to be involved and given opportunities to provide feedback and put forward their ideas for the service.

Rating at last inspection: Good (Inspection report published in November 2016)

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 19 September 2016 and was unannounced.

Haven Lodge provides accommodation and personal care for up to seven people who have mental health needs. At the time of our inspection seven people were using the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associate Regulations about how the service is run.

Management and staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions in some areas of the their care, treatment and support.

There were enough staff who had been recruited safely and who had the skills and knowledge to provide care and support in ways that people preferred. People were safe because staff understood their responsibilities in managing risk and identifying abuse. People received safe care that met their assessed needs.

People’s health needs were managed with input from relevant health care professionals, and there were systems in place to manage medicines so that people were supported to take their prescribed medicines safely.

People were treated with kindness and respect by staff that knew them well and were supported to maintain relationships with family and friends. Staff supported people to have sufficient food and drink.

The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.

Some of the people who lived at Haven Lodge had some complex needs but most were able to speak with us. We spoke with people who used the service on the day of our inspection. We gathered evidence of people's experiences of the service by observing how they spent their time and we noted how they interacted with other people who lived in the service and with staff. We also spoke with staff members. We looked at two people's care records. Other records viewed included staff rotas, training and supervision records, health and safety checks, staff and resident meeting minutes, medication records and records which related to the quality assurance of the service.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive?

Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service we were asked for our identification and asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

The Care Quality Commission monitors the operation of the Deprivation of Liberty

Safeguards (DoLS) which applies to care homes. The service was aware of new changes in the law with regard to DoLS. Whilst no applications had needed to be submitted, appropriate policies and procedures were in place and had been followed. Relevant staff had been trained to understand when an application should be made and how to submit one.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns. We saw the service had processes in place which ensured that staff had the skills and knowledge to support people safely.

We saw that people's personal records including medical records were accurate and that staff records and other records relevant to the management of the service were accurate and fit for purpose.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information.

We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service and how those needs were to be met.

Is the service caring?

We saw that the staff interacted with people who lived in the service in a caring, and

respectful manner. We saw that staff treated people with respect.

Staff had a good knowledge and understanding of people's care and support needs,

including recognising and supporting them as an individual. Where people required

assistance, staff provided this in a timely manner and at a relaxed pace. This ensured

people received care and support consistently and in ways that they preferred.

People's preferences, interests, aspirations and diverse needs had been recorded and

care and support had been provided in accordance with people's wishes.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken into account and listened to.

People told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns appropriate action had been taken to address them. People could therefore be assured that complaints were investigated and action was taken as necessary.

People's care records showed that where concerns about their wellbeing had been

identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from healthcare professionals.

Is the service well-led?

The service worked well with other agencies and services to make sure people received

their care in a joined up way.

Staff told us they were clear about their roles and responsibilities. Staff had a good

understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good service at all times.

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

The service had a quality assurance system in place and records seen by us showed that identified shortfalls were addressed promptly. The service had processes in place to collate the information they had gathered, identify the service's strengths and weaknesses, and plan the actions required to improve the experiences of people who used the service. This ensured continued improvement in the areas identified.

Some of the people who lived at Haven Lodge had complex needs but most were able to speak with us. We gathered evidence of people’s experiences of the service by observing how they spent their time and we noted how they interacted with other peoplewho lived in the home and with staff.

We saw that people had individual ways of communicating and were able to make members of staff aware of their needs and preferences. We saw that people were comfortable in their surroundings.

We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service. We saw that staff treated people with respect.

Haven Lodge was well managed and the registered manager had systems and processes in place which ensured people received a good service that took into account their needs and preferences.

We used a number of different methods to help us understand the experiences of people who used the service, as some of the people using the service had complex needs which meant they were not able to tell us their experiences. Where people were unable to provide a response or tell us about their experiences, for example as a result of their limited verbal communication or poor cognitive ability, we noted their non verbal cues and these indicated that people were generally relaxed and comfortable and found their experience at Haven Lodge to be positive.

We observed that staff members were polite and attentive towards people who used the service, in particular those people with no or limited verbal communication. We saw that staff made good eye contact with people.

People told us they were satisfied with the level of care and support they received at Haven Lodge. One person told us "It's good here they look after you."

Feedback about the service from the people we spoke with was overall positive and the comments they made to us during the inspection were relayed back to the manager. They told us that staff were kind, approachable, listened to their views, provided good care and were always available.

People with whom we spoke had limited and varying verbal communication skills but were able to participate in a conversation and we noted their non verbal cues.

People spoken with indicated that they were satisfied with the level of care and support they received at Haven Lodge.

Those people with whom we spoke indicated they could choose whether or not to join in activities and could spend time alone in their room pursuing their own interests if they preferred.

The people with whom we spoke made the following comments "I am happy today." and "I like living here and we all get on." and "They help me and tell me what to do."

People told us that they enjoyed the food at the home, and were always given choices about what they wanted to eat and drink. One person told us, "The food is good and if I don't like something they will make me something else."

We spoke with people living in the home and they told us what they do on a daily basis. All the people with whom we spoke were able to go out independently. People told us that they go out to the library, regularly go to church on Sundays, take the bus to visit relatives in Colchester, go to the seafront and have a drink in local cafes. One person told us, " I really like it here." Another person said, "The food is good."