We inspected Newhaven Residential Home on 22 February 2017. This was an unannounced inspection. The service provides care and support for up to 25 people. When we undertook our inspection there were 22 people living at the home.

People living at the home were mainly older people. Some people required more assistance because of physical illnesses or because they had problems coping with everyday tasks.

There was a registered manager in post. 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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. At the time of our inspection there was no one subject to such an authorisation.

We found that people’s health care needs were assessed and care was planned and delivered in a consistent way through the use of their care plans. People were involved in the planning of their care, but many did not wish to see their care plans. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed, but plans were not put in place to minimise risk in order to keep people safe. The care plans were all being reviewed as a new format was being introduced.

People had been consulted about the development of the home and quality checks had been completed to ensure the home could meet people’s requirements. However, there was little analysis of quality checks. Where this had taken place the lessons to be learnt had been passed on to staff through staff meetings.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

People were treated with kindness and respect. Staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it. However, there were no menus on display so people could not remind themselves of the choices they had made.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. On-going training and support was available for all staff.

There had been some refurbishment and renewal of some floor coverings and furniture since our last inspection. There was a system in place to ensure the refurbishment programme continued.

The service provides care and support for up to 25 people. When we undertook our inspection there were 22 people living at the service.

We inspected Newhaven Residential Home on 26 February 2015. This was an unannounced inspection. Our last inspection took place on 27 August 2014 during which we found the service was not meeting all the standards we assessed. This was because we found at our August 2014 inspection we found the policies regarding safeguarding procedures had not been reviewed since 2009 and an incident had not been reported to the relevant statutory bodies. The provider sent us an action plan and at this inspection the provider was compliant.

There was a registered manager in post. 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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. There were no people living at the home that were subject to any such restrictions.

There were a mixture of people who lived at the home of varying age groups. Some were mobile and could walk around easily, whilst others required walking aids or wheelchairs. Some people liked to spend their time in sitting rooms and the garden. Others preferred to stay in their bedrooms most of the day and saw their visitors in those rooms.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.

The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home.

People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed thorough training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual. There were sufficient staff to meet people’s needs.

People had been consulted about the development of the home and quality checks had been completed. However, some areas of the home and some equipment required refurbishment and there was no plan in place to ensure the environment and equipment was updated.

A single inspector carried out this inspection. We talked to six of the 22 people using the service and three visitors. We looked at five people’s care records and observed care provided. We talked with two staff, the manager and the deputy manager. We examined training records and the documentation relating to quality audits.

This helped us to answer the questions below.

Is the service safe?

Risk assessments were in place to identify the risks to people using the service and identify action needed to reduce these risks. Where required equipment was in place to meet the needs of people using the service, for example, standing aids, specialist beds and mattresses.

People told us they felt safe at the home. They had confidence in the staff caring for them and the managers

We found that safeguarding policies and procedures required review to ensure they meet current requirements. We were concerned that a safeguarding incident had not been identified and therefore reported appropriately.

Is the service effective

Care plans were developed with the involvement of people using the service and reflected their needs and preferences. They were reviewed and updated regularly to ensure they met current needs.

Visitors confirmed they were able to visit freely and were able to see their relative in private if they wished.

The home collaborated with other professionals and services to ensure people’s health needs were identified and met.

Is the service caring?

People told us staff were friendly and caring. One person said, “I don’t think anybody could do any better.” Another person described it as, “Feeling like home “

People’s privacy and confidentiality was maintained and they were treated with dignity and respect.

Is the service responsive?

People were provided with information on how to make a complaint and told us they felt able to raise any issues with the staff or manager. One person said, “They (the manager) told me how to make a complaint and they said that if there is ever anything I am unhappy about come and talk to us. I feel that I can do that as they are easy to talk to.”

Senior staff met with each person using the service monthly to review the quality of the service provided and identify changes.

Staff listened to feedback from people using the service and responded to this wherever possible.

Is the service well led?

There was a programme of quality audits to assess the quality of care and introduce improvements.

A training programme was in place to ensure staff had the knowledge and skills necessary for their roles. However, staff did not have regular supervision or appraisal to assess their progress and identify their training needs.

The manager was available to staff and people using the service on a daily basis and was proactive in identifying issues.

We looked at four care plans for people who used the service. Care and treatment was planned and delivered in such a way that was intended to ensure people’s safety and welfare.

We saw the home had taken steps to promote people’s dignity; one person’s care plan we reviewed stated, “XXX wishes for female carers to attend her personal needs.”

We looked around the home and observed a high overall standard of cleanliness. We saw people’s rooms were clean and communal areas were clean and tidy. One person living at the home told us, “I think they do a good job keeping this place clean, I’ve no complaints about its cleanliness.”

We observed that care staff were attentive to people’s needs and their interaction with people was friendly, respectful and professional.

The home was kept clean and free from odour. Towels and flannels were washed each day; bed linen as washed regularly.

People who lived at the home were well presented and well groomed.

One person told us, “You could not find a better home. It’s lovely. They couldn’t look after us any better. It’s very homely; it just feels like home to me.”

We saw people were given choices in how they wished to spend their day and were encouraged to join in a programme that offered both group and one-to-one activities each weekday.

We observed people were given a good choice of hot and cold food from a menu. Refreshments were available throughout the day.

We spoke with four people who told us that they were happy living at Newhaven. One person told us that they had lived there for ten years and would never want to move.

Another person had recently decided to make their move to Newhaven permanent. “I have been here on a temporary basis for a while and thought I might go home again. I’ve decided to stay because I like it here and feel safe.”

All the people we spoke with told us there were always plenty of staff on duty who took time to talk with them if they were worried about anything.

One person told us “The staff are excellent. The care I receive is wonderful, as is the food. There is always plenty of good, home cooked food.”

We observed that people seemed very relaxed and content and this was confirmed by those we spoke with.

A relative told us that they were always made welcome and staff kept them informed about their relative. “My relative seems to be content. They never complain about anything and always look clean and smart.”