We inspected The Haven Residential Care Home on the 6 December 2018.

The Haven Residential Care Home caters for up to five people with mental health issues. At the time of our inspection five people were using the service. The service had spacious living areas and was set over two floors. The service was set in a residential area with easy access to the local community and had a small garden. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager. 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.

The service was safe. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for the needs of people.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed choices.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis. People were supported to follow their interests and participate in social activities. The registered manager responded to complaints received in a timely manner.

The service was well-led. The registered manager had systems in place to monitor and provide good care and these were reviewed on a regular basis.

The Haven Residential Care Home provides accommodation, care and support for up to five adults with mental health needs. There were four people in the service when we inspected on 25 April 2016. This was an unannounced inspection.

There was a registered manager in post. The manager was also a director of the organisation. 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 received care that was personalised to them and met their needs and wishes. Staff listened to people and acted on what they said. The atmosphere in the service was relaxed and welcoming.

Feedback from people about the staff and management was positive.

Procedures were in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew how to report any concerns to management.

Staff knew how to minimise risks and provide people with safe care. Procedures and processes guided staff on how to ensure the safety of the people who used the service.

People were provided with their medicines when they needed them and in a safe manner.

There were sufficient numbers of staff to meet people’s needs. Recruitment processes checked the suitability of staff to work in the service. People were treated with kindness by the staff. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.

Staff were trained and supported to meet the needs of the people who used the service. People’s nutritional needs were assessed and met. People were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.

People were involved in decisions about how they were supported outside of the service. However, it was apparent that at least one person was not free to leave the service on their own. The registered manager recognised the importance of ensuring relevant safeguards were in place to protect people who may be deprived of their liberty. They confirmed they would consult the latest Deprivation of Liberty Safeguards (DoLS) guidance and make relevant applications if necessary.

A complaints procedure was in place. People’s comments, concerns and complaints were listened to and addressed in a timely manner.

There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had a quality assurance system where shortfalls could be identified and addressed promptly. As a result the quality of the service continued to improve.

Our previous inspection of 2 January 2014 found that there were improvements needed in the service’s medication procedures. As part of this scheduled inspection we checked that improvements had been made to address the identified shortfalls.

We spoke with three of the five people who used the service. We also spoke with the registered manager and a staff member. We looked at three people's care records. Other records viewed included staff training, staff recruitment and health and safety checks. 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 the registered manager looked at our identification and asked us 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 (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that staff had been trained to understand when an application should be made, and how to submit one. We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and DoLS. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

The service was safe. Records showed that the health and safety in the service was regularly checked. This included regular fire safety checks, which meant that people were protected in the event of a fire.

Recruitment practice was safe and thorough. This meant that the appropriate checks had been made on staff to ensure they were able to work with vulnerable people.

People were provided with their medication in a safe manner and at the prescribed times. Medication was stored safely.

Is the service effective?

People told us that they were happy living in the service. One person said, "I am happy here."

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 reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

People's dietary needs were met and people's choices relating to the food that they ate were listened to.

Is the service caring?

The staff interacted with people living in the service in a caring, respectful and professional manner. People told us that the staff treated them with kindness.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with their 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 in to account and listened to.

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 health care professionals, including a doctor and mental health professionals.

We looked at how complaints had been dealt with, and found that the responses had been open, thorough, and timely. People could therefore be assured that complaints were investigated and action where taken as necessary.

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.

The service had an effective quality assurance system and records reviewed by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

We spoke with two of the five people who used the service. They told us that they felt that the staff are very supportive and nice. One person said, "I am new here, the staff are helping me to get to know the area, they have helped me to join the library." People told us that they were consulted about the care they required and were involved in writing their care plans and risk assessments.

During our visit we saw that the staff listened to people's choices and acted upon them, such as what time they wanted to prepare their lunch.

We found that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Staff told us about the training and supervision they had received to enable them to carry out their role in supporting people. Staff told us they felt supported by the manager.

We found that the provider had systems in place to monitor and respond to any complaints received about the home.

We spoke with three of the four people who used the service. They told us that they felt that the support they received from the service met their needs. One person said, “I am happy here, they (staff) all make sure I am well.” Another person said, “I am happy living here.”

People told us that they were consulted about the care they were provided with. One person said, “In every area of my care, they (staff) ask for my consent.” Another person said, “They (staff) always ask me what I want and how I want it done.” During our visit we saw that the staff listened to people’s choices and acted upon them, such as what time they wanted to go shopping.

People told us that the care workers treated them with respect. One person said, “They (staff) treat me with respect and kindness.” During our visit we saw that the staff interacted with people in a caring, respectful and professional manner. They were attentive to people’s needs and responded to requests for assistance promptly.

We looked at the care records of four people who used the service and found that people experienced care, treatment and support that met their needs and protected their rights. We found that the staff were trained and supported to meet the needs of the people who used the service.