Haven Care Wirral Limited

At our last inspection in October and November 2016, we found a breach of the Health and Social Care Act 2008 (Regulated Activities) 2014, relating to the use of systems and processes to assess, monitor and improve the quality and safety of care. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve the key question, 'is the service well-led', to at least good. At this inspection we found that the issues we had identified had been addressed and rectified.

However, at this inspection, we found that some statutory notifications had not been made to us in relation to some safeguarding concerns, which is a ratings limiter to the 'well-led' question. These concerns had though, been notified to the local authority.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community and supports people with a range of needs. The people whom it supports range from older to younger adults all of whom live in their own homes in either an individual domestic setting or in supported or extra care housing. Haven Care employs approximately 144 staff and supports approximately 130 people in these various settings in the community. These figures vary according to the needs of people needing support.

Supported housing provides care and support to people living in a 'supported living' setting, so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant's own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support services.

Recently, some other providers had reduced or ceased trading and some of the people they were supporting were transferred to Haven Care. These were the people who lived in the supported living and extra care accommodation. Some of the usual staff who supported them had also transferred to Haven Care, which enabled continuity. The process is colloquially known as TUPE (or Transfer of Undertakings Protection of Employment). The new services which Haven Care provided were to a group supported living community and a service in an extra care housing service. The service to their original service users who lived in their own homes in an individual domestic setting in the community continued to be delivered.

The service requires a registered manager and there were two in post who had been there for several years. 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. One of the registered manager's for Haven Care is also the provider of the service. The other registered manager was not available for the inspection.

At our previous inspection we found that audit and quality assurance systems were not robust. At this inspection we saw that improvements had been made in relation to these. The provider's managers had completed spot checks on staff and care record and medication record audits. We found that the auditing and quality assurance processes had improved. The provider was also a registered manager of the service and there was another registered manager who was on long term leave at the time of our inspection. The provider and the other managers of the service (the deputy managers and the care coordinators of the teams) who we talked with, had an open, supportive, accountable and transparent relationship with people who used the service, and the staff. They also had a similar relationship and had had good partnership working, with various organisations.

Recruitment processes were robust which ensured the safe employment of suitable staff. There were sufficient staff to meet people's needs but recruitment was continual, although the service had a good staff retention record.

Staff were being bought up to date with training although all had had either their previous employers training or that provided by Haven Care; supervisions had been increased and appraisals completed and planned. A schedule of training and supervision dates had been completed for the following year.

People were protected from the risk of abuse. All staff had completed training in safeguarding vulnerable adults, but some needed to be updated. They all knew how and to whom to report any concerns they may have This helped to ensure people's safety.

People told us that positive relationships had been developed between them and staff. They told us staff were, "Lovely" and "Helpful". One family member had written in a satisfaction survey, that staff made their relative laugh and other people told us they felt relaxed and at ease whilst being supported by staff.

People told us and we saw, that they were treated with dignity and respect. People told us that staff conducted themselves respectfully and left their homes clean and tidy.

People's care records contained accurate and up-to-date information about their needs. People were involved in their care planning and their preferences and choices respected. Risk assessments were in place and provided information to staff around how to manage those risks presented to people. This helped ensure that staff had access to information about supporting people and how to keep them safe.

There were sufficient numbers of staff in post. People commented that staff usually arrived on time, or within an acceptable time frame. People confirmed that staff always turned up for their care call. Staff told us they had enough time to spend with people in order to support them and chat with them and did not feel stretched. They told us that travelling time was built in to their schedules and was separate from the call times.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. This ensured that people's rights were protected under the Mental Capacity Act 2005. At the time of this inspection there were no people subject to any restrictions.

The five questions we ask about services and what we found