Explora Haven improved from Requires Improvement to Good overall, having remediated previous breaches of Regulation 19 regarding recruitment checks and governance audit failures. All five key questions rated Good, with people reporting they felt safe, well-cared for and treated with dignity by a stable, trained workforce.
Concerns (1)
minor
Communication with families
: “some people advised us that sometimes the agency did not tell them when care workers changed or if they were running late.”
Strengths
· Recruitment procedures improved since last inspection; pre-employment checks completed on all care workers before starting employment.
· People felt safe with care workers and reported no concerns about abuse or harm.
· Risk assessments and management plans were regularly reviewed and updated when people's needs changed.
· Medicines administered safely with appropriate records completed to a good standard.
· Care workers received induction, regular training, quarterly supervisions and annual appraisals.
Quality-Statement breakdown (23)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
Explora Haven received a Good rating across all five key questions at its first inspection under the new legal entity in June 2016. Minor gaps in refresher training tracking and staff appraisals were noted but were being addressed by management.
Concerns (2)
minorStaff training: “there was no system in place to identify further training needs and when refresher training was due so that staff skills were maintained”
minorSupervision / appraisal: “So far none of the care workers had received an appraisal due to not having worked at agency for more than a year.”
Strengths
· People felt safe around care workers and relatives raised no safety concerns
· Care workers arrived on time consistently and people received the same care worker regularly
· Robust recruitment checks including enhanced DBS, identity verification and two written references
· Medicines managed safely with individual assessments, trained staff and completed care records
· Staff received regular supervision and felt well supported by management
Explora Haven was rated Requires Improvement overall following a January 2019 inspection, primarily due to a breach of Regulation 19 concerning unsafe recruitment practices including missing references, unverified employment gaps, and absent address checks. Care delivery, staff training, person-centred practice and leadership were otherwise rated Good, with people and relatives consistently reporting high satisfaction with the care received.
Concerns (3)
criticalStaffing levels: “two references as stated in the providers recruitment procedure, were not always obtained from the current or previous employer.”
criticalGovernance: “the service did not always ensure that safe recruitment practices were followed and appropriate recruitment checks were obtained for prospective employees.”
minorSupervision / appraisal: “Records showed that these were not always provided as frequently as stated in the provider's supervisions procedure.”
Strengths
· People felt safe with their care workers and reported high satisfaction with the care received.
· Medicines administration was managed safely with correctly completed MARs in line with national guidelines.
· Care plans were holistic, person-centred, comprehensive and regularly reviewed.
· Staff received a wide range of induction and annual refresher training.
· The service maintained consistent care worker allocation, promoting familiarity and professional relationships.
Quality-Statement breakdown (22)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: The provision of accessible informationGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Planning and promoting person-centred, high-quality care and support; and how the provider understands and acts on duty of candour responsibilityGood
well-led: Leadership and managementGood
well-led: Continuous learning and improving careGood