Background to this inspection
Updated
21 June 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection was carried out by one inspector on 12 April 2017 and was announced. We gave 48 hours’ notice, due to the size of the service and we wanted to be sure that we would be able to speak with at least one person who used the service.
During the inspection we spoke with one person living in the home. We made general observations of the care and support provided. We also spoke with the registered manager and two members of staff.
We reviewed three people’s care files and their medicine administration record charts. We viewed two records relating to staff recruitment as well as training, induction and supervision records. We also looked at a range of monitoring reports and audits undertaken by the service manager and provider.
Updated
21 June 2017
The inspection took place on 12 April 2017 and was announced.
Prospects for People 3 Norwich Road provides accommodation and care for up to 3 people who have autism and or learning disabilities. At the time of our inspection 3 people were living in the home.
A registered manager was 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.
During our previous inspection on 22 February 2016 we found that the provider was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider was required to take action to address the concerns we found. During this inspection on 12 April 2017 we found that these actions had been completed.
We found a further breach of the regulations as there was a lack of robust systems in place to routinely monitor and assess the quality of the service being delivered. The registered manager did not audit people’s care records or people’s medicines. The registered manager did audit the weekly health and safety checks but did not provide an action plan for any shortfalls found. Any remedial action was not taken in a timely manner. A member of the provider’s quality assurance team conducted an internal monthly quality audit, again these were ineffective at addressing concerns within the service.
The registered manager was also the registered manager for another of the provider’s services which meant that the registered manager was not on site all of the time. They maintained regular contact via telephone and used a staff message book to communicate with staff. Staff added that they were able to contact the manager and felt supported in their role.
Whilst permanent staff received regular supervision, we found that the staff who worked on an as and when basis did not receive any formal supervision. There were also gaps in staff training records. Staff did not have regular meetings and this was due to the difficulties with agreeing on a suitable time for everyone. In spite of this, staff felt supported in their role by both the registered manager and their colleagues.
People’s care plans were not always person centred and some of what was written in people’s care plans was duplicated across all three people’s care plans. However, people’s individual communication needs were clearly documented as were risks to people’s health and wellbeing.
Staff were caring and treated people in a kind and compassionate manner. Staff engaged with people well. They supported people to make choices about what they wanted to do with their day through to how they preferred to have their care and treatment delivered. People were supported to be as independent as possible and they contributed towards weekly health and safety checks and shopping for the home. People were given opportunities to pursue their interests and hobbies both inside and outside of the home.
The service was working within the principles of the Mental Capacity Act 2005 and no one was being unlawfully deprived of their liberty. We saw that appropriate applications had been made to the relevant authorising body to deprive people of their liberty, in order to provide safe care and treatment.
Staff knew what constituted abuse and what procedures they would follow to report any concerns. There were safe recruitment practices for new staff and appropriate references and police checks had been sought before staff started working in the home. This helped to ensure that people were protected from abuse.
People’s medicines were not consistently audited but we saw that they were stored and administered in a safe way.