Background to this inspection
Updated
12 September 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.
We visited Prospect House 25 and 26 July 2018 to carry out an unannounced comprehensive inspection. The inspection team consisted of one adult social care inspector and one inspection manager, who attended on the first day.
Before the inspection, we reviewed the information we held about the service, including notifications and previous inspection reports. A notification is information about important events which the service is required to send us by law. We contacted the local authority contract monitoring team, the local authority safeguarding team, commissioners of care, social workers, learning disability nurses, care coordinators and a consultant psychologist.
The provider sent us a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to decide which areas to focus on during the inspection.
We used a number of different methods to help us understand the experiences of people who used the service. During the inspection visit, we spent some time talking with people, observing interactions and the support provided by staff. We talked with two people living at Prospect House about their experiences at the service. We spoke with three support workers, a team leader, the manager, a team leader, deputy manager and the quality manager.
We looked at a sample of records, including three care plans and other related care documentation, two staff recruitment records, training records, menus, complaints records, meeting records, policies and procedures, quality assurance records and audits.
Updated
12 September 2018
We carried out an unannounced inspection of Prospect House on 25 and 26 July 2018.
Prospect House is a 'care home' which is registered to provide care and accommodation for up to
seven adults with autism. The care service had been developed and designed in line with the values that underpin the CQC policy 'Registering the Right Support' and other best practice guidance.
People in care homes receive accommodation and nursing care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Nursing care is not provided at Prospect House. At the time of our inspection seven people were using the service.
At the time of the inspection there was no registered manager at the service. However, the manager in post had applied for registration. 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.
At our last inspection in the service was rated Requires Improvement. We found the provider was in breach of one regulation of the Health and Social Care Act (Regulated Activities) Regulations 2014. This related to the provider having unsafe processes for the management of medicines. At this inspection we found sufficient action had been completed to make improvements.
During this inspection we found there were no breaches of the regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014. We found evidence to support the overall rating of Good.
We found there were management and leadership arrangements in place to support the effective day to day running of the service. The manager had made several improvements and staff morale had improved.
There were processes in place for dealing with complaints. However, we found there was a lack of information to show how concerns had been dealt with and resolved. The manager took action to rectify this matter and we will check for further progress at our next inspection.
Processes were in place to provide people with safe support with their medicines.
People were safe at the service. Risks to people's well-being were being assessed and managed.
Staff had received training on supporting people safely and on abuse and protection matters. They had also received training on positively responding to people's behaviours. Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns.
Processes were in place to make sure all appropriate checks were carried out before staff started working at the service.
There were enough staff available to provide care and support; we found staffing arrangements were kept under review.
Systems were in place to maintain a safe environment for people who used the service and others.
Arrangements were in place to gather information on people's backgrounds, their needs, abilities and preferences before they used the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and processes at the service supported this practice.
We found people were effectively and sensitively supported with their healthcare needs and medical appointments. Changes in people's health and well-being were monitored and responded to.
People's individual dietary needs, likes and dislikes were known and catered for. Arrangements were in place to help make sure people were offered a balanced diet and healthy eating was encouraged.
We received positive comments about the staff team. We observed positive and respectful interactions between people using the service and staff.
Staff expressed a practical awareness of promoting people's dignity, rights and choices. People were supported to develop skills and engage in meaningful activities at the service and in the community.
Beneficial relationships with relatives and other people were supported.
Each person had detailed care records, describing their individual needs, preferences and routines. This provided clear guidance for staff on how to provide support.
People's needs and choices were kept under review, with the involvement of other people involved in their support.
People had communication profiles with plans in place, to highlight ways of sharing their feelings, needs and preferences.
There were systems in place to consult with people who used the service, relatives, staff and others, to assess and monitor the quality of their experiences. Various checks on quality and safety were regularly completed.