Archived: National Autistic Society - Prospect House

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.

Prospect House is owned by The National Autistic Society (NAS). It is a care home which is registered to provide care and accommodation for up to seven adults with a diagnosis of autism and does not provide nursing care.

Prospect House provides accommodation and support for seven younger adults with autism. It is located on a main road in Altham near Accrington. There are various communal rooms; some are equipped to offer sensory, therapeutic and recreational activities. All the bedrooms are single and six have en-suite facilities. There is an enclosed patio/garden area to the rear of the home. Car parking is available at the front of the premises. The service aims to support people in their progression towards living more independently. At the time of the inspection there were six people accommodated at the service.

The service was managed by 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.

At our last inspection on 12 & 13 February 2015 the overall rating of the service was Good, however there was a breach of regulations which meant the domain Well-led was rated requires improvement. We asked the provider to make improvements in relation to monitoring and improving the quality of the service provided. We received an action plan from the provider indicating how and when they would meet the relevant legal requirements. At this inspection we found sufficient improvements had been made on these matters.

At this inspection 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. You can see what action we told the provider to take at the back of the full version of the report.

We found there were management and leadership arrangements in place to support the day to day running of the service. Comments from staff indicated there was discontentment about some aspects of management.

Recruitment practices made sure appropriate checks were carried out before staff started working at the service.

There were sufficient numbers of staff at the service. The use of agency staff was being monitored and kept under review.

Risks to people’s well-being were being assessed and managed. Systems were in place to maintain a safe environment for people who used the service and others.

Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Staff said they had received training on safeguarding and protection matters. They had also received training on positively responding to people’s behaviours.

We observed positive and respectful interactions between people using the service and staff. People made positive comments about the staff team.

Arrangements were in place to gather information on people’s backgrounds, their needs, abilities, preferences and routines before they used the service.

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 and changes were responded to.

Staff expressed a practical awareness of promoting people’s dignity, rights and choices. People were supported to engage in meaningful activities at the service and in the community. Beneficial relationships with relatives and other people were supported.

People were supported as much as possible to make their own choices and decisions. We saw staff considerately consulting with people and involving them in routine decisions. We found the service was working within the principles of the MCA (Mental Capacity Act 2005).

People were effectively 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.

There were systems in place to consult with people who used the service and staff, to assess and monitor the quality of their experiences.

People were supported to access resources and activities within the community and keep in touch with others.

People were supported to make choices, try new experiences and develop independence skills.

People were getting support with healthcare needs and they had access to on-going attention from health care professionals.

People were provided with safe, comfortable and pleasant accommodation.

We found the staffing arrangements were sufficient in ensuring people received effective care and support.

There were systems in place to help support people to make complaints and raise concerns.