Archived: Prospect House Care Home

Prospect House care home is a 33-bedded service providing personal care to older people, people living with dementia and people with physical disabilities. At the time of our visit there were 29 people using the service.

People’s experience of using this service:

People who used the service and their relatives told us staff were caring, helpful, attentive and caring. We saw people were treated with dignity, respect and compassion. 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.

People’s healthcare needs were being met and medicines were being stored and managed safely.

Staff knew about people’s dietary needs and preferences. People told us there was a good choice of meals and said the food was very good. There were plenty of drinks and snacks available for people in between meals.

Activities were on offer to keep people occupied both on a group and individual basis. Visitors were made to feel welcome and could have a meal at the home if they wished.

The home was clean and tidy, but in need of refurbishment in some areas. A plan was in place to address this.

Staff were being recruited safely and there were enough staff to take care of people and to keep the home clean. Staff were receiving appropriate training and they told us the training was good and relevant to their role. Staff were supported by the registered manager and were receiving formal supervision where they could discuss their ongoing development needs.

Care plans were up to date and detailed what care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate identified risks. People felt safe at the home and appropriate referrals were being made to the safeguarding team when this had been necessary.

There were a complaints procedure and people knew how to complain.

Everyone spoke highly of the registered manager who they said was approachable and supportive. The provider had effective systems in place to monitor the quality of care provided and where issues were identified, they acted to make improvements.

Rating at last inspection:

Good (report published August 2016)

Why we inspected:

This was a planned inspection to confirm that this service remained good.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Prospect House was last inspected by CQC on 2 June 2014 and was compliant with the regulations in force at that time.

Prospect House provides care and accommodation for up to 33 people. On the day of our inspection there were 31 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager had worked at the home for over 10 years.

Accidents and incidents were appropriately recorded and investigated, with the registered manager reviewing the incident three days after it occurred for any after effects which was good practice. Risk assessments were in place for people who used the service and staff and described potential risks and the safeguards in place. Staff had been trained in end of life care and in safeguarding vulnerable adults. Medicines were stored safely and securely, and procedures were in place to ensure people received their medicines as prescribed.

The home was clean, spacious and suitable for the people who used the service, although some redecoration was needed we saw this was planned by the registered provider. Appropriate health and safety checks had been carried out on the building.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and training sessions were planned for any due or overdue refresher training. Staff received regular supervisions and appraisals.

The provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS).

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists to people’s physical health was supported.

People who used the service, and family members, were complimentary about the standard of care at Prospect House. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed by a senior manager from the service before they moved into Prospect House and care plans were written in a person centred way. Care records were well detailed and showed people’s needs were reviewed regularly.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs. The activity co-ordinator had lots of ideas to keep people active and fulfilled at the service.

People who used the service, and family members, were aware of how to make a complaint however there had been no formal complaints recorded at the service.

We saw the registered manager was updating care plans following training they had undertaken in oral health. As well as the training information the manager was using best practice guidance to ensure the oral health plans were as up to date as possible.

The service regularly used community services and facilities and had links with other local organisations. Staff felt supported by the registered manager and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service. Family members told us the management were approachable, supportive and understanding.

We considered all the evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff understood their role in safeguarding the people they supported. People who lived in the home said, 'I'm safe and sound' and 'The staff keep me safe.' One relative told us, "We feel very lucky to have found this place, my family member is kept safe and we can go home and sleep at night."

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, relevant policies and procedures were in place. Appropriate staff had been trained to understand when an application should be made, and how to submit one. This meant that people would be safeguarded as required.

People were protected against the risks associated with the unsafe administration of medicines. At this inspection we observed staff dispense and administer medication to people safely.

Is the service effective?

Care files we checked confirmed that initial assessments had been carried out by the staff before people moved into the home. This was to ensure the home was able to effectively meet the needs of the people who were to live there. People's health and care needs were assessed with them, and their family and friends were involved in the formulation of their plans of care. Specialist mobility and equipment needs had been identified in care plans where required.

We found people were provided with a choice of nutritious food. Some people required specialised diets for health or personal reasons. We found the service provided food and drinks specifically requested by people. People told us, 'There's always a choice, so I can always have something I like' and 'I've put weight on since I got here because the food is good.'

Four relatives we spoke with confirmed they were able to see their family member in private and that visiting times were flexible. One relative said, "The staff take my mum to her room after lunch each day so when father visits each afternoon they can have some private time together."

Is the service caring?

We found people were treated with respect and dignity by the staff. During our inspection we observed staff speaking with people who used the service in a friendly and caring way. We observed care and support was provided to people when requested.

Three care workers we spoke with demonstrated a good understanding of people's needs and were able to give examples of how they promoted people's independence. Staff were skilled and confident in recognising the diversity, values and human rights of people who used the service.

People we spoke with told us staff were, "marvellous" and "lovely." A relative said, 'I visit my family member nearly every day and the staff are very good. They liven up the home, chatting with people and encouraging fun and laughter.'

Is the service responsive?

Staff told us the care and support provided was flexible to the person's needs and adjustments could be made where required. Staff said they informed the manager if they felt any change in needs was required and the support was reviewed.

One relative told us, 'My family member has only been here a few weeks and the staff have arranged the optician, chiropodist and GP to visit, they've never looked so well. We don't need to ask they just sort it out.'

People were able to join in with a range of activities. An activity worker was employed and we observed the activity worker encouraging people to join in with a selection of activities. We also saw care workers spending time with people on a one to one basis, playing games and talking about 'the good old days.' It was very evident that people enjoyed and benefitted from this.

People knew how to make a complaint if they were unhappy. Relatives spoken with said they had no worries or concerns about the home but if they did they could talk to the home manager or any of the staff and they would listen and sort it out."

Is the service well-led?

The service worked in partnership with key organisations, including the local authority and safeguarding teams, to support care provision. We saw evidence the service had taken advice provided by other healthcare professionals so that the quality of the service would be improved.

There was a system in place to make sure the manager and staff learnt from events such as incidents, complaints, concerns and investigations. This helped to protect people from the risk of harm and helped to ensure that lessons were learned from mistakes.

The service had a quality assurance system. Records seen by us showed that shortfalls identified in the manager's audits had been addressed.

People who used the service, their relatives, friends and other healthcare professionals involved with the service had completed a satisfaction survey. We saw the majority of comments made were positive and that most people rated the service highly.

Records checked showed that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

During the inspection we spent time sitting with people in the communal areas of the home and with people individually in their rooms. We found that care and support was offered appropriately to people.

We spoke with two relatives who were visiting the home and they confirmed that they were satisfied with the care provided.

People living in the home and their relatives told us the home was a safe place to be.

Our conversations with people, relatives and staff, together with observations on the day of our inspection evidenced that the staff working in the home were appropriately qualified to do their jobs. The provider had carried out relevant recruitment checks on all staff prior to their employment.

The provider had an appropriate system in place for gathering, recording and evaluating information about the quality and safety of care the service provided. People who used the service and their representatives were asked for their views about their care and treatment.

People that we were unable to fully communicate with looked content and we observed positive interactions with staff and people living at the home.

Records checked showed that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Relatives we talked with told us, where people lacked capacity, they were also involved in these decisions.

We spoke with three relatives who were visiting the home and they confirmed that they were satisfied with the care provided.

We found that, where necessary, people were supported with the administration of their medicines, by staff that were trained in medication administration.

We found that a complaints policy and procedure was in place. People had been provided with information on how to make a complaint. All of the people and their relatives spoken with said they had no complaints or concerns about the home.

We spoke with Barnsley Local Authority, Contracting, Commissioning and Safeguarding and they told us that they had not identified any concerns at the home.