Prospect House - Care Home

About the service

Prospect House is a residential care home comprising of 4 small units and 2 ‘independent living’ flats. At the time of our inspection, it was providing personal care to 20 people. The service can support up to 22 people.

People’s experience of using this service and what we found

Right Support:

We have made a recommendation about staffing; people received the care and support they needed to be safe. However, staff appeared rushed. Care became task focused rather than person centred. Staff supported people to take part in activities and pursue their interests in the local area. One person was supported to work in the voluntary sector and lived in their own flat within the service. People had a choice about their living environment and were able to personalise their rooms. Staff communicated with people in a way that met their needs. People were supported with their medicines in a way that promoted their independence and achieved the best possible health outcome. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. People’s care, treatment and support plans reflected their range of needs, and this promoted their well-being and enjoyment of life. Staff and people collaborated to assess risks people might face, where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture:

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments, or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. Staff placed people’s wishes, needs, and rights at the heart of everything they did. People and those important to them were involved in planning their care. Staff ensured the risks of a closed culture were minimised so that people received support based on transparency, respect, and inclusivity.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 12 December 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service and due to the length of time since the service was last inspected.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Prospect House – Care Home on our website at www.cqc.org.uk

Recommendations

We have made a recommendation about staffing levels. The provider needs to review this to ensure there are sufficient staff on duty to respond to people’s changing needs.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

There are four units within the service, each with a kitchen, dining room, lounge area, bathroom and bedrooms. In addition to this, there are two flats for people who are able to live more independently. There is a passenger lift so people are able to access the first floor if they cannot manage the stairs. There is a large communal room on the ground floor that is used for group activities.

As part of the Care Quality Commission’s (CQC) response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice was safe and the service was compliant with IPC measures.

We found the following examples of good practice

The systems in place allowed people to be admitted to the home safely.

There was clear signage on the correct use of personal protective equipment (PPE) and handwashing techniques and staff had received appropriate infection control and prevention training.

A risk assessment was in place for ensuring safe visits, this included a booking system, to allow for social distancing, visitor agreement form, health screening and use of PPE. Local restrictions on visiting were in place at the time of the inspection and alternative measures such as video calls were being used.

The environment was clean. Additional cleaning was taking place including of frequently touched surfaces.

There were detailed risk assessments to manage and minimise the risks Covid-19 presented to people who used the service, staff and visitors.

Further information is in the detailed findings below.

Prospect House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Prospect House provides accommodation and support to a maximum of 24 people who may have a learning disability or autistic spectrum disorder. At the time of this inspection there were 22 people using the service full time and one person who used the service for short periods of respite.

At our last inspection in March 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The home is set out over four areas, each with a kitchen, dining room, lounge area, bathroom and bedrooms. In addition, there are two self-contained flats for people who could live more independently. The first floor is accessible via stairs and a passenger lift. There is a large communal room on the ground floor that is used for group activities. Access is available to outdoor areas, a large kitchen and office areas.

There was a registered manager in place. 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.

Staff had access to a safeguarding policy and procedure and understood how to recognise and report any signs of abuse. Systems and processes were maintained to record, evaluate and action any outcomes where safeguarding concerns had been raised.

Support plans provided information about people's assessed risks for staff and other health professionals to ensure people received safe care and support without undue restrictions in place.

Staff recruitment included pre-employment checks that meant only suitable employees were recruited to work in the home. The provider maintained safe staffing levels to meet people's needs all of the time.

People were assessed and supported to take their medicines safely as prescribed by staff who had been checked as competent and who followed national best practice.

People received appropriate care and support to meet their individual needs because staff were supported to have the skills, knowledge and supervision they needed to carry out their roles.

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.

Everybody spoke positively about the registered manager. Systems and processes ensured the service was continually evaluated and checked, with actions implemented as appropriate, to maintain and improve standards for everyone.

Further information is in the detailed findings below.

The home is registered to provide accommodation for up to 24 people who have a learning disability or autistic spectrum disorder. On the day of the inspection there were 19 people living at the home. The home is situated in Goole, in the East Riding of Yorkshire. There are four units within the home, each with a kitchen, dining room, lounge area, bathroom and bedrooms. In addition to this, there are two flats for people who are able to live more independently, although at the time of the inspection the flats were unoccupied. There is a passenger lift so people are able to access the first floor if they cannot manage the stairs. There is a large communal room on the ground floor that is used for group activities.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager who was registered with the Care Quality Commission (CQC). 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.

On the day of the inspection we saw that there were sufficient numbers of staff employed to meet people's individual needs. New staff had been employed following robust recruitment and selection policies and this ensured that only people considered suitable to work with vulnerable people were working at Prospect House.

People told us that they felt safe whilst they were living at the home. People were protected from the risks of harm or abuse because there were effective systems in place to manage any safeguarding concerns. The registered manager and care staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

Staff confirmed that they received induction training when they were new in post and told us that they were happy with the training provided for them. This included training on the administration of medication. We saw that medicines were administered safely.

People told us that staff were caring and that their privacy and dignity was respected. They said that they received the support they required from staff.

People's nutritional needs had been assessed and people told us they were very happy with the food provided. We observed that people’s individual food and drink requirements were met.

We saw that any complaints made to the home had been thoroughly investigated and that people had been provided with details of the investigation and outcome. There were also systems in place to seek feedback from people who lived at the home, relatives and staff.

Staff, people who lived at the home and a health care professional told us that the home was well managed. Quality audits undertaken by the registered manager were designed to identify any areas of improvement to staff practice that would promote safety and optimum care to people who lived at the home. Staff told us that, on occasions, feedback received at the home was used as a learning opportunity and to make improvements to the service provided.

Our inspector visited the service and the information they collected helped answer one of our five 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.

The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Not applicable

Is the service effective?

Not applicable

Is the service caring?

Not applicable

Is the service responsive?

Not applicable

Is the service well-led?

There was a registered manager in post. At the last inspection we were concerned that some issued had not been identified during quality audits. At this inspection we saw that audits were taking place and that issues were being identified; any identified issues had been dealt with appropriately. Action had been taken to consult with relatives / visitors, health care professionals and staff to give them the opportunity to comment on the way the service was operated.

Our inspector visited the service and the information they collected helped answer two of our five 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. The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Not applicable

Is the service effective?

Not applicable

Is the service caring?

We saw that staff were caring and compassionate, and that there was good interaction between people who lived at the home and staff. People were supported to take part in appropriate activities and to be as independent as possible.

Is the service responsive?

Not applicable

Is the service well-led?

There was a registered manager in post. We were concerned that some issued had not been identified during quality audits, such as notifications not being submitted to the Commission. A lack of quality surveys meant that people did not have sufficient opportunities to comment on the way the service was being operated.

We found that people received the support that they needed and that their care plans were a true reflection of the care and support that they required. People's individual needs had been taken into consideration as part of the care planning process, including their specific dietary needs. Care staff and the chef were able to explain people's individual dietary needs to us and on the day of the inspection we saw that suitable meals had been prepared. There were sufficient numbers of staff on duty to provide the level of care that people needed.

Staff had undertaken training on safeguarding adults from abuse and were aware of the action they needed to take if they became aware of an abusive situation or suspected that abuse had taken place.

There were monitoring systems in place to measure the quality of service that was being provided. These included audits to check that systems in place at the home had been followed by staff, and a satisfactory complaints system. This gave people who lived at the home, relatives and staff the opportunity to express their views about the service provided.

The home was well maintained and this protected people who lived and worked at the home from the risk of harm.

Staff had undertaken training on the control of infection and we saw the the home was being maintained in a clean and hygienic condition.

We observed the administration of medication and checked the storage arrangements and administration records. We found these to be satisfactory.

We checked the recruitment records for two new members of staff. These evidenced that only people considered suitable to work with vulnerable adults had been employed at the home. New staff undertook appropriate induction training before they commenced work with people who lived at the home.

There were systems in place to monitor the quality of the service provided to people who lived at the home.