Prospect Neuro

Updated 22 May 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 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.

We gave the service 48 hours’ notice of the inspection visit because we needed to be sure the manager, staff and people we needed to speak to were available.

The inspection took place on the 22 and 23 March 2018, and was the first inspection at the service. It included visiting the site office, visiting one person with communication difficulties in their home with staff present and speaking to one relative by telephone so that we could further understand their experiences. The inspection team consisted of one inspector.

Prior to the inspection, we gathered and reviewed information we held about the service. This included notifications from the service and information shared with us by the commissioning local authority and health professionals. We used information the provider sent us in the 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 spoke with two people using the outreach service, one relative, a social worker, three staff, the registered manager and the operations manager. We visited one person at home, with their agreement and made observations of staff interactions with them. We looked at one person’s care plan, four staff files, staff training records, policies and procedures, quality assurance documentation and information and policies in relation to people’s medicines. We contacted one relative, one commissioner and local authority contract teams during the inspection process. We have included their feedback in the main body of the report.

Updated 22 May 2018

The inspection took place on the 22 and 23 March 2018 and was announced. It was the first inspection since the service was registered with us on 16 December 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

Prospect Neuro is a domiciliary care agency registered to provide personal care to adults with physical disabilities, sensory needs, learning disabilities and those living with mental health conditions. It provides a care to people living with an acquired brain injury who live in their own houses and flats.

The service also provides an outreach service and became registered when it started to provide personal care. At the time of our inspection one person was receiving a personal care service, and a further eleven people were supported by the outreach service. Not everyone using Prospect Neuro receives a regulated activity; CQC only inspects the service being received by people provided with personal care; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had 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.

A person and their relative told us they felt safe and that the care was good. The relative told us, “I can trust the staff 100% with my relative’s safety”.

Quality assurance and governance systems were not fully developed. The provider did not have up to date policies and procedures in place to ensure staff had all the information and guidance they needed, For example, the equalities policy was not inclusive of promoting people’s equalities characteristics and there was no comprehensive system of monitoring trends and themes in relation to potential complaints, safeguarding’s or health and safety incidents. The impact of this was reduced due to the size of the service. However as the service had plans to expand we have made a recommendation that provider sources reputable guidance on developing their overarching governance of quality and improvement.

The person’s communication needs were anticipated and met and staff and the provider had an understanding of the Accessible Information Standard (AIS). This is the standard that since August 2016 had required services to promote people’s information and communication needs. We made a recommendation that the provider sources further information about the AIS.

There were good systems and processes in place to keep people safe. Risks and accidents were assessed and staff received guidance on what actions to take to mitigate risk and ensure people and staff’s wellbeing at the service site and in the community. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe.

The registered manager ensured that when new staff were employed, safe recruitment practices were followed. They also ensured there were sufficient suitably skilled staff available to meet people’s needs. Staff received an induction and training to ensure they had up to date guidance on how to carry out their roles and responsibilities. Staff told us they felt well supported through supervision, appraisal and regular contact with each other.

People were supported to maintain good health and had assistance to access health care services when they needed to. Where needed, people were supported to receive their medicines safely, by staff that were trained and competent in administering medicines. Staff had a good understanding of the needs of people with an acquired brain injury.

The service and staff considered people’s capacity and worked in line with the Mental Capacity Act (MCA) 2005. People’s capacity to make decisions was assessed and staff recognised the importance of choice respecting people’s choice and self-determination. People’s right to privacy, to be different and to be treated with dignity was respected. One staff told us, “I accept and treat people as I would want to be treated myself”.

A person, relative and social care professional told us the service was caring and kind. The person showed us the pictures of people they cared for that staff supported them to have contact with. They used gestures and facial expressions to tell us what was important to them and how staff cared for them. For example, they had really wanted a particular DVD and staff had helped them find it. Staff understood the person’s life history, emotional and health needs and this was also reflected in the care planning. A relative and social care professional spoke highly of how staff listened to the person to fully understand their goals, needs and choices. The service supported the person to access food and drink of their choice and adaptations to ensure they could live as independently as possible in their home.

There were clear management lines of responsibility and accountability. The service had an established leadership and the values discussed and demonstrated by the registered manager and operations manager were reflected in their staff teams actions and motivations. One staff member told us, “We aim to give people a sense of achievement, build their self-esteem, set goals, and maintain their health and relationships”. The provider was committed to supporting people with an acquired brain injury to gain as much independence as they could achieve. The service had an open transparent culture, where complaints and surveys were encouraged and acted on.