We carried out a review of the data available to us about Prospect House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Prospect House, you can give feedback on this service.
Prospect House supports people with a learning disability, dementia and/or mental health needs. It accommodates up to nine people in a large detached house on a residential street. There were nine people living at Prospect House at the time of the inspection.
We found the following examples of good practice.
People had been supported to understand the measures in place to protect them from COVID-19. Visits to the service had been adapted in line with recognised safe visiting guidance and lockdown restrictions. People could speak with their friends and relatives regularly, by telephone and via video calls.
People using the service were in a household bubble but maintained social distance from others during our visit. People were supported to access local areas for walks and drives out, as lockdown permitted. People were involved in craft and domestic activities within the service.
Policies were in place to ensure people could be admitted to the service safely, including when they returned from hospital. While there had not been any admissions during the pandemic, staff were clear people would be tested for COVID-19 before admission and supported to self-isolate on arrival. This reduced the risk of introducing infection to others at Prospect House.
People and staff had been supported to receive their vaccinations and COVID-19 testing. Staff ensured people accessed health care when needed and supported them with regular testing. Staff worked remotely with health care professionals to ensure people's health care needs were reviewed.
The provider updated the staff team on changes to national guidance. Action cards and an outbreak plan were in place for staff to refer to in the event of an outbreak. Managers accessed the Skills for Care managers' forum to share solutions and lessons learned by similar services, to ensure people were protected from COVID-19.
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. Prospect House accommodates up to nine people in one adapted building. It is registered for younger and older adults with a range of different needs including learning disability, autism, mental health needs, dementia and physical disability. At the time of this inspection six people were living there.
Accommodation is provided on two floors, the ground floor is wheelchair accessible. People had individual bedrooms, most with en-suite facilities and all had access to communal bathrooms. Spacious communal areas were provided on the ground floor, including lounge, kitchen and dining areas. A stair lift was fitted to assist people with limited mobility to access the first floor. Outside there was a parking area and small garden to the front and a large garden to the back and side.
At our comprehensive inspection in October 2017 we found three breaches of the regulations and rated the service as ‘Requires Improvement’. We inspected the service again on 17 March 2017 and found the required improvements had been made and the requirements of the regulations were met. At this inspection we found the service had sustained these improvements and we rated the service as ‘Good’.
The service had a registered manager. 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 was registered with CQC in October 2010 to manage the service. They were also registered to manage the provider’s other care home in Hereford.
People felt safe at prospect House and were comfortable with the staff who supported them there. Staff understood how to protect people from harm and abuse. Risks to people's safety were identified and clear support plans were followed. Incidents and accidents were monitored and action was taken to reduce risks to people. Environmental risks were assessed and managed appropriately. There were enough staff to meet people’s needs and recruitment checks were thorough. People received their medicines as prescribed.
People were supported by knowledgeable staff who received ongoing training and support to maintain or improve their skills and competency. Technology was used to make information accessible to people, to support people’s independence and to support the delivery of care. People were encouraged to make their own decisions about the support they received wherever possible. Deprivation of liberty safeguards were in place where people were restricted of their liberty.
Facilities at Prospect House were adapted to meet the needs of the people living there. People were supported to have a healthy and nutritious diet which reflected their individual dietary needs. Staff worked closely with external professionals to meet people's health and well-being needs.
People received support from caring staff who valued and understood them. 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 privacy was respected and they were treated with dignity, kindness and compassion. People were supported to maintain relationships with others who were important to them. They received personalised and responsive care which enabled them to live as full a life as possible. People could raise concerns about the service and have their complaints listened to.
Everyone we spoke with was positive about the leadership of the service which they described as ‘friendly’ and accessible. Leaders were aware of the day to day culture at prospect House and upheld the provider’s values, acting inclusively and with integrity. There were systems in place to seek the views of people, their relatives, staff and visiting care professionals. Feedback was taken into account to improve and develop the service provided to people. The registered manager maintained and updated their knowledge through local provider networks and with reference to local and national policies. Additional systems ensured key messages were communicated and the quality of the service was closely monitored.
We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk”
Prospect House is a small home which provides accommodation and personal care for up to nine people with a learning disability, mental health needs and/or a sensory or physical disability. Nine people were living at the home at the time of the inspection.
The registered manager was present during the inspection. 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.
This unannounced inspection was carried out on 17 March 2017. At the inspection on 25 and 26 November 2016, we asked the provider to take action to make improvements to:
• staff recruitment checks
• staff training and supervision
• the service’s statement of purpose.
We found that the actions in the provider’s plan had been completed.
Staff recruitment processes had been reviewed and checklists developed to highlight the checks required and document when these had been completed. No staff had been recruited since the previous inspection but we were satisfied that legal requirements had been met.
Staff had received training relevant to the needs of the people they supported and were confident in recognising and responding to potential changes in people’s health needs. Staff felt well supported and confident in their roles. Staff supervision was in progress and we were assured this would be completed within a month of our inspection.
The statement of purpose and service the service user bands registered with CQC had been updated to reflect the service that was provided.
There was a registered manager in post. 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. The registered manager also managed another home owned by the provider in Herefordshire and divided their time between the two homes.
People had not been protected against the risks of employing unsuitable staff. Safe recruitment and selection procedures had not been followed. Staff had not received mental health training so they could effectively meet the needs of people diagnosed with this condition. Staff did not receive on going individual support to enable them to reflect on their roles and responsibilities. Quality assurance records were not available to evidence consultation with people or the support provided from the provider to the manager. The statement of purpose did not reflect all the needs of people currently living in the home.
People’s care and support was individualised and monitored to make sure care records reflected any changes in their health or wellbeing. People had appointments with health care professionals and staff implemented their recommendations to keep people safe and well. People were supported to have a healthy diet and their medicines were managed satisfactorily. People’s rights were upheld and staff understood their responsibilities to recognise and report abuse. People were encouraged to make decisions about their day to day lives in line with the Mental Capacity Act 2005. If needed best interests’ decisions were made on their behalf involving people important to them. When deprivation of liberty safeguards were needed, the least restrictive practice was implemented and authorisations granted to keep people safe.
People enjoyed a range of meaningful activities which reflected their lifestyle choices and preferences. People used local facilities such as places of worship, the gym, the swimming pool and shops. There were opportunities to volunteer and attend college. People said they looked forward to special events which they shared with families and friends. They also liked to go on holiday in this country and abroad. People had positive relationships with staff and managers. They were relaxed in their company sharing light hearted banter. They were treated with kindness and reassured when needed. Staff understood people well.
People talked to staff and managers about any problems or concerns. Their feedback had resulted in the kitchen being refurbished. Quality assurance systems monitored the environment and health and safety checks were carried out. Staff were confident any concerns raised under whistle blowing would be listened to and action taken as needed. They had access to training considered mandatory by the provider such as safeguarding, food hygiene, fire and first aid. The registered manager and staff said “We are like one big family” and “We are like a family.”
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) Regulations 2009 (Part 4). You can see what action we told the provider to take at the back of the full version of the report.
We found that people were well supported. People we met told us they were happy and liked living here. One person said "it's great here". Another person smiled when we asked them if they were happy.
Care plans and risk assessments were well written and clear to understand. We saw they were up to date, and respected the wishes of the people they described.
There were sufficient skilled and experienced staff available to meet the needs of each person in the service. Staff we met told us that their inductions and ongoing training was of a good standard and helped them support people appropriately. One staff told us "lots of training, all of it very useful".
Senior staff monitored all aspects of medicine management in accordance with national guidelines. There were systems in place to ensure safe practices.
People were supported in a safe environment. Staff told us safeguarding training had helped them in their roles. One staff said it "makes you realise the responsibility placed on you".
There was an effective quality assurance system in place to monitor the standard of support in the service.
In summary, this inspection found that Prospect House was providing a good standard of care and support to the people were using the services.