Archived: Prospect House Community Care Office

People's experience of using this service: People received a safe service, from staff who were trained and supported in their role. People told us staff arrived on time and provided all the support they required. Staff were aware to report any safeguarding concerns and, where required, staff supported people to receive their medicines in line with their prescription.

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 said staff were caring, promoted their independence and respected their privacy and dignity.

Care plans were in place to give staff the information they needed to support people in line with their preferences. The provider took action during the inspection to address some record keeping issues in relation to people’s health conditions and related support needs.

People had the opportunity to provide feedback on the service they received and the provider conducted regular checks and audits on the quality and safety of the service. The provider was taking action to update policies in line with appropriate guidance and best practice. People and staff told us the management team were very visible and approachable.

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

Rating at last inspection: Good (report published 4 October 2016).

Why we inspected: This was a scheduled inspection based on the service’s previous rating.

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.

We inspected the service on 25 August 2016. The inspection was announced. The registered provider was given 48 hours’ notice of our visit because the location provides a domiciliary care service and we needed to be sure that someone would be in the location’s office when we visited.

At the time of our inspection, there were 29 people using the service and the majority of these people received support with the regulated activity ‘personal care’.

The service was last inspected in March 2015, when it was rated ‘Requires improvement’.

The registered provider is an individual and therefore there is no requirement for them to have 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.

During our inspection, we found staff understood their role and responsibilities with regards to safeguarding vulnerable adults. Medicines were managed safely and audits were completed to monitor and address any issues with staff's practice. Staff completed risk assessments to identify risks and plans were put in place to manage these risks to keep people who used the service safe. Some risks assessments contained limited detail; however, other systems were in place to ensure staff provided safe care and support. The registered provider agreed to review and address these minor recording issues. Although there had been no accidents or incidents involving people who used the service, staff and the registered provider appropriately described what action they would take to record and respond to accidents and incidents where necessary.

People who used the service told us staff were reliable and never missed a visit. The registered provider had a waiting list and only agreed to provide support to new people when there was sufficient staff available to meet their needs.

Staff had the knowledge and skills to support people who used the service. Staff were able to update their skills through regular training and the registered provider was responsive to any additional training needs that staff identified. Staff had supervisions and appraisals. The registered provider had an ‘open door’ policy and staff described them as approachable and supportive.

Staff understood the importance of consent and people who used the service were supported and encouraged to make decisions and have choice and control over their care and support. Although no one who used the service lacked capacity to consent to their care and support, we recommended that the registered provider developed effective procedures to ensure that capacity assessments and best interest decisions would be appropriately completed and documented where needed.

People who used the service were supported by staff to ensure they ate and drank enough. Staff were attentive to people’s health needs and sought appropriate advice, guidance and medical attention when needed.

We received positive feedback from people who used the service about the caring staff. People were encouraged to make decisions and support was provided to maintain people’s privacy and dignity. People’s needs were assessed to ensure their care and support was delivered in a personalised way. Person-centred care plans were in place to guide staff on how to meet people's needs.

We received consistently positive feedback about the service provided and the management. People told us the registered provider was approachable and responsive to feedback. There was a system in place to gather feedback and respond to complaints. Quality assurance systems were in place to monitor and improve the service provided.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with staff 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?

Our checks of the records and documents within the service showed that staff received training in safe working practices. Health and safety risk assessments were in place with regard to moving and handling and daily activities of living.

Is the service caring?

Not applicable.

Is the service responsive?

Not applicable.

Is the service well-led?

We found that the provider had taken appropriate action to improve the quality assurance system for the service. Records seen by us showed that audits were being completed that identified any shortfalls within the service and these were addressed promptly. As a result the quality of the service was continuingly improving.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff who supported 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?

People were treated with respect and dignity by the staff. Every person we met or spoke with, agreed that they received a very personal service from staff that they knew and trusted. We were told that 'I get the care I need in the way I want it', 'Nothing is too much trouble for them' and 'They treat me with respect and listen to me when I talk about my care. I have no worries or complaints about the support I receive.'

People told us 'We get our medicine on time and when we need it' and we found that appropriate arrangements were in place in relation to the ordering, handling and administration of medicines.

Is the service effective?

People's health and care needs were assessed with them and care plans were in place. Three people said "We see someone from the agency at least once or twice a year to discuss our care and we can always talk to the staff if we want any changes".

We looked at induction, training and supervision of staff and found that robust processes were not in place.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to supporting staff.

Is the service caring?

People told us that their experience was a positive one. They were involved in the decisions about using the service and staff discussed their care and treatment with them. People said 'I am extremely happy with my care', 'Staff respect my need to be as independent as possible and treat me as an individual' and 'The care staff are fantastic and the standard of care is excellent.'

Is the service responsive?

People said that they could make a complaint if they wanted to. We spoke with five people who used the service. They told us they felt they received a good level of care from friendly and helpful staff. People told us "I can get hold of someone in the office every time I ring up. They are always polite and sort things out quickly" and "I have no concerns about the service. They turn up on time, give me my care and support in a way that I like and need and are responsive if I ask for any changes."

Is the service well led?

The service did not have an effective quality assurance system. There was a lack of record keeping to evidence that any shortfalls identified had been addressed. Policies and procedures were not always in place or detailed enough to give staff appropriate guidance and direction.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance.