Core Prospects Limited - 37 Sandringham Crescent

Core Prospects Limited - 37 Sandringham Crescent is a supported living service for people with mental health support needs. People receiving support live in four shared houses with communal facilities, such as kitchen, lounges and bathrooms. Each shared house had an office and sleep-in facility for staff where required. At the time of our inspection the service was providing support to 17 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

Although people’s support plans and risk assessments were generally in good order, we found a person’s risk assessment and support had not been updated to reflect recent incidents. We have given a recommendation about the need to review admission processes.

The provider and the housing association had carried out risk assessments in relation to the environment.

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, However, the policies and systems in the service did not always support this practice. We noted that there was a need to develop the arrangements for mental capacity assessments. However, we also noted the provider had liaised with a local authority in relation to a Deprivation of Liberties Safeguarding (DoLS) request to the Court of Protection for a person where there were concerns.

The provider had systems in place to monitor the quality of support and safety at the service.

The provider was in the process of introducing an electronic monitoring system to the service. This was designed to ensure failures in support activities and record keeping were identified and addressed immediately.

Staff were safely recruited. The provider’s recruitment processes included checks of staff suitability prior to appointments being made. There had been some recent staff turnover resulting in agency staff being used to fill staff shortages. The provider had developed a staff recruitment strategy to support the service in recruiting new permanent staff. Staff received training on a range of mandatory topics, and this was refreshed annually. The provider had commissioned positive behavioural support training for staff.

People’s medicines were safely managed. Staff had received training in medicines administration and understood the reasons why medicines were prescribed for people. Risk assessments were in place for people who were administering their own prescribed medicines, and these were monitored.

People were able to participate in meetings designed to share information and give their views on issues in relation to their support. People told us their support staff were helpful.

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 4 December 2018).

Why we inspected

We received concerns in relation to safeguarding, support planning and staff training. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained Good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Core Prospects Limited – 37 Sandringham Crescent on our website at www.cqc.org.uk.

Follow up

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

Core Prospects Limited 37 Sandringham Crescent is a supported living service for people with mental health support needs. People receiving support live in two shared houses with communal facilities and in their own flats in the local community. At the time of our inspection the service was providing support to 12 people.

At our last inspection of 31 December 2015 and 7 January 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 service has a registered manager. Like registered providers, registered managers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

People told us that they felt safe. We saw that that they were comfortable and familiar with the staff supporting them. Staff members were knowledgeable about people’s needs and preferences.

Staff members had received training in safeguarding adults, and were able to demonstrate their understanding of what this meant for the people they were supporting. They described their roles in ensuring that people were safe and that concerns were reported appropriately.

Some people received support to take their medicines. We saw that medicines were stored safely. Records were appropriately recorded and showed that people received their medicines on time. All staff members had received training in the safe administration of medicines.

We saw that staff supported people in a caring and respectful way. They were responsive to people’s needs and requests and ensured that their privacy was maintained.

The service was meeting the requirements of The Mental Capacity Act 2005 (MCA). Information about people’s capacity to make decisions was included in their support plans. People told us that staff members had asked for their consent when providing support.

Staff who worked at the service received regular training and supervision. Appropriate checks had taken place as part of the recruitment process to ensure that staff were suitable for the work that they would be undertaking.

People’s support plans and risk assessments were person centred and provided detailed guidance for staff on people's individual needs and preferences. These were regularly reviewed and updated where there were any changes in people’s needs. Regular meetings with people and mental health professionals had taken place to review progress and agree objectives designed to support people to develop greater independence.

The service supported people to participate in a range of activities in the local community. Staff members worked with people to access cultural and social activities in accordance with their preferences.

People knew what to do if they had a complaint or concern. The service had a complaints procedure that was provided in an easy read format. Other information was provided in accessible formats according to people’s needs.

Systems were in place to ensure that the quality of the service was assessed and improved where required. The provider was developing systems to ensure that their quality assurance monitoring was effective.

Core Prospects Limited is a supported living service situated in South Harrow. The service provides 24 hour support to four people living at in a shared house, along with individualised support packages to three further people living in their own flats. The people who use the service have mental health support needs, with some having additional needs such as learning disabilities, autism and physical and sensory impairments.

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.

At our previous inspection of Core Prospects Ltd on 11 October 2013 we found that the service was compliant with the regulations that we assessed.

People who used the service told us that they felt safe and well supported. We observed that people appeared comfortable and familiar with the staff who were supporting them.

People were protected from the risk of abuse. Staff members had received training in safeguarding, and were able to demonstrate their understanding of what this meant for the people they were supporting. They were also knowledgeable about their role in ensuring that people were safe and that concerns were reported appropriately.

Medicines at the service were generally well managed. People’s medicines were managed appropriately and records of medicines were well maintained. Some people managed their own medicines or were being supported to work towards self-management. Medicines risk assessments were in place for people. However, we found that the medicines administration record regarding prescribed pain relief for one person did not include information about who it was for, the dosage and when it should be given. This meant that we could not be sure that the medicine was always administered safely.

We have made a recommendation about the recording of prescribed medicines.

We saw that staff at the service supported people in a caring and respectful way, and responded promptly to meet their needs and requests. There were enough staff members on duty to meet the needs of the people using the service.

Staff who worked at the service received regular relevant training and demonstrated that they were knowledgeable about their roles and responsibilities. Appropriate checks took place as part of the recruitment process to ensure that they were suitable for the work that they would be undertaking. All staff members received regular supervision from a manager, and those whom we spoke with told us that they felt well supported.

The service was meeting the requirements of The Mental Capacity Act 2005 (MCA). Assessments of capacity had been undertaken. Staff members had received MCA training.

People were supported to shop for and prepare healthy meals. One person told us that staff members were supporting them to learn to cook a wider variety of meals. Records showed that people were supported to make healthy food choices.

Support plans and risk assessments were person centred and provided detailed guidance for staff around meeting people’s needs. Care plans were produced in an easy to read format. People had monthly meetings with their key workers where they were able to assess and review their progress in relation to outcomes identified within their plans.

People participated in a range of community activities along with group activities that were facilitated by the service. Staff members engaged people supportively in participation in activities. People’s cultural, religious and relationship needs were supported by the service as required and detailed information about these was contained in people’s care plans.

The service had a complaints procedure that was available in an easy to read format. People knew how to complain and we saw that complaints had been dealt with promptly.

The care documentation that we saw showed that people’s health needs were regularly reviewed. The service liaised with health professionals to ensure that people received the support that they needed.

We saw that there were systems in place to review and monitor the quality of the service, and action plans had been put in place and addressed where there were concerns. Policies and procedures were up to date.

People who used the service and staff members spoke positively about the management of the service.

People who used the service received appropriate care and support that met their individual needs and were treated with dignity and respect.

There were processes in place to protect people who used the service from harm. The staff had received training to recognise the signs of abuse and to report concerns in accordance with the home's procedures.

There were enough qualified, skilled and experienced staff to meet people's needs.

There were systems in place to monitor the quality and safety of the service and accurate and appropriate records were maintained. There was an effective complaints system available.

Records kept were fit for purpose and held securely.

We found that care records were detailed and comprehensive and staff had a good understanding of people's support needs and were able to meet them effectively. We also found where the service identified a change in a person's health condition the service ensured the person received the appropriate care and treatment.

We found that people were safeguarded from the risks of abuse. We found that staff were able to tell us about different forms of abuse and how they would report it.

We found that staff were trained in appropriate subject areas to ensure the effective care delivery to people using the service. We also found that staff were supported in professional development and received supervision regularly.

We looked at the quality and monitoring systems and identified the service did not have effective quality and monitoring systems in place to ensure the safety and well being of people using the service.