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We are carrying out a review of quality at Prospect House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 2 July 2019

About the service: Prospect House is a residential care home that was providing personal care to seven people with a learning disability at the time of the inspection.

People’s experience of using this service:

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons; lack of choice and control. Staff often made decisions on people’s behalf but did not follow a formal decision-making process or record the decision. For example, staff made decisions autonomously about when people had snacks rather than following person centred guidance. Staff asked people to add their meal preferences to the menu but then cooked different meals.

People were not safe. Risks to individuals were not assessed and appropriately managed. Staff were using restraint but national guidance around safe restrictive interventions was not followed. Incident forms were not reviewed in a timely way by the management team. Medicines were not managed safely. Lessons were not learned when things went wrong. Some people did not receive the appropriate staffing support even though they had specific funding. The recruitment process was not always followed robustly. Some areas of the home looked clean, but others required deep cleaning.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice. Staff received training and supervision, but this did not equip them with the skills required to do their job well. People told us they enjoyed the meals and chose what they wanted for breakfast, snacks, light meals and supper. Records showed people had been seen by health professionals but there was no overview of people’s health and staff could not find out when people had last attended some appointments. People lived in a pleasant environment and had personalised rooms and access to a range of communal areas.

Staff and management did not always pay attention to detail, for example, laundering of clothes. People looked well cared for when we visited but relatives told us this was not always the case. Examples of people making choices and caring staff practices were seen on both days of the inspection. People enjoyed the company of staff who supported them. Staff explained how they ensured people had privacy, for example, giving a person time alone during personal care. However, listening monitors were sometimes used inappropriately which did not provide people with privacy.

People did not always receive opportunities to engage in person centred activities. Activities were not well planned although people told us they had enjoyed various outings. People’s support plans contained a lot of information but did not always reflect their needs. The provider did not have an accessible system for identifying, receiving, recording, handling and responding to complaints.

The service was not well led. The provider's quality management systems were not effective and did not identify areas where the service had to improve. The registered manager and provider did not demonstrate they understood their responsibilities and accountability. Opportunities for people who used the service, their relatives and staff to engage in the service varied.

The service has a history of providing poor quality care; it has only been awarded ratings of requires improvement or inadequate. We have previously met with the provider to discuss our concerns about the service.

Rating at last inspection: Requires improvement; not in breach of regulation (Published date: 26 May 2018).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We referred our concerns to the local safeguarding authority and asked the provider to send us evidence of improvements and action points. This was used when decisions were made about our regu

Inspection areas

Safe

Inadequate

Updated 2 July 2019

The service was not safe.

Details are in our Safe findings below.

Effective

Inadequate

Updated 2 July 2019

The service was not effective.

Details are in our Effective findings below.

Caring

Requires improvement

Updated 2 July 2019

The service was not always caring

Details are in our Caring findings below.

Responsive

Inadequate

Updated 2 July 2019

The service was not responsive.

Details are in our Responsive findings below.

Well-led

Inadequate

Updated 2 July 2019

The service was not well-led.

Details are in our Well-Led findings below.