Prospect House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment, the rating has changed to good.

This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had worked hard to develop a proactive learning culture. They had robust incident recording, reporting, and learning processes and staff confirmed their involvement in this. Reporting to partner agencies including CQC when required was done in a timely way.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Care plans and support documents showed the provider had a consistent approach to people joining the service, with the involvement of partner organisations as appropriate. Pre-admission discussions and assessments were held with people and their relatives to give assurance that moving to the service was appropriate.

Where people had needed to access other services including hospitals this was recorded. Important information was shared with hospital/medical staff and people were supported by staff to attend appointments and during hospital stays as well as in-person support from staff to ensure good continuity of care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. The provider shared concerns quickly and appropriately.

Safeguarding processes were well understood by staff, and incidents were reported consistently to partner agencies. People and relatives were informed of their rights appropriately. External partners confirmed that the home operated safely and responsibly.

People told us they felt safe at the service, although some felt less safe at night. One person explained that this was because they preferred their key worker who only worked during the day. Relatives gave mixed feedback, expressing more confidence in staff who worked during the day in comparison to night staff, as they did not know them as well. The provider had held meetings with relatives during the assessment period to give assurances about continuity of care.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We found the service was working within the principles of the MCA and managed DoLS well.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them.

People were involved in managing risks that affected their daily lives. We observed people interacting with staff to complete tasks and go about their daily routines; with carers explaining why tasks contributed to wellbeing.

One person enjoyed experiencing liked being outside a lot, especially in rain, so this was managed in terms of risk by staff reminding the person to take a coat or umbrella when going out.

A relative said: “[My relative] is safe here all the members of staff are good. [My relative] likes to go to the kitchen but the staff go with them.”

Other relatives shared that the service had improved since the last assessment, with one saying, “I applaud them as to how it has got to how it is today.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Environmental risks were monitored and well controlled. Equipment such as soft play and sensory items were well maintained with some spaces for people at the service personalised, for example a music room. Communal areas were safe, spacious and clutter free, and equipment not in use was stored appropriately.

At the time of assessment improvements were being made to the garden areas to increase accessibility and safety.

The provider made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. They worked together well to provide safe care that met people’s individual needs.

Staffing records, rotas, and the dependency tool indicated a history of safe staffing levels. Staff appeared busy but not overwhelmed, and staff confirmed this.

Staff were recruited safely and appropriate checks were carried out prior to employment.

Staffing levels were consistently safe, and staff were skilled, well supported and encouraged to develop. Observed practice showed good teamwork, respectful communication, and competence. Training, supervision, and appraisal records reflected a strong culture of professional growth. Staff noted improvements and told us that management had worked hard to improve organisational culture, particularly in the prior 12 months.

People and families reported high confidence in staff availability and capability but said they did not know all the night staff well. This was addressed by management during the assessment period through meetings with relatives.

A relative said, when discussing improvements; “They have got more regular staff, and the agency ones are people we know.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The home was visibly clean and odour free, with good hygiene practices in place. Staff used personal, protective equipment (PPE) appropriately, and infection risks were managed. External agencies had raised no concerns, and relatives praised cleanliness.

One relative told us that their loved one enjoyed taking part in cleaning and tidying their own room. We observed people taking part in laundry tasks, tidying the communal area, and discussing keeping things clean.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. Staff involved people in planning, including when changes happened.

The provider demonstrated safe and effective medicines optimisation practices; systems supported people’s needs, preferences, and involvement in their care.

Medicines, including controlled drugs, were securely stored in designated areas, and while temperature monitoring processes were in place, some records were incomplete, although improvements had already been initiated to address this. Medicines were managed and administered safely.

Person-centred protocols for medicines prescribed on a ‘when required’ basis were accessible, regularly reviewed and provided clear guidance for staff, including when to seek further clinical advice, with appropriate documentation recorded when administered.

Individual medication care plans were in place and supported staff in meeting people’s needs, including risk assessments for higher-risk treatments such as flammable emollients.

Staff had up-to-date training and competency assessments, supported by systems to monitor compliance. Medicines-related incidents were recorded in detail, and learning was shared effectively with staff to reduce recurrence. Regular audits were undertaken and demonstrated improving compliance, with identified issues addressed promptly, reflecting a proactive and responsive governance approach to medicines optimisation.