Archived: Prudhoe House

We undertook this focused inspection to confirm that they have 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 Prudhoe House on our website at www.cqc.org.uk.

Prudhoe House is a small residential care home based in Prudhoe, Northumberland. The people accommodated at the service are living with a range of autism spectrum disorders, and/or learning and physical disabilities. People receive 24 hour personal care and support from a team of care staff.

This focused inspection took place on 3 February 2017 and was unannounced. This meant the provider, registered manager and care staff did not know we would be visiting.

At the time of our visit a registered manager was in post who had been registered with the Commission to manage the carrying on of the regulated activity since July 2016. 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.

We did not review all of the key lines of enquiry in the effective and well led domains. This was because at our last comprehensive inspection, legal requirements in relation to the other regulations that fall within these domains, had already been met and incorporated into the overall rating.

CQC is responsible for monitoring the application of the Mental Capacity Act (2005) and deprivation of liberty safeguards (DoLS). In line with the requirements of the Mental Capacity Act 2005 (MCA), we checked to see if the provider had now made applications to lawfully deprive people of their liberty, as these had not been completed at our last inspection. We found that applications had been made to supervisory bodies within the relevant local authorities, and in all but one case, the decisions about these applications were still in progress. A deprivation of liberty order had been authorised for one person in February 2016.

This meant the provider was now meeting the legal requirements of Regulation 11 of the Health and Social Care Act (Regulated Activities) Regulations 2014. As a result, we have changed the rating in the effective domain from 'Requires Improvement' to 'Good', because the failure to progress DoLS applications, was the only area which fell short of legal requirements at our last visit.

When we visited the home we identified the provider and registered manager had not ensured that the performance rating issued as a result of our comprehensive inspection in December 2015, was displayed for visitors to see. In addition, we established that the provider had not arranged for the last inspection report and performance rating to be accessible on their website. Following this inspection the registered manager has confirmed that the last performance rating issued by the Commission had been displayed within the location and on the provider's website. We have recommended that the provider re-familiarises themselves with the requirements of this regulation.

We also noted at this inspection that in respect of the granted deprivation of liberty order, a statutory notification about this had not been submitted to the Commission in line with the legal requirements of Regulation 18 of the Care Quality Commission (Registration) Requirements 2009. The registered manager apologised for this oversight and has subsequently submitted the required notification retrospectively. We have recommended that the provider re-familiarises themselves with the requirements of this regulation.

Prudhoe House provides residential care, with no nursing provision, for up to five people with learning and physical disabilities. Staff at the service support people to access a variety of activities and to lead full lives with the support of care staff. At the time of our inspection there were four people living at the service, some of whom received one to one support.

The service had 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.

Medicines were managed safely and in line with safe working practices in the management of medicines. A pharmacist audited the homes medicines regularly.

Accidents and incidents were recorded and monitored for trends forming and where appropriate, risk assessments were put in place for people and for the environment they lived in.

People told us they felt safe at the service. Staff were aware of their responsibilities to report any safeguarding concerns to the registered manager. People told us there were enough staff at the service to support them and we confirmed this through records.

Emergency procedures were in place and regular checks on the maintenance of the building were conducted.

People told us they were happy with the food and refreshments available to them and we saw a wide range of quality fresh food and vegetables within the kitchen. We found staff were trained and received induction, supervision and appraisal from the registered manager. The registered manager was in the process of reviewing and refreshing staff training.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The registered manager had not fully complied with the requirements of the MCA and people who were deprived of their liberties had not all been assessed to confirm this was done in line with the Deprivation of Liberty Safeguards.

Staff were caring and kind and treated people as individuals. People were respect and their dignity was maintained. People’s care needs were detailed, recorded and reviewed by staff with input from people where possible, their families and healthcare professionals. We noted that the registered manager and staff were in the process of updating every person’s care records to be in line with the paperwork used by the new provider.

People had choices and were able to participate in a wide range of activities. Staff encouraged and supported everyone to maintain social and family links. People and their relatives told us they knew how to complain and would be able to if necessary.

Staff told us they felt supported by their colleagues and the registered manager and felt they worked well as a team. There was some disappointment between staff members due to the possibility of changes being implemented by the new provider in relation to their terms and conditions of employment.

Audits and checks were in place to support the registered manager to monitor the quality of the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to the need for consent. You can see what action we told the provider to take at the back of the full version of this report.