Archived: Prospects Supported Living Limited

Updated 5 February 2016

We undertook an unannounced focused inspection of Prospects Supported Living Limited on 27 October and 18 November 2015. This inspection was done to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection on 13 and 14 May 2015 had been made. The team inspected the service against three of the five questions we ask about services: is the service safe, effective and well-led. This was because we identified that the service was not meeting some legal requirements.

The inspection team consisted of an adult social care inspector as well as an adult social care inspection manager.

Before the inspection we reviewed information we had received about the service since our previous inspection in May 2015. This included the provider’s action plan, which set out the actions they planned to take to meet legal requirements and any statutory notifications received from the service. We were aware of a serious incident that had occurred at the home and as such wanted to see what the service provider had done to improve safety and care at the home for people using the service.

During the inspection, we spoke with one of the care staff, the acting manager, and a registered mental health nurse who came to support the inspection but who was normally based in another home within the group.

We looked at a sample of records including care plans, risk assessments and other associated documentation, training records, a selection of staff files, minutes from meetings, medication administration records, policies and procedures and records of audits.

Updated 5 February 2016

We carried out an inspection of Prospects Supported Living on 13 and 14 May 2015. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches related to risk management and the skills of the staff team in order to ensure adequate support of people during critical times in their mental health recovery.

We undertook this focused inspection to check that they had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to these topics and additional areas of concern noted during the inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Prospects Supported Living Limited on our website at www.cqc.org.uk

The home provides accommodation for four adults with mental health needs. The property at (Wessex Close) provides single occupancy bedrooms and is located on the outskirts of Accrington in Lancashire. At the time of this inspection there was one person living at the home.

At the time of our inspection the service did not have 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. An acting manager was however in post and we saw that they had submitted their application to register with the Commission.

Whilst it was evident that some work had been undertaken to progress areas requiring improvement identified on the last inspection, on this inspection we found additional issues of concern. During this inspection we found there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The service provider was providing nursing care at the home which was contrary to their conditions of registration. Following the inspection the service provider has submitted applications to address this matter and these are currently being considered by the Commission.

There had been a significant number of incidents occurring at the home which had not been notified to the Commission.

The service provider had not displayed their inspection rating in the home as they are required to do.

Medication items given to service users for use on home leave were not managed effectively. Policies needed enhancing to ensure that a record was maintained of medication handed in to staff and to ensure that there was direction for the staff on how to mange this medication going forward.

Risk assessments had been updated since the last inspection and provided greater detail about self-harming behaviours. Information was available to direct staff when they should intervene and offer support.

Evidence of completed environmental risk assessments and audits were noted in the home however these did not include specific risks such as ligature risks. We recommend the provider access best practice guidance relating to risk assessing and making adjustments to the environment where people are at risk of ligaturing.

Staff had access to the safeguarding policy and procedures in the home and we saw evidence of safeguarding of vulnerable adults training in the training matrix we looked at.

We saw that some training had taken place and that more was planned in order to ensure that all staff had received training to equip them with the skills and knowledge to care for individuals with complex mental health needs. It was noted however that the training in self-harming behaviours was only delivered over a short period of time but was regularly refreshed through internal practices such as staff supervison and core group meetings.

A number of policies were available for staff reference such as accident and incident reporting (RIDDOR) policy, dealing with accidents and emergencies policy and a first aid policy. However these policies need to be enhanced to reflect a mental health care focus.

Risk assessments had been enhanced to include details of how to support and monitor people with an eating disorder and how to monitor any health related matters.

Evidence of a supervision matrix of staff was seen and there were copies of supervision records in place for staff member.