Great Prospects Care Ltd

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 registered manager had established a robust safety culture within the service. Staff actively listened to safety concerns, thoroughly investigated incidents, and reported them appropriately. Staff completed timely accident and incident forms which were reviewed by the management team to ensure immediate actions were taken as needed.

Lessons were continuously learned to identify and embed good practice. For example, when a routine spot check found that a support worker had left a visit early, leaving one member of staff with a person who required the support of 2 staff, that individual was immediately made safe by the provider because there was a backup carer system in place for each person. The staff member who had left the visit early was removed from duties and underwent a formal disciplinary procedure. All staff were reminded of the potential dangers that could arise from such poor practice, and staff completed a piece of reflective practice on the incident to embed the learning. Additional spot checks were also booked around staff handover periods.

The registered manager regularly analysed accidents and incidents to identify patterns and trends. For example, when a medicine audit found that the escalation of information with the GP was inconsistent, a new medication check list was created. All staff received regular supervision which focussed on accidents, prevention strategies, and reflected on lessons learned.

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.

People’s needs were assessed prior to receiving support from Great Prospects Care. People had the opportunity to visit the supported living service prior to moving in to ensure they were happy with their decision. The registered manager told us, “We complete a thorough assessment of people’s needs, including their preferred communication approach, support network, religious, cultural, sexual and health needs, their medication, equipment, and pets. We want to know what is important to them, how and when to support them. This is the first part of the care plan that staff see when supporting a person, and it is updated as changes arise.”

People, their relatives, and other professionals were involved in planning people’s care and support needs. We saw records of multi-disciplinary meetings, held to discuss safe care and treatment pathways for people, and staff knew when to refer to specialist services to support and manage people’s care safely.

When people attended health appointments, they were supported by a member of staff. One health care professional told us, “The deputy manager is always happy to pass information on from us to his care staff, to ensure there is as much continuity of care as possible.”

One relative told us, “The carers are very kind and polite and reassuring with [person]. They kindly explain things, so [person] understands, and this keeps them calm and in control as much as possible.”

People and their families had access and input into their care plans. The registered manager told us, “At the end of the day, this is the person’s home, and we want them to choose who they want and how they want to be supported, so as to make them most comfortable.”

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.

People told us they felt safe. One person told us, “I am safe because the carer always checks the equipment I need before helping me to use it.” A relative told us, “I know [person] is safe because [person] is so happy. They pay close attention to how [person] is feeling and make sure [person] is feeling secure. Staff also make sure I am feeling ok too, which is lovely.”

The manager understood their role and responsibilities to safeguard people from abuse and had taken appropriate actions to address allegations of abuse in both services. This included raising safeguarding alerts to the local authority, undertaking investigations, and notifying the CQC.

Staff had a good understanding of how to identify abuse, were confident that actions would be taken if concerns were raised and would take further action to escalate their concerns if these were not addressed in a timely manner. One staff member told us, “I would inform the local authority and CQC if I had to, but I know the managers would definitely deal with any concern because they all listen and act straight away.”

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack capacity to make specific decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. All staff had received training on the MCA and understood their role and responsibility in promoting the principles of the MCA, and people’s rights and freedoms were promoted by Great Prospects Care.

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.

The registered manager and the staff team worked with people to understand and manage risks by thinking holistically. There was a proactive approach to involving people to manage risks to their health and in enabling positive risk taking. One staff member told us, “[Person] likes to smoke, so we built them a safe and sheltered place to enjoy a smoke outdoors in their garden, regardless of the weather.”

The registered manager told us, “One client, once so active and independent, went into a crisis suddenly, and we worked hard to avoid them being sectioned under the Mental Health Act.” Together, with the community mental health team, this person now enjoys day trips to London. The registered manager told us, “We have put in place specific risk assessments for this person, highlighting all potential risks, guidance for staff on how to manage potential triggers, and ensure they have their favourite support worker to go with them. We also worked closely with

their family. The person chose what they wanted to do, which was a river cruise. We have also facilitated trips out to Hasting’s aquarium, mini golf, and the Kent show.”

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do things that mattered to them. One person told us, “The carers are lovely, you only have to ask, and they will do everything they can to help. Nothing is too much bother.”

One relative told us, “The staff really care and treat [person] so well and support them to do so many activities like swimming and going to the pictures. We have experienced a few different care home companies, and no one bends over backwards for their clients more than Great Prospects Care.” Another relative told us, “Staff make sure people can do the activities they want to do and ensure it’s a safe experience as well as a happy one. They give [person] so many choices about day trips and ask them what day and time they want to go to places such as the zoo, and when they want to go bike riding in the park.”

Staff understood the health risks people faced and how to mitigate the risks to keep people safe. People’s care plans were detailed, and risk assessments were reviewed regularly and updated to reflect people’s changing needs, and staff followed the measures in place to support people safely. One staff member told us, “Following an assessment from the dietician, [person] has thickener in their fluids and a soft diet. We know how much thickener to put into their drink because it’s clearly written in the care notes, and we record everything they eat and drink every day.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. For example, the provider had ensured that all actions had been taken to safely evacuate people in the event of an emergency. Fire drills, to check that staff had the practical skills needed, had taken place with all staff. The provider had ensured that people had the correct equipment in place to safely evacuate them in the event of a fire, and carbon monoxide alarms were regularly tested in people’s homes. People benefitted from environments that were kept clean, tidy and warm, and records showed that health and safety checks were carried out frequently. Care equipment, such as moving and handling aids were serviced and records of maintenance kept.

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.

We observed appropriate staffing levels across both services. People, their relatives and staff told us there were enough carers to provide people with safe, calm, person-centred care. One person told us, “I am never rushed. The staff are polite, professional and know the routine, so I don’t need to explain things over again. They know my care plan very well.” Another person told us, “I have been with the service a long time and the staff are regular and consistent; this made it much easier for me to settle when I moved to the area.” A relative told us, “The staff are wonderful, and [person’s name] has had the same member of staff since their first day.”

The registered manager regularly carried out spot checks which included the scrutiny of staff deployment. Staff underwent a robust induction, training and shadowing programme prior to working on their own. All staff told us the induction and training provided by Great Prospects Care was excellent and provided them with the knowledge and skills they needed to be a competent member of staff. They confirmed where specialist training was required, this was provided for them, for example in PEG (Percutaneous Endoscopic Gastrostomy) care. A PEG is a feeding tube inserted directly into the stomach, to provide liquid nutrition, fluids and

medications to people who cannot feed by mouth.

Staff received support through formal and informal face to face meetings with their line manager. This gave them the opportunity to discuss their role, concerns and training needs as well as personal welfare.

Prospective staff went through a safe recruitment process which included their right to work in the UK and their fitness for the role. All staff had undergone a Disclosure and Barring Service (DBS) checklist to help ensure they were suitable to work for the company.

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.

We found the environments people lived in were clean and hygienic. Staff worked throughout the day, and when needed at night, to maintain a good standard of cleanliness.

Staff had access to appropriate personal protective equipment (PPE) when they needed it, such as gloves and aprons, and we saw them correctly wearing PPE at times throughout the day, such as when they were serving meals or giving people drinks.

The registered manager carried out regular infection control audits and their frequent spot check included the cleanliness of people’s homes.

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.

People received their medicines as prescribed. We reviewed medicine administration records (MARs) and were able to reconcile people’s medicine supply. MARs had accurate information for staff to administer people’s medicines safely, including details of allergies, when and how to administer PRN (when required) medicines, and how people preferred to take their medicines.

Medicines were stored safely. Risk assessments and care plans for high-risk medicines were in place; these were person-centred and had the right information for staff to follow to ensure that risks were managed safely. We saw that staff had a good and kind rapport with people and gave their medicines safely as prescribed.

Medicine audits were completed regularly, and appropriate actions implemented.