Prospect House Care Home

Updated 12 April 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The service was inspected by 1 inspector.

Service and service type

Prospect house is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Prospect House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection. We sought feedback from the Local Authority. We used this information to plan out inspection.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke to 3 family members and 8 staff members. We reviewed 5 medication records and 4 care plans for people who lived in the service. We looked at information in relation to the governance of the service and checked 3 recruitment files.

Updated 12 April 2024

About the service

Prospect House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Prospect House is registered to provide accommodation and personal care for up to 24 people. There were 22 people living at the service at the time of the inspection.

People’s experience of using this service and what we found

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 and in their best interests; the policies and systems in the service did not support this practice.

People or their representative were not always actively involved in their care planning. Care plans lacked person-centred details and did not contain enough information to guide staff on how to support people safely.

Not all health and safety checks were routinely carried out, we identified the lift was being operated without a valid Loler certificate. This had not been identified by the registered manager.

Medicines were not always safely stored and monitored, we found medication that required storing in the fridge left on the side. Protocols in place for as and when required medication lacked person centred detail to enable staff to recognise when to utilise this medication, how much was required and its effectiveness.

Not all staff had received mandatory training to enable them to support people safely, this was discussed with the registered manager and refresher courses were being provided.

Safe recruitment policies were in place however they were not always followed, gaps in employment were not always accounted for.

We observed limited activities taking place throughout the inspection. People were not actively encouraged to participate and were observed to be sitting in the same place for long periods of time.

People’s fluid and nutrition was not always accurately recorded as it was not documented at the time, records were often updated sometime after support had been provided and on the reliance of the carer being aware of what each person had drank and eaten.

Not all people’s dietary requirements were catered for, there was no alternative meal option for people with diabetes.

We observed positive and caring interactions between staff and people who lived in the home. Staff knew the people they supported well. Management was visible in the home and knew people well however governance systems were in effective and did not drive improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last inspection was carried out (published 02 May 2018) with a rating of good.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Prospect House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to support not being carried out in the least restrictive way and consent not being sought in line with the Mental Capacity Act 20025. Risk assessments and care plans were not updated frequently and lacked person centred details. Staff did not all have the mandatory training to support people safely. Governance systems that were in place were ineffective and did not identify concerns found during this inspection. Concerns were raised regarding the deployment and number of staff working within the home.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.