CQC report explained · a nursing home
What the CQC found at Prospect House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from harm, medicines were managed safely, risks were assessed and there were enough suitably skilled staff. Inspectors also found good infection control arrangements and appropriate use of PPE.
- Effective?
- Good
- People's care, health, food and drink needs were assessed and supported. Staff received induction, training and supervision, and the home followed the Mental Capacity Act requirements described in the report.
- Caring?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found effective systems for checking quality and safety. Relatives said communication was good, and the management team was open about problems and acted on feedback.
What inspectors found, February 2021
Rated Good; inspectors found major improvements in safe care, effective support and management since the previous inspection.
Inspectors visited on 14 January 2021. This was a focused inspection, announced the day before because of the COVID-19 pandemic. They spoke with people, relatives and staff, observed care and meals, checked medicines, looked around the home and reviewed care, staffing, cleaning and management records.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found medicines were managed safely, risks were assessed, staffing was sufficient and infection control measures were being followed. People's care records, health support, food and drink arrangements had improved.
The inspection found that significant improvements since the previous inspection had been made and sustained. The home was no longer breaching regulations that had been breached at the previous inspection. Caring and Responsive were not assessed during this inspection, so their previous ratings were used in the overall rating.
Safer medicines
Medicines were received, stored, given, recorded and disposed of safely. Staff giving medicines had suitable training and their competence had been checked.
“Medicines were received, stored, administered, recorded and disposed of in line with national good practice guidelines.” from the report
Infection control
The home was clean and hygienic. Staff used PPE appropriately, and inspectors found measures to reduce the risk of COVID-19 spreading.
“Staff followed good IPC practices. Increased cleaning was in place and the service was clean and hygienic.” from the report
Improved management
The systems for checking quality and safety had improved and were being used. The provider had acted on the previous inspection's action plan.
“Significant improvements had been made and sustained since the last inspection.” from the report
Support for people's needs
People's health, nutrition and hydration needs were assessed and supported. Staff worked with healthcare professionals when needed.
“People's nutritional and hydration needs had been assessed and were being met.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you continue to check that medicines are given on time and recorded correctly?
- 02How do you assess and review risks for each person, including their emergency evacuation plan?
- 03How are Caring and Responsive care checked now, as they were not assessed during this inspection?
- 04What quality checks are currently used to make sure the improvements found in this report have been maintained?
- 05How will you keep relatives informed about changes in their loved one's health or care?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not assessed and their previous ratings were carried forward into the overall rating. This explanation was written from the published report of 4 February 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2019
Rated Requires Improvement; inspectors found kind, responsive care but serious weaknesses in medicines, records and oversight.
Inspectors visited without notice on 28 August, 30 August and 5 September 2019. They spoke with people, relatives, staff and a healthcare professional. They reviewed care records, medicine records, staff files and management records.
The main risks were unsafe medicine management, incomplete or inaccurate records, and quality checks that had failed to identify these problems. One person went without a prescribed medicine for almost two months. The provider took immediate action during and after the inspection.
People were treated with kindness and respect. The home had enough staff, was clean, provided activities and served food that people generally enjoyed. However, some mealtime support for people living with dementia needed improvement.
The overall rating was Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement, while Caring and Responsive were rated Good. The overall rating had fallen from Good at the previous inspection.
Kind and respectful care
People and relatives described staff as kind, respectful and knowledgeable. Staff knew people well and supported their dignity, choices and independence.
“People were treated with dignity and respect by kind and caring staff that knew them well.” from the report
Enough staff
Inspectors found enough safely recruited staff on duty to meet people's needs. People and relatives also said staffing levels were sufficient.
“There were sufficient numbers of suitably qualified and experienced staff on duty to meet people's needs.” from the report
Activities and social contact
People had access to a broad programme of activities in the home and local community. Relatives could visit and were made welcome.
“A range of activities were available seven days per week in the home and in the local community.” from the report
Food and dietary needs
The home met people's nutritional needs and dietary preferences. People generally enjoyed the homemade food.
“People's nutritional needs and dietary preferences were met.” from the report
Medicines were not always safe
seriousMedicine checks, stock records, administration guidance and fridge storage were not reliable. One person did not receive a prescribed medicine for almost two months.
“One person did not have one of their prescribed medicines for almost two months.” from the report
Records and checks were not reliable
seriousCare records were not always up to date or accurate, and monitoring did not always show whether nurses had been alerted when people did not meet fluid targets. Quality checks failed to identify these problems.
“The systems in place for checking on the quality and safety of the service were not always robust enough to identify shortfalls in records and bring about improvements.” from the report
Dementia mealtimes needed improvement
needs fixingStaff did not always follow good practice when offering choices or helping people living with dementia to eat. The manager acted immediately, but the report said improvements needed to become routine.
“Staff did not always follow good practice guidelines when offering people living with dementia a choice of meal or when supporting them to eat.” from the report
Dementia training was incomplete
needs fixingNot all staff involved in care had completed dementia care training, despite the home supporting many people living with dementia.
“The service accommodates a large number of people who were living with dementia however not all the staff involved in the delivery of care had completed training in dementia care.” from the report
- 01What changes have you made to ensure people receive every prescribed medicine, including medicines prescribed when someone first moves in?
- 02How do you now check medicine stock records, written guidance and fridge temperatures?
- 03How do you make sure care plans accurately reflect assessments and changes in people's needs?
- 04What dementia care training have staff completed, and how do you check that good practice is followed at mealtimes?
- 05How do your current quality checks identify and act on problems before they put people at risk?
This inspection was prompted by concerns about medicines and records but assessed all five CQC questions; Safe, Effective and Well-led fell from Good, while Caring and Responsive remained Good. This explanation was written from the published report of 15 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Prospect House
4 rated inspections over 5 years: the service has held its Good rating throughout.
- February 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- November 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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