This inspection took place on 19 and 20 December 2017. It was unannounced and was carried out by one inspector.

Prospect House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 accommodates up to nine people in one adapted building. It is registered for younger and older adults with a range of different needs including learning disability, autism, mental health needs, dementia and physical disability. At the time of this inspection six people were living there.

Accommodation is provided on two floors, the ground floor is wheelchair accessible. People had individual bedrooms, most with en-suite facilities and all had access to communal bathrooms. Spacious communal areas were provided on the ground floor, including lounge, kitchen and dining areas. A stair lift was fitted to assist people with limited mobility to access the first floor. Outside there was a parking area and small garden to the front and a large garden to the back and side.

At our comprehensive inspection in October 2017 we found three breaches of the regulations and rated the service as ‘Requires Improvement’. We inspected the service again on 17 March 2017 and found the required improvements had been made and the requirements of the regulations were met. At this inspection we found the service had sustained these improvements and we rated the service as ‘Good’.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager was registered with CQC in October 2010 to manage the service. They were also registered to manage the provider’s other care home in Hereford.

People felt safe at prospect House and were comfortable with the staff who supported them there. Staff understood how to protect people from harm and abuse. Risks to people's safety were identified and clear support plans were followed. Incidents and accidents were monitored and action was taken to reduce risks to people. Environmental risks were assessed and managed appropriately. There were enough staff to meet people’s needs and recruitment checks were thorough. People received their medicines as prescribed.

People were supported by knowledgeable staff who received ongoing training and support to maintain or improve their skills and competency. Technology was used to make information accessible to people, to support people’s independence and to support the delivery of care. People were encouraged to make their own decisions about the support they received wherever possible. Deprivation of liberty safeguards were in place where people were restricted of their liberty.

Facilities at Prospect House were adapted to meet the needs of the people living there. People were supported to have a healthy and nutritious diet which reflected their individual dietary needs. Staff worked closely with external professionals to meet people's health and well-being needs.

People received support from caring staff who valued and understood them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's privacy was respected and they were treated with dignity, kindness and compassion. People were supported to maintain relationships with others who were important to them. They received personalised and responsive care which enabled them to live as full a life as possible. People could raise concerns about the service and hav

We carried out an unannounced comprehensive inspection of this service on 25 and 26 November 2016. 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 staff recruitment checks, staff training and supervision and the statement of purpose.

We undertook this focused inspection to check that they had followed their plan and to confirm that they 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 (location's name) on our website at www.cqc.org.uk”

Prospect House is a small home which provides accommodation and personal care for up to nine people with a learning disability, mental health needs and/or a sensory or physical disability. Nine people were living at the home at the time of the inspection.

The registered manager was present during the inspection. 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.

This unannounced inspection was carried out on 17 March 2017. At the inspection on 25 and 26 November 2016, we asked the provider to take action to make improvements to:

• staff recruitment checks

• staff training and supervision

• the service’s statement of purpose.

We found that the actions in the provider’s plan had been completed.

Staff recruitment processes had been reviewed and checklists developed to highlight the checks required and document when these had been completed. No staff had been recruited since the previous inspection but we were satisfied that legal requirements had been met.

Staff had received training relevant to the needs of the people they supported and were confident in recognising and responding to potential changes in people’s health needs. Staff felt well supported and confident in their roles. Staff supervision was in progress and we were assured this would be completed within a month of our inspection.

The statement of purpose and service the service user bands registered with CQC had been updated to reflect the service that was provided.

This was an unannounced inspection which took place on the 25 and 26 October 2016. Prospect House provides accommodation and personal care for up to nine people with a learning disability mental health needs and a sensory or physical disability.

There was 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. The registered manager also managed another home owned by the provider in Herefordshire and divided their time between the two homes.

People had not been protected against the risks of employing unsuitable staff. Safe recruitment and selection procedures had not been followed. Staff had not received mental health training so they could effectively meet the needs of people diagnosed with this condition. Staff did not receive on going individual support to enable them to reflect on their roles and responsibilities. Quality assurance records were not available to evidence consultation with people or the support provided from the provider to the manager. The statement of purpose did not reflect all the needs of people currently living in the home.

People’s care and support was individualised and monitored to make sure care records reflected any changes in their health or wellbeing. People had appointments with health care professionals and staff implemented their recommendations to keep people safe and well. People were supported to have a healthy diet and their medicines were managed satisfactorily. People’s rights were upheld and staff understood their responsibilities to recognise and report abuse. People were encouraged to make decisions about their day to day lives in line with the Mental Capacity Act 2005. If needed best interests’ decisions were made on their behalf involving people important to them. When deprivation of liberty safeguards were needed, the least restrictive practice was implemented and authorisations granted to keep people safe.

People enjoyed a range of meaningful activities which reflected their lifestyle choices and preferences. People used local facilities such as places of worship, the gym, the swimming pool and shops. There were opportunities to volunteer and attend college. People said they looked forward to special events which they shared with families and friends. They also liked to go on holiday in this country and abroad. People had positive relationships with staff and managers. They were relaxed in their company sharing light hearted banter. They were treated with kindness and reassured when needed. Staff understood people well.

People talked to staff and managers about any problems or concerns. Their feedback had resulted in the kitchen being refurbished. Quality assurance systems monitored the environment and health and safety checks were carried out. Staff were confident any concerns raised under whistle blowing would be listened to and action taken as needed. They had access to training considered mandatory by the provider such as safeguarding, food hygiene, fire and first aid. The registered manager and staff said “We are like one big family” and “We are like a family.”

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) Regulations 2009 (Part 4). You can see what action we told the provider to take at the back of the full version of the report.

There were nine people at the service at the time of our visit. We observed care practices, met people, talked to staff and looked at care records to help us understand how people viewed the support they received at this service. This was because some people we met did not communicate verbally and were not able to tell us about their experiences.

We found that people were well supported. People we met told us they were happy and liked living here. One person said "it's great here". Another person smiled when we asked them if they were happy.

Care plans and risk assessments were well written and clear to understand. We saw they were up to date, and respected the wishes of the people they described.

There were sufficient skilled and experienced staff available to meet the needs of each person in the service. Staff we met told us that their inductions and ongoing training was of a good standard and helped them support people appropriately. One staff told us "lots of training, all of it very useful".

Senior staff monitored all aspects of medicine management in accordance with national guidelines. There were systems in place to ensure safe practices.

People were supported in a safe environment. Staff told us safeguarding training had helped them in their roles. One staff said it "makes you realise the responsibility placed on you".

There was an effective quality assurance system in place to monitor the standard of support in the service.

We found that the provider was providing a service which had respected the privacy and dignity of people who used their service. Assessment and reviews conducted by the service had consulted with people who used the service and recorded how they wished to be supported. People told us:” that staff are excellent" and how” I really enjoy living here and that staff listen to me ". Monitoring by senior staff had ensured that staff followed support plans and respected the wishes of people used the service. There were sufficient skilled and experienced staff to safely meet the needs of people who used the service. The standard of induction and subsequent training for staff was of a good standard. The training had enabled staff to effectively respond to the recent fire at the home.

In summary, this inspection found that Prospect House was providing a good standard of care and support to the people were using the services.