The last inspection of The Progress Project took place on 2 June 2016. As a result of this inspection, we found the provider in breach of two regulations, one relating to safe care and treatment and the other associated with good governance. We asked the provider to submit an action plan on how they would address these breaches. An action plan was submitted by the provider which identified the steps that would be taken. At this inspection, we found the provider and registered manager had taken appropriate action and these regulations had been met. As a result, the overall rating for this service has improved from 'Requires Improvement’ to ‘Good’.

The Progress Project provides support and accommodation for up to 16 people with on-going mental health conditions, including dual diagnoses such as schizophrenia and substance misuse. The aim of the service is to provide personalised support to enable people to move out of the service and live independently in the community. There were 12 people living at the service at the time of our inspection (including one person who had been admitted to hospital). The Progress Project is situated in a large, detached house not far from Worthing town centre and seafront. Communal areas include a sitting room, dining room with kitchen area, a games room with pool table and a smaller sitting area and an outdoor patio area. All rooms are of single occupancy.

A registered manager was 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.

People felt safe living at the service and their risks were identified and managed appropriately. Staff received guidance on how to support people safely and mitigate any risks. Premises were managed safely and equipment was serviced regularly. Staff had been trained to recognise the signs of potential abuse and knew what action to take if they had any concerns about people. Staffing levels were sufficient to meet people’s needs and safe recruitment practices were employed. Medicines were managed safely.

Staff had been trained in a range of areas relating to people’s care and support needs and in mental health conditions. They were encouraged to study for qualifications such as diplomas in health and social care. New staff followed the Care Certificate, a nationally recognised qualification. Staff had regular supervision meetings and attended team meetings. The service worked within the requirements of the Mental Capacity Act 2005 and associated legislation. People had sufficient to eat and drink and were encouraged to shop for their own food for their lunchtime meals. People had access to a range of healthcare professionals and services and staff supported people to attend their healthcare appointments where needed.

People were looked after by kind and caring staff and positive relationships had been developed. People were supported to express their views and to be involved in making decisions about their care. They were treated with dignity and respect by staff and had the privacy they needed.

Care was personalised to meet people’s needs. People met with their keyworkers on a regular basis and were involved in reviewing their care plans. Support was provided that aimed to develop people’s independence, with a view to them eventually living independently in the community. Care plans were detailed and provided information to staff on how to support people in a responsive way. People pursued their hobbies and interests and were encouraged in this by staff. Complaints were listened to and managed effectively.

Residents’ meetings took place on a monthly basis and people felt involved in developing the service. Any improvements identified would be

The inspection took place on 5 and 14 April 2016 and was unannounced.

The Progress Project provides support and accommodation for up to 16 people with on-going mental health conditions, including dual diagnosis such as schizophrenia and substance misuse. The aim of the service is to provide personalised support to enable people to move out of the service and live independently in the community. There were nine people living at the service at the time of our inspection. The low occupancy had been planned as building works were in progress affecting the availability of suitable rooms. The Progress Project is situated in a large, detached house not far from Worthing town centre and seafront. Communal areas include a sitting room, dining room with kitchen area, a games room with pool table and smaller sitting area and an outdoor patio area. All rooms are of single occupancy.

There was no 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 day to day management of the service was undertaken by an acting manager.

The level of cleanliness in some parts of the service was not satisfactory. Areas in a bathroom and wet room were dirty and in need of a thorough clean. Infection control audits had not identified these issues and information recorded was inaccurate.

Four incidents that had taken place between July 2015 and February 2016 relating to safeguarding issues had not been notified to the Commission, although the provider had taken appropriate action to ensure the safety of the people concerned.

People were protected from avoidable abuse and harm as staff had been trained in safeguarding adults at risk and knew what action to take. Risks to people had been identified and assessed and information was provided to staff on how to manage people’s risks. At the time of inspection, the premises were undergoing maintenance and refurbishment; this was due to be completed within six to eight weeks. There were sufficient numbers of staff on duty to keep people safe. New staff were recruited in line with robust recruitment practices. People’s medicines were managed safely. Some people had been assessed as being able to self-medicate and manage their own medicines.

Staff had completed training in a range of essential areas and were able to undertake additional training as needed to meet people’s needs. New staff followed the Care Certificate, a universally recognised qualification. Staff had supervision meetings with their manager, although some staff had not always received supervision every four to six weeks in line with the provider’s policy. However, the acting manager was readily available and handover meetings between shifts were an opportunity for staff to discuss any ongoing issues relating to people’s care and support. Staff meetings were held usually every three months. Consent to care and treatment was sought by staff in line with legislation and guidance. People were free to come and go as they pleased. They had sufficient to eat and drink and were supported to maintain a healthy lifestyle. A range of healthcare professionals and services were available to people. People had furnished and personalised their rooms according to their preferences.

People were supported by kind and caring staff who knew them well and understood how to meet their mental health needs. People spoke highly of the care and support they received from staff and were involved in decisions about their care and treatment. They were treated with dignity and respect and had the privacy they needed at the time they wanted it. Relatives and friends could visit freely.

Care plans were extremely detailed in the informat

As part of our inspection we followed up non-compliance we identified during our previous inspection on 9 October 2013. Following our inspection the provider responded to us on 18 December 2013 and advised us of the actions they would take to ensure that those regulations would be met.

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

The Progress Project provides support and accommodation for up to 16 people with on-going mental health concerns including substance misuse. On the day of our inspection 10 people were living at the home. We looked at documentation such as care plans, policies and procedures, training records, staff records, surveys and quality and audits. We spoke with four people using the service, the manager, deputy manager, and two members of staff.

Is the service safe?

The service was safe because the provider had undertaken a detailed assessment and completed a personal profile for each person. People’s needs assessment addressed areas of mental health, mobility, communication, personal relationships, risks and physical health. The plans had been checked and updated regularly to reflect the level of support or care required.

There were effective recruitment and selection processes in place. We looked at records for four staff members who worked at The Progress Project. This included proof of identity, a completed Disclosure and Barring Service (DBS) check and satisfactory evidence of conduct in previous employment concerned with the provision of health or social care.

Staffing levels were consistent and adequate to meet people’s needs and ensure staff safety. Staff had received appropriate training in the relevant policies and guidance surrounding the detention of people under the MHA.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

The service was effective because the provider operated a key worker system that allowed people to build positive relationships with their key workers. This enabled both parties to be constructive in regard to their expectations, goals and meeting their needs as part of the rehabilitation programme.

Key workers prepared support plans with each person to ensure their individual goals were identified. This supported people to take control of their own recovery and plans for their future.

Is the service caring?

The service was caring because people’s needs assessment addressed areas of mental health, mobility, communication, personal relationships, risks and physical health. The plans had been checked and updated regularly to reflect the level of support or care required.

People living at the home told us: “Staff are good; they understand and are always willing to listen to me”.

Is the service responsive?

The service was responsive. People living at The Progress Project were supported by staff whe were responive to peoples needs to live independently in preparing and submitting their curriculum vitae (CV) to prospective employers as a step to gaining full time employment and independence.

Is the service well led?

The service was well led. The service had not had the consistency of a registered manager however the manager was going through the registration process to become the registered manager at The Progress Project with The Care Quality Commission.

There were processes in place to record and respond to complaints. The manager told us that any complaint would be investigated and responded to in a timely manner.

A system of staff supervisions and appraisals was in place, which included providing staff with feedback. Although the manager was unable to show us any records of appraisals taking place we were shown diary appointments to demonstrate that these were due to take place for all staff during June and July 2014.

Supervision meetings were used to review what had been learned from training courses, job roles and objectives, staff wellbeing and future development, and the needs of people using the service.

We completed a responsive inspection at The Progress Project because we had received concerns about insufficient staffing and lack of support. The registered manager had recently resigned from the service and no longer worked there. The deputy manager was acting as the manager in the interim.

We spoke with people who lived at The Progress Project. People told us that they felt safe and well cared for. They said that staff were kind and supportive of them. However, people felt their personal progress had slowed and felt affected by staffing changes and lack of specialist support.

We found that although people's needs were assessed and recorded, their care was not always delivered in line with this. Although people wished to increase their independence, the care they received did not accomplish this. People told us they felt unprepared to transition into the community.

We found that there were not always enough suitably qualified staff to meet people's needs safely and appropriately. There was a lack of qualified staff such as Registered Mental Health Nurse (RMN), Occupational Therapists (OTs) and activities coordinators to support people's recovery.

We found that staff had not received appropriate training to understand the needs of people with mental health and substance misuse issues. Therefore staff were unprepared to deal with mental illness and challenging behaviours. Staff were ill-equipped to empower people's independence and coping skills.

We spoke with four people who used the service and one relative. People gave positive feedback about the service and said the staff were, "Very welcoming" and "Very good." People were happy with the care and support they received and felt included in decisions about their care. People's care and treatment was planned and implemented in line with their individual needs and preferences. People were given many opportunities to give consent, both verbally and in writing. People were given choices in their daily activities and care.

People were supported by staff who were experienced, skilled and knowledgeable. Staff had completed mandatory training but training records indicated that most staff training was not up to date. However, the provider had a plan in place for updating and reviewing training for all staff.

The provider had various methods for ensuring the quality of their service. This included obtaining feedback from people, visitors and staff. People's views and feedback were considered in the on-going improvement of the home.