The White House Falmouth

Updated 28 April 2023

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 inspection was carried out by an inspector.

Service and service type

The White House Falmouth 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.

This provider is not required to have a registered manager to oversee the delivery of regulated activities at this location. The provider is an individual and is 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 deputy manager in post who was responsible for the day to day leadership of the service.

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 as part of the planning process.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We met and spoke with 5 people who lived at the service and 1 relative who visited regularly. We also spoke with 4 care staff, the deputy manager and the provider about the service’s current performance.

We looked at records relating to people’s care. This included 3 care plans, medicine administration records (MARs), 3 staff files and records relating to the management of the service including staffing rotas, quality assurance audits and safety documentation.

Updated 28 April 2023

About the service

The White House Falmouth is registered to provide care and support for up to 17 older people. At the time of the inspection the service was supporting 14 people.

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

Disclosure and barring service checks had been completed for all staff employed since our last inspection. However, recruitment records remained disorganised and the required information necessary to demonstrate prospective staff were suitable for employment in the care sector, was absent.

Additional night staff had been recruited and recruitment of day staff was ongoing. This increase in staffing and the appropriate use of regular agency staff, had enabled the dedicated staff team to have more time off. Staff who had previously been working excessive hours were now enabled to have a reasonable work life balance.

People’s care plans and risk assessments had been reviewed and updated since our last inspection. These documents now accurately reflected people’s current needs and gave staff with guidance on how to manage identified risks.

Environmental safety had improved. Fire doors were no longer tied open and cleaning materials were stored safely when not in use. Personal emergency evacuation plans were now available for people detailing the level of support they would need in an emergency. A fire risk assessment had been completed and an action plan was being developed to resolve issues identified by the risk assessment.

People were supported to access their medicines as prescribed and additional guidance had been provided to staff on when ‘as required’ medicines should be used. Additional appropriate storage facilities for medicines that required stricter controls had been installed.

The provider and deputy manager now had an understanding of the requirement of the Mental Capacity Act. Appropriate applications had been made to the local authority for the authorisation where people lacked capacity to make specific decisions their care plans were potentially restrictive. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Effective quality assurance systems had not yet been introduced and daily care records were not been consistently completed.

People were comfortable in the service and relatives were complimentary of the care provided. Staff told us, “I think people are 100% safe and they are happy which is also important”.

The provider had taken action in response to the findings of our previous inspection. A deputy manager had been appointed and the service was accessing additional managerial support facilitated by the local authority.

Staff were complimentary of the deputy manager and recognised the service’s performance was improving. The current responsibilities of the deputy manager were understood by the staff team.

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

Rating at last inspection and update

The last rating for the service was requires improvement overall but inadequate in well led. (Published 17 February 2023). At this focused inspection we found both warning notices had been complied with and the service’s rating was changed to requires improvement. Ongoing breaches of the regulations were identified.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

Although we have recognised significant improvements in the service’s performance, ongoing breaches of the regulations in relation to Good governance and the fitness of staff employed were identified at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.