- Care home
Mount Pleasant House
Assessment report published 24 March 2026
Contents
Ratings
Our view of the service
Date of assessment: 12 and 14 January 2026. Mount Pleasant House is a ‘care home’ providing support for a maximum of 19 people. On the day of the assessment, 16 people were living at the service.
During our previous inspection conducted on 19 April 2023 we identified a breach of regulations relating to safe care and treatment and good governance. During this assessment we again found a breach of the regulation in relation to good governance. We also identified additional breaches in relation to safeguarding service users from abuse and recruitment of fit and proper persons.
An assessment has been undertaken of a service that is used by autistic people or people with a learning disability but is not registered as a specialist service. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.
People were not always protected from all forms of abuse and prompt referrals to the local authority had not been completed.
The provider had not established a good learning culture. Action taken when things went wrong did not mitigate the risk of recurrence. We identified examples of poor care which were repeated despite managers being aware of the shortfalls. Audits were not always carried out to monitor the service.
Care plans and risk assessments were missing or had not been regularly reviewed to ensure they remained an accurate reflection of people’s needs.
Staff were not recruited safely, lacked training in some areas and were not receiving support through regular supervision.
The service was clean. All necessary checks had been completed to ensure the safety of the environment and equipment by external companies. However, where a fixture was broken, this had not always been repaired in a timely manner, and records had not been updated to reflect when repairs had been completed.
People received their medication however one person did not have their medication administered as prescribed. Competency assessments had not been carried out for all staff responsible for administering medication to ensure they were safe to carry out their role.
Staff were kind, compassionate and enjoyed their role caring for people. They told us they were well supported by the acting manager.
Staff and management did not always work within the principles of the Mental Capacity Act 2005 (MCA). Mental capacity assessments were not consistently completed and those that had been completed were not always accurate.
The provider did not have clear oversight of the service or identify and address areas requiring improvement.
Quality monitoring processes did not identify the concerns we found during this assessment
People's experience of this service
We observed staff interacting with people and used a structured observation tool to assess whether they received good care. We saw support was provided compassionately and was not rushed.
People and their relatives were complimentary of the staff. People and relatives told us staff were “kind”. One commented, “The girls are lovely, super. Nothing is too much trouble.” Relatives had confidence in the management of the home and were kept informed.