• Care Home
  • Care home

The White House

Overall: Requires improvement read more about inspection ratings

Limerick Close, Ipswich, Suffolk, IP1 5LR (01473) 740872

Provided and run by:
Brama Care Ltd

Latest inspection summary

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Background to this inspection

Updated 7 February 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

This inspection was carried out by three Inspectors including a pharmacy Inspector and a specialist advisor with a specialist background in eating disorders.

Service and service type

The service is registered both as a domiciliary care agency providing personal care and support to people living in the community. And, as a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The White House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are 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 registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We used observation to gather evidence of people's experiences of the service. We spoke with six people who used the service including people who had previously used the service. We received feedback from 2 relatives. We spoke with 7 members of staff including the registered manager, administrator and deputy manager.

We reviewed a variety of records including 6 people’s care records, staff recruitment, incident reports, audits, medicines records, policies and procedures.

We continued to seek clarification from the provider to validate the evidence found.

We provided feedback with our findings to the registered manager on the 21 December 2022.

Overall inspection

Requires improvement

Updated 7 February 2023

About the service

The White House provides treatment and care to people with eating disorders. The service provides support to people who are transitioning from hospital into the community. The residential service has six bedrooms over three floors. Four bedrooms were en-suite and two bedrooms shared a bathroom.

The provider is also registered to provide personal care to people living in the community.

At the time of our inspection there was six people living in the residential care home and three people in receipt of supported living.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

The provider was not registered to support people with learning disabilities or autistic people. However, they were supporting people with eating disorders who were autistic. We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were autistic people using the service.

Right Support: Staff understood their responsibilities in relation to the Mental Capacity Act 2005.

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.

Where people had given consent to do so, their relatives were involved in their care and no decisions about care were made without the person being at the centre of discussions before plans were agreed.

Right Care: Care and support provided was person-centred and promoted people’s dignity, privacy and human rights.

Right Culture: The ethos, values, attitudes and behaviours of nurses and support staff ensured people using services were treated with kindness and supported in line with their recovery plan. Further work was needed to ensure the management of quality and safety assurance systems were strengthened.

We found medicines continued not to be managed safely. The service had good care outcomes for people but there was a lack of clear and consistent systems to ensure the registered manager and provider had good oversight of the service.

We recommended the provider refers to current guidance to ensure all pre-employment checks are received prior to a new staff member starting work.

The service was clean and well maintained. However, further work was needed to ensure fire safety checks were carried out as required and staff, including the registered manager have access to the records maintained.

For the care service to be correctly registered for the regulated activity of Personal care, there must be a real separation between the provision of personal care and the accommodation agreements. This was not in place for people in receipt of supported living.

People were supported by staff who had received a variety of training including autism, and eating disorders. People told us staff treated them with kindness.

People were supported to access all relevant health professionals in order to support their recovery and ensure their health and wellbeing were being appropriately monitored.

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

Whilst the last rating for this service was good (published 24 January 2020) there was a breach of regulation. The provider did not complete an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

We undertook this focused inspection to check the provider now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-Led which contain those requirements.

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.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The White House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and governance at this inspection. Please see the action we have told the provider to take at the end of this 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 also meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Other CQC inspections of services

Community & mental health inspection reports for The White House can be found at Brama Care Ltd. Each report covers findings for one service across multiple locations