WhiteHorse Care - Brownhills

Whitehorse is a residential care home providing personal care for up to 8 people. The service provides support to people with learning disabilities and autistic people.

Whitehorse is a residential detached bungalow with some adaptions. At the time of our inspection there was 6 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

The provider was working within the principles and values of Right support, right care, right culture.

Right Support:

Whitehorse is a small, ordinary home forming part of a local community. The property does not appear to be a care home and mirrors the other properties on the road.

People's needs were assessed, risks were identified, and steps taken to keep them safe. People were safeguarded from abuse and staff were knowledgeable about how to support people safely. People's medicines were safely managed. People's care records had been improved, further improvements were needed so they captured how people were supported to try new things.

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.

Right Care:

People were supported by caring and kind staff. Staff had received appropriate training, knew people well and supported people in line with their preferences. Staff worked in partnership with other agencies to promote people's health and wellbeing.

Right Culture:

Improvements had been made at the service. The registered manager promoted a positive culture and led by example. There was a relaxed, friendly welcoming atmosphere. People were treated with dignity and respect. Improvements had been made to the environment and further work was planned so the environment remained safe for people.

Most relatives told us there had been improvements at the service, and they had confidence in the leadership of the service.

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

Rating at last inspection

The last rating for the service was inadequate (published August 2022). There were 3 breaches of the regulations in relation to safe care, staffing and good governance, the service was placed in special measures. We imposed positive conditions, and the provider was required to send us a monthly report to show what they would do, and by when, to improve.

At this inspection we found significant improvements had been made and the service is no longer in breach of the regulations. The rating has improved to requires improvement, and the service is no longer in special measures.

Why we inspected

We undertook this inspection to monitor progress on the breaches of regulations.

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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Whitehorse care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection program. If we receive any concerning information we may inspect sooner.

About the service

Whitehorse Care Brownhills is a residential care home providing personal care to eight people at the time of the inspection, seven of those people had a learning disability or autism. The service can support up to eight people.

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

The service was not able to demonstrate they were meeting the underpinning principles of right support, right care, right culture.

Right Support

There were ongoing incidents between people using the service and staff had not received training from the provider in order to support people when they became distressed. The home’s communal area was noisy and busy in the mornings and late afternoon onwards. This atmosphere was not conducive to people who disliked noise. Risk assessments were not clear and did not provide guidance to staff on how to meet peoples’ support needs. There were not enough meaningful activities to engage people. One relative said, “They [people] need to get out more. It doesn’t happen now. It hasn’t happened for a long time.” Another relative said, “There is not much in the way of activity.”

Right Care

People were not supported by staff who knew them well and understood their needs. Staff on the day of inspection were either new or agency. There had been a high turnover of staff. Not having regular staff was having a negative impact on people. One relative told us, “[Name of person] was very distressed. This is normally down to a change or not used to the people [staff]. There has been a lot of upheaval. There have been a few incidents with [name of person] and other residents.”

Right culture

The new provider had not made enough improvements to improve the quality of care for people. The provider had not identified or addressed the root cause of why there were continuing incidents between people using the service in order to ensure people were safe and free to live from abuse.

They had not been able to maintain either a stable management team or stable 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

This service was registered with us on 23 September 2021 this is the first inspection.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture. The provider had changed the name of their legal entity and registered as a new company. This means they now are registered as a new service and we needed to inspect and rate the service. The inspection was prompted in part due to concerns received about safe care and treatment and staffing. A decision was made for us to inspect and examine those risks.

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. This included checking the provider was meeting COVID-19 vaccination requirements.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, staffing and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will 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 work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.