20 February 2023
During an inspection looking at part of 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.