Background to this inspection
Updated
30 December 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 1 inspector.
Service and service type
White Pearl House is 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. White Pearl House is a care home without 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
We gave the service notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the 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 sought feedback from the local authority. We used all this information to plan our inspection.
During the inspection
We spoke with 1 person who used the service and 3 relatives about their experience of the care provided. We spoke with 7 staff including the team leader, activity co-ordinator, care workers, quality lead and the registered manager. The registered manager is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We had a tour of the building with the registered manager. We reviewed a range of records including records relating to medicines, staff recruitment, building maintenance, cleaning and equipment checks and accidents and incidents. We also looked at a variety of records relating to the management of the service including audits and policies and procedures.
Updated
30 December 2023
About the service
White Pearl House is a residential care home providing accommodation and personal care to up to 5 people. The service provides support to younger adults with learning disabilities, autism spectrum disorders and mental health. At the time of our inspection there were 3 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
Right Support
Risks to people’s safety were not always identified or managed. 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. However, the policies and systems in the service did not support this practice as capacity assessments and consent to care forms were not always in place. Reviews were taking place to ensure the design of the service was meeting people’s needs. There were enough skilled and experienced staff to safely care for people and recruitment processes were safe. We were assured IPC practices were safe. Staff supported people to maintain relationships, follow their interests and take part in activities.
Right Care
Medicines were not always being stored and managed safely. People’s needs were assessed prior to them starting to use this service. However, work was needed to ensure support plans were accurate and up to date. We made a recommendation about this. People were treated well and their privacy, dignity and independence was respected.
Right Culture
Governance systems were not effective at improving the quality and safety of the service. Audits did not always identify concerns found during the inspection and there was no evidence of provider oversight. There was limited evidence of lessons learnt following on from an incident, we made a recommendation about this. There was a complaints procedure in place and relative feedback was sought. Staff attended regular meetings and supervisions and they felt comfortable raising concerns. People’s communication needs were considered.
For more details, please see the full report for White Pearl House which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 17 January 2023). The provider completed 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
The inspection was prompted in part due to concerns received about the care and treatment people were receiving at this service and to follow up on actions we told the provider to take at the last inspection. A decision was made for us to inspect and examine those risks.
Enforcement and Recommendations
We have identified breaches in relation to the health and safety of people living at this service, medicines management, consent and good governance at this inspection. We made recommendations in relation to lessons learnt processes and support plans.
Please see the action we have told the provider to take at the end of this report.
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 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.