White Hill House Residential Care Home

Updated 25 March 2020

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 Care Act 2014.

Inspection team

This inspection was carried out by an Inspector.

Service and service type

White Hill House Residential Home for the Elderly is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

White Hill House Residential Home for the Elderly are not required to have a registered manager in place because they are the sole provider. The registered provider has overall responsibility for the day to day management of the service. Registered persons have been registered with the Care Quality Commission and have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people about their experience of the care provided, three staff members including the deputy manager. We observed the care provided and examined documents related to the employment of two staff members, their supervision records and policies and procedures. We asked the deputy manager to send us a copy of the training matrix and other documents which weren’t all readily available at the time of our visit. We reviewed documents related to six people’s care and multiple medication records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with a fire officer who had previously visited the service.

Updated 25 March 2020

About the service

White Hill House Residential Home for the Elderly is a residential care home which accommodates up to 10 older people. It does not provide nursing care. At the time of our inspection there were nine people living in one adapted building.

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

People told us they felt safe living in the service, but we found concerns which demonstrated they weren’t safe. Risk assessments had not been carried out in relation to the environment, people’s health, medicines and staffing levels at night. The environment was not safe as risks had not been managed. This placed people at risk of falls, trips and objects falling from height. Advice from the fire and rescue service had not been actioned, fire drills had not been carried out regularly and exits were not always free of obstruction. This was a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Authorisation had not been applied for to restrict people’s exit out of the building. Access to the kitchen was restricted. This was a breach of Regulation 11 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Employment checks were not always thorough and did not protect people from the risk of unsuitable staff. This meant the provider had failed to protect people against the risk of inappropriate or unsafe care. Staff were not always supported to carry out their roles, there was a lack of supervision taking place and no team meetings. Staff told us they would like these to happen. This was a breach of Regulation 18 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The lack of management oversight and documentation to show improvements were being made to the service, meant there was a breach of Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider has a legal requirement to inform us of certain events that occur in the service. We found the service was not always doing this. We have made a recommendation about notifications being sent when appropriate to do so.

People appeared well cared for, and they told us they were happy in the service. People’s appearance was clean, and they were dressed appropriately for the weather. One person told us People told us they were happy with the care, one person told us “I truly haven’t got any complaints.”

People were generally able to communicate verbally about their care, and to discuss if they were happy. Where people were unable to do this their relatives were consulted. People told us “I can assure you I won’t be neglected.” Another said “Staff know us and what we need. …They [staff] listen to you and are prepared to discuss things. We are very happy to just plod along.” There was a lack of activities being offered to people, we have made a recommendation about the provider offering person centred care to people.

People told us they were treated well, and staff showed them respect.

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 this service was good. (published 10 October 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the Is the service safe, is the service effective, is the service responsive and is the service well led sections of this full report.

Following the inspection, the provider sent us an action plan which detailed how they were to address the shortfalls we found.

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

Please see the action we have told the provider to take at the end of this report.

Follow up

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

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.