Falmouth House

Updated 29 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 22 February 2022 and was announced the day before.

Updated 29 March 2022

The inspection took place on 1 October 2018 and was unannounced. This meant the provider and staff did not know we would be coming.

We previously inspected Falmouth House in August 2017, at which time the service was rated requires improvement. At this inspection, the service was rated good.

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

Falmouth House accommodates a maximum of 10 people with a range of mental health needs. The service is split across three floors. Nursing care is not provided. There were eight people using the service at the time of our inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was also responsible for the management of the provider’s other small service nearby and was supported by a deputy manager.

At the previous inspection we found care plans were not always person-centred and people’s aspirations and goals and achieving them were not always well planned. At this inspection we found improvements had been made in both regards.

There had been improvements in the fabric of the building since our last inspection, including some new flooring and redecoration to people’s rooms. The provider showed us the plans for further refurbishment of the premises on an ongoing basis. The service was generally clean although at the time of inspection the provider was awaiting the new cleaner to start, meaning care staff were currently covering cleaning duties.

The care service had been registered for a number of years, in a converted terraced house, and had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. We found however, despite the building not being in line with current best practice guidance, that people with learning disabilities using the service could live as ordinary a life as any citizen and were supported by staff to do so.

Medicines administration practices were safe, with staff trained appropriately and their competence assessed annually by the deputy manager. Staff demonstrated a good knowledge of people’s medicinal needs.

Risk assessments were in place and were specific to people’s individual needs and circumstances. Staff demonstrated a good working knowledge of these risks and described what factors to look out for that may indicate people becoming more at risk.

Staffing levels were appropriate to the needs of people who used the service and rotas were planned in advance.

All staff understood their safeguarding responsibilities and were committed to making sure people were safely cared for. People who used the service felt safe and secure.

Training and support was effective, with the induction giving new staff introductions to each person’s needs. Training ensured staff had the core skills required. Staff told us they were well supported.

People had a choice of meal options and had been encouraged to try healthy alternatives such as salad.

People were supported to have maximum choice and control of their lives in the least restrictive way possible. The policies and procedures in place supported this practice. Staff had received training in the Mental Capacity Act (2005) and consent was evident in care planning and through day to day interactions.

Care plans contained sufficient guidance for staff to ensure people’s needs were met and that visiting healthcare professionals could understand people’s recent health and wellbeing. These care plans had been reviewed and audited to check for required changes and updates.

People who used the service gave positive feedback about how staff were patient and respectful with them. External professionals provided us with similar feedback about the interactions they have observed. The provider had introduced a dignity competence assessment and all staff treated people who used the service as respected individuals.

Activities provision was still a work in progress, with one member of care staff taking the lead alongside care duties. They had organised arts and crafts recently. People who used the service had been consulted on what activities and outings they would like to take part in and the provider assured us they would continue the good work started.

There had been no complaints but people who used the service were clear they knew how to complain and to whom, if they needed. This information was available in easy-read formats in a communal area, as was safeguarding information.

People had been asked about their preferences regarding end of life care, although no one who used the service was in need of this at the time of inspection.

The deputy manager and registered manager interacted well with people who used the service and staff. The culture was open, inclusive and the atmosphere welcoming. People felt at home and reassured due to the continuity of care provided.

Audits of core processes were in place and the managers demonstrated an awareness of areas of recent good practice. The deputy manager was aware of their responsibilities with regard to making appropriate notifications to CQC.