The White House Care Home

Updated 21 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector and one inspection manager.

Service and service type

This service 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.

The service had a manager registered with the Care Quality Commission. They and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

Before the inspection we reviewed the information we held about this service including notifications the provider is required by law to send us about events and incidents involving people. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke to two people using the service and one visiting relative about their experiences of the care and support provided by staff. As most people using the service were unable to speak with us due to their communication needs, we also observed interactions between people and staff.

We looked at three people’s care records and staff records relating to training, supervision and recruitment. We reviewed medicines management arrangements and other records relating to the management of the service, including audits, policies and procedures. We also spoke to the registered manager, the deputy manager and a senior care support worker.

After the inspection

We spoke to one relative and asked them for their feedback about the service. We continued to seek clarification from the provider to validate evidence found. We looked at servicing and maintenance information related to the lift and the service’s complaints policy.

Updated 21 March 2020

About the service

The White House Care Home is a residential care home which specialises in supporting people with learning disabilities. The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The White House Care Home is a large home, bigger than most domestic style properties. It is registered for the support of up to 9 people. Nine people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting in with the residential area and other domestic homes of a similar size. There were no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.

People’s experience of using this service

People said they were safe at the service. Staff were trained to safeguard people from abuse and knew how to minimise identified risks to people’s safety. Health and safety checks were carried out of the premises and equipment to make sure they were safe. The premises were clean and tidy. Staff followed current practice to reduce infection and hygiene risks at the service.

There were enough staff to support people. Managers carried out checks on new staff to make sure they were suitable to support people. Staff were given relevant training to help them meet people’s needs. Staff were supported by managers to review and improve their working practices so that people experienced high quality care and support.

People had personalised their rooms and communal areas which created a homely and comfortable environment for people to live in. People took part in a range of activities and events and were encouraged to pursue their interests and hobbies. Staff supported people to build and maintain social relationships with others and the people that mattered to them.

People and their relatives were involved in planning and making decisions about the care and support they needed. People had current care plans which set out how their care and support needs should be provided. Staff knew people well and understood how their needs should be met.

Staff used people’s preferred method of communication when interacting and engaging with them. Staff were kind, friendly and caring. They supported people in a dignified way which maintained their privacy and independence. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were encouraged to keep healthy and stay well. Staff supported people to eat and drink enough to meet their needs and to take their prescribed medicines. We identified a medicines recording error. Managers said they would undertake weekly checks of medicines after this inspection to make sure records were maintained properly. People were able to access healthcare services when needed. Staff worked well with other healthcare professionals and acted on their recommendations. When people became unwell, staff sought help for them promptly.

People and their relatives had no concerns about the care and support provided by staff. They knew how to make a complaint if they needed to. Managers made sure any accidents, incidents and complaints were fully investigated and people were informed of the outcome. Learning from investigations was acted on and shared with staff to help them improve the quality and safety of the support they provided.

Managers undertook quality and safety checks of the service. Some of the formats used did not help managers identify areas where the service could improve further. Managers said they would review current arrangements to make sure they supported the service to continuously improve.

People, relatives and staff were encouraged to have their say about how the service could improve. Managers acted to make improvements and since our last inspection had introduced a new electronic records system. This had improved managers’ oversight of the service. Managers were looking for further ways to improve the service for people. They had plans to refurbish the premises with a view to making this more accessible and responsive to people’s changing needs.

Managers understood their responsibility for meeting regulatory requirements. They worked proactively with other agencies and acted on their recommendations to design the care and support provided to people.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 30 August 2017).

Why we inspected

This inspection was planned based on the previous rating of ‘Good’.

Follow up

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned in line with our inspection schedule or in response to concerns.