The White House Nursing Home Limited

We found the following examples of good practice

• No visitors were being admitted to the home. The provider had built a 'visiting marquee' to the rear of the premises. A large perspex screen had been installed allowing people to see and talk to their visitors whilst remaining protected from infection. Visitors were provided with Personal Protective Equipment (PPE) as required.

• People who tested positive for COVID-19 or showing symptoms were provided with one to one staff to support their needs, including their meals and social support such as activities. Dedicated moving and handling equipment and PPE was provided for their use.

• Digital care planning allowed relatives and other representatives to access their daily records in 'real time' through a secure internet gateway. This provided instant reassurance and updates as to the persons health status, appetite and daily activities.

• Staff received training from multiple sources to make sure of their good practice in infection prevention and control. Staff were also supported to access a number of resources to support their own mental health and wellbeing.

• Proactive and decisive management planning had enabled the service to prevent an outbreak of infection and safely protect the people using the service. PPE was in good supply throughout the lockdown period with the service being able to help out other local services who were running short. The home had locked down early with a strong emphasis on containment and communication. This approach was continuing to build future resilience for the Autumn / Winter months ahead.

At the last CQC inspection of this home in April 2015 we rated them ‘Good’ overall and for all five key questions. In February 2016 ‘The White House Nursing Home Limited’ re-registered with us and therefore this inspection will represent the first time we have rated this ‘new’ provider. We have rated the home ‘Outstanding’ overall and for the two key questions, ‘Is the service responsive and well-led?’ We have rated them ‘Good’ for the other three key questions, ‘Is the service safe, effective and caring’.

The service had a registered manager who had been in post since February 2016. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People living in the home and their relatives were extremely positive about the quality of the care and support provided at The White House Nursing Home. People, relatives, community health and social care professionals and staff were also very complimentary about the service’s registered manager and company director (owner). They said they were both highly regarded by everyone and worked well together as a team, which had a positive impact on the quality of the service provided at the home. People and staff said the managers were ever present in the home, approachable and always interested to hear what they had to say about the White House Nursing Home including any suggestions people, their relatives and staff might have about improving practice there.

The managers ensured the company’s values and vision for the home were fully embedded in the service's systems and processes and demonstrated by staff through their behaviours and actions. There was clear oversight and scrutiny of the service. They used well-established quality assurance systems to ensure all aspects of the service were routinely monitored and could be improved for people. This helped them to check that people were consistently experiencing good quality care and support. Any shortfalls or gaps identified through these checks were addressed promptly.

Managers encouraged and supported staff to deliver high quality care and recognised and rewarded them when they demonstrated excellence in the work place. Staff told us The White House Nursing Home was an excellent place to work, were very proud of the high standard of care they provided there and felt well-supported by the managers. People and their relatives felt there was a strong commitment within the staff team to continuously improve and develop their working practices. This ensured staff continued to deliver high quality personalised care to people living in the home. All of the external health and social care professionals we received feedback from were very positive about the quality of service delivery and joint working arrangements.

People had access to a wide range of group and individual activities and events they could choose to participate in, which were tailored to meet their specific social needs and interests. This enabled people to live an active and fulfilling life. People who preferred or needed to stay in their bedroom were also protected from social isolation. People regularly participated in outings and activities in the local community. The service also had strong links with local community groups and institutions. For example, children and young people from a local nursery and a school, University students, entertainers, musicians, religious leaders and volunteers visited the home regularly to perform plays, concerts and engage with people who lived there.

When people were nearing the end of their life, they received compassionate and supportive care. The home was awarded a Gold Standards Framework (GSF) accreditation with ‘Beacon’ status in 2016, which is the highest status for training and support systems for services providing care to people at the end of their lives. Anniversary memorial events were regularly held in the home to remember those that had died.

People received person-centred care which was responsive to their specific needs and wishes. Each person had an up to date, personalised care plan, which set out how their care and support needs should be met by staff. Assessments were regularly undertaken to review people’s needs and any changes in the support they required. These were reviewed regularly. Staff continued to receive regular and relevant training and supervision to help them to meet people's needs. Staff were aware of people’s communication methods and provided them with any support they required to communicate in order to ensure their wishes were identified and they were enabled to make informed decisions and choices about the care and support they received.

The service had appropriate arrangements in place for dealing with people's complaints if they were unhappy with any aspect of the support provided at the home. People and their relatives said they were confident any concerns they might have about the home would be appropriately dealt with by the managers. The service had received numerous compliments about the staff and the care and support provided at the home.

People were supported to maintain relationships with those that mattered to them and relatives and visitors were warmly welcomed when they came to the home. Staff had developed caring relationships with people and their relatives, and ensured people received the right levels of care and support in a dignified and respectful way. Staff also maintained people’s privacy at all times. Staff were aware of people’s preferred name and their preferences in how they were supported. Staff respected people’s individual differences, their religious preferences and their culture and provided any support people required with these. People were also supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People said they felt safe at the home. Staff knew how to recognise and report abuse and neglect in order to protect people from the risk of harm. The provider had arrangements in place for checking the suitability and fitness of new staff employed to work at the service. There were enough staff deployed in the home to support people, keep them safe and ensure staff were highly visible at all times. Staff followed appropriate guidance to minimise identified risks to people's health, safety and welfare. The premises and equipment were safe for people and staff to use because managers and the relevant professionals regularly carried out health and safety maintenance and servicing checks on these. We observed the environment was kept hygienically clean and staff demonstrated good awareness of their role and responsibilities in relation to infection control and food hygiene. Medicines were managed safely and suitably trained staff ensured people received their medicines as prescribed.

Staff were aware of their duties under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff sought people's consent before providing any care and support and followed legal requirements when people did not have the capacity to do so. People were supported to eat and drink enough to meet their dietary needs and preferences. Staff ensured mealtimes were an enjoyable and personalised experience. Staff regularly monitored people's general health and wellbeing. Where there were any issues or concerns about a person's health, they ensured they received prompt care and attention from appropriate health care professionals. People said The White House Nursing Home was a homely and comfortable place to live.