We carried out a review of the data available to us about Whites House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Whites House, you can give feedback on this service.
This comprehensive inspection took place on 10 March 2018 and was unannounced. The inspection was carried out by one adult social care inspector.
Before the inspection, we looked at information we held about the provider and home. This included their Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We took this into account during the inspection.
We were unable to speak with most people using the service, due to their highly complex needs. We therefore spoke with one person, three people’s relatives, four staff and one healthcare professional to help form our judgements. We observed the care and support provided and the interaction between staff and people. We looked at three people’s care records and associated documents, health and safety paperwork, statement of purpose, minutes from resident and staff meetings and a selection of the provider’s policies.
After the inspection we spoke with the registered manager, who provided information from staff records, accident and incident records, complaints and compliments and quality assurance that we had not been able to see on the day.
This inspection took place on the 12 December 2015 and was unannounced. When the service was last inspected in April 2014 there were no breaches of the legal requirements identified.
Whites House is registered to provide care and support for up to eight people with a learning disability. At the time of our inspection the house was at full occupancy.
A registered manager was in post at the time of inspection. A registered manager is a person who has registered with the Care Quality Commission 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.
People’s rights were being upheld in line with the Mental Capacity Act 2005. This is a legal framework to protect people who are unable to make certain decisions themselves. We saw information in people’s support plans about mental capacity and Deprivation of Liberty Safeguards (DoLS). DoLS applications had been applied for appropriately. These safeguards aim to protect people living in homes from being inappropriately deprived of their liberty
People had their physical and mental health needs monitored. All care records that we viewed showed people had access to healthcare professionals according to their specific needs.
Where appropriate people maintained contact with their family and were therefore not isolated from those people closest to them.
Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. Staff we spoke with felt the staffing level was appropriate. People were supported with their medicines by staff and people had their medicines when they needed them.
People received effective care from the staff that supported them. Staff were caring towards people and there was a good relationship between people and staff. People and their representatives were involved in the planning of their care and support. Staff demonstrated and in-depth understanding of the needs and preferences of the people they cared for.
Support provided to people met their needs. Supporting records highlighted personalised information about what was important to people and how to support them. People were involved in activities of their choice.
There were systems in place to assess, monitor and improve the quality and safety of the service. Arrangements were also in place for obtaining people’s feedback about the service.
Below is a summary of what we found. This is based on our visit to the home when we met with the people who used the service and with members of the staff and management team. Not everybody who used the service was able to express their views verbally and our observations in the home helped us to make judgements about the support that people received.
Please read the full report if you want to see the evidence supporting our summary.
Is the service safe?
Procedures were in place for assessing risks and for monitoring people's safety in the home. There were systems which helped to ensure that managers and staff learnt from events such as accidents and incidents. This reduced the risks to people and meant that the service continually improved.
Staff received training so they knew how to provide safe care to people. Guidance and protocols helped to ensure that people received support in a safe way, for example when receiving their medicines. There were procedures in place for checking that the home was safe and was a well maintained environment for people.
Is the service effective?
Staff understood the needs of the people who used the service. Good information was available to staff about people's individual routines and their personal preferences. Care and support plans had been produced. We observed occasions, such as a mealtime, when staff were following the guidance in people's risk assessments and individual plans. This meant that people received the support that had been agreed and which met their needs. People who used the service helped to plan the menus. At lunchtime, one person gave us the 'thumbs up' sign to confirm that they had enjoyed their meal.
People's needs were being kept under review. Staff in the role of key worker monitored people's health and care needs and produced a monthly report about this. Procedures were in place for people to receive support from health and social care professionals when needed.
Is the service caring?
People were supported by staff who respected their individual and diverse needs. The relationships between staff and the people who used the service appeared to be friendly and positive.
Care and support were planned and provided in ways which promoted people's independence. For example, people took part in a 'lifeskills' day each week when they carried out household tasks and were supported to develop their skills.
Systems were in place for gaining feedback about the care and support that people received.
Is the service responsive?
Routines in the home were flexible and took account of people's individual circumstances and preferences. People who used the service had the opportunity to take part in activities outside the home, such as swimming and shopping.
Changes in people's needs were being anticipated and responded to. Staff, for example, had identified the possibility of dementia being a factor in one person's care needs. Action had then been taken to follow this up.
Is the service well-led?
Members of the staff and management team we spoke with with were clear about their roles and responsibilities. Staff had a good understanding of the aims of the home. They felt well supported in their work and able to raise any concerns with a manager.
The provider operated effective systems for checking the quality of service that people received. Senior managers visited the home on a regular basis. This helped to ensure that they were well informed about the service and how well it was meeting people's needs.
Plans were in place for improving the service when any shortcomings were identified.
Most of the people we spoke with were unable to verbally tell us about the care they received and if they were happy, due to their individual communication needs. Therefore we carried out observations of people's care and observed staff interactions in the communal areas of the home to see if they appeared relaxed and happy living in the home.
People appeared happy and relaxed in the company of the staff and were seen to be engaged in discussions about the day's activities ahead. We observed that they were moving around the house and secure surrounding garden area freely. Staff supported people in a sensitive and inclusive manner.
People who were able to tell us of their experience made positive comments about the service they received. People's comments included; Happy here', 'Nice here', 'I went to London on train' ,'like watches' and 'I had quiche and spaghetti hoops, nice'.
Staff we spoke with told us "I like it here. It was a long induction and equipped me for the role'; 'Management team are always in the office for support on a daily basis they are very hands on for help'; 'We can tell by people's facial expressions and gestures if they are happy or not happy to do something, we always respect that'.
Throughout our visit we found staff had a good understanding of people's individual needs. Interactions were observed to be appropriate and in line with their individual care plan.
We observed the lunch time activity and people appeared relaxed at the choices that were offered, and staff had a good understanding of the nutritional support needs of people.
People we spoke with who could tell us of their experience said they were happy living at Whites House. Comments included,' I want to stay here at whites house', 'happy here', 'they are nice, it's ok'.
We spoke with three members of staff who told us they felt they delivered a high standard of care to people. Staff comments included. 'I love it here it's the best home I have worked in', 'the person comes first', 'support from the team and management is great'.
People appeared relaxed in their own environment and around the staff members. People were observed moving around the home freely, and leaving the home to walk around the secure garden area, when they wished to be alone.
We spoke with one person who was supported by the manager when talking with us.
We were told about the choices they made such as choosing their meals, and the activities they enjoyed such as gardening. They confirmed they were supported by staff with life skills such as doing their laundry and cleaning their room.
We were told there were arrangements for them to keep their own money and saw them signing to agree they had received money so that they could go shopping.
Some people were unable to tell us about their involvement in their care and if they were respected by staff due to their individual communication needs. For these people we carried out observations of their care and interaction with staff in the communal areas during a midday meal.
We found staff responded to peoples' individual communication in a respectful way. We saw that the people were satisfied that they had been offered a choice of refreshment and had been listened to and understood.