We carried out a review of the data available to us about The White 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 The White House, you can give feedback on this service.
The White House provides residential care for up to six people living with a learning disability including autism. There were six people using the service at the time of our inspection.
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 Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
People’s experience of using this service and what we found
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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.
Staff were responsive to people’s individual needs and knew them well. They supported each person by spending time with them and listening to them. They ensured that each person felt included and valued as an individual. People were engaged in meaningful activities of their choice. They were consulted about what they wanted to do and were listened to.
People who used the service and their relatives were happy with the service they received. Their needs were met in a personalised way and they had been involved in planning and reviewing their care. People said the staff were kind, caring and respectful and they had developed good relationships with them.
The provider worked closely with other professionals to make sure people had access to health care services. People received their medicines safely and as prescribed. People’s nutritional needs were assessed and met.
People's needs were assessed before they started using the service and care plans were developed from initial assessments. People and those important to them were involved in reviewing care plans. Risks to their safety and wellbeing were appropriately assessed and mitigated. There were systems for monitoring the quality of the service, gathering feedback from others and making continuous improvements.
Staff were happy and felt well supported. They enjoyed their work and spoke positively about the people they cared for. They received the training, support and information they needed to provide effective care. The provider had robust procedures for recruiting and inducting staff to help ensure only suitable staff were employed.
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 13 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
The White House provides residential care for up to six adults living with learning disabilities including autism. There were six people living at the service at the time of our inspection whose ages ranged between 43 and 61 years old.
There was a registered manager in post at the service at the time of our 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 told us they felt safe and we saw there were systems and processes in place to protect people from the risk of harm. There were enough staff on duty to meet people's needs and there were contingency plans in place in the event of staff shortage to ensure people's safety.
Staff had undertaken training in the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS). They ensured people were given choices and opportunities to make their own decisions.
There were arrangements in place for the management of people's medicines and staff had received training in the administration of medicines.
People's nutritional needs were met, and people were involved in weekly meetings with staff to choose what they wanted to eat and drink.
Staff received effective training, supervision and appraisal. The registered manager sought guidance and support from other healthcare professionals and attended workshops and conferences in order to keep themselves abreast of developments within the social care sector.
Staff were caring and treated people with dignity and respect. Support plans were clear and comprehensive and written in a way to address each person's individual needs, including what was important to them, and how they wanted their care to be provided.
A range of activities were provided both in the home and in the community. We saw that people were cared for in a way that took account of their diversity, values and human rights.
People, staff, relatives and healthcare professionals told us that the management team were approachable and supportive. There was a clear management structure, and they encouraged an open and transparent culture within the service. People and staff were supported to raise concerns and make suggestions about where improvements could be made.
The provider had effective systems in place to monitor the quality of the service to ensure that areas for improvement were identified and addressed.
The inspection took place on 24 March 2015 and was unannounced.
The last inspection of the service was carried out on 2 October 2013 when we found no breaches of the regulations.
The White House is a care home providing personal care and support forup to six adults who have a learning disability. The service is managed by Parkcare Homes (No.2) Limited, part of the Priory Group who are a national provider of care and health services.
At the time of our inspection five people were living at the home. There was no registered manager in post. However a manager had been appointed and had worked at the home since February 2015. He was in the process of applying to be registered with the Care Quality Commission. 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 and associated Regulations about how the service is run.
The people who lived at the home were happy there and felt well supported. The staff told us they were also well supported and enjoyed working at the service.
There were procedures designed to protect people and to safeguard them from abuse. The staff were aware of these and had received training so they knew what to do if they were concerned about someone’s safety.
The staff had undertaken risk assessments where people were considered at risk. These included information on the support the person needed to stay safe.
There were enough staff employed to meet people’s needs in a safe way and the staff recruitment procedures ensured thorough checks were made on potential staff.
People received the right medicines to meet their needs.
The staff were well trained and supported and this meant they were able to meet people’s needs.
The Care Quality Commission monitors the implementation of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) to make sure registered providers are acting within their legal responsibilities. The provider had assessed people’s capacity to consent, although these assessments were not detailed enough. People had consented to their care. The provider had identified that one person’s freedom was restricted and they were making an application to the local authority in accordance with DoLS.
People were given enough food and drink and had a balanced diet. Their health care needs were assessed, monitored and met.
People who lived at the home and the staff had positive relationships. People were treated with respect and kindness. They were able to make choices and their privacy was respected.
People’s needs had been assessed and their care was planned to meet these needs. They had care which was personalised and individual. They were able to learn independent living skills, were supported to access the community and took part in a range of different activities.
There was an appropriate complaints procedure and people knew how to make a complaint.
There was a positive culture and atmosphere. People living at the home and staff felt supported. The staff were able to contribute their ideas and be involved in the running of the home.
There were appropriate systems for monitoring the quality of the service and for making improvements.
People were asked for their consent to the care and support provided and encouraged to make decisions. We saw clear information in people's care records about their individual communication needs. This meant that staff had information to enable them to support people to make decisions for themselves where they were able to do so.
People's needs were assessed and a care plan developed so staff knew what action to take to meet these. We observed positive interactions between the staff and people using the service. For example, we saw staff giving people time to respond to choices offered to them and staff respected the choices people made and involved them in conversations. One person we spoke with said, "the staff are good, I like to go out and play pool and the staff help me to go shopping so I can be more independent in the future."
The staff we spoke with were able to demonstrate their understanding of the safeguarding policies and procedures for the home and informed us that they would report any concerns they had to the relevant professionals immediately.
There were enough staff on duty with the skills and experience to meet people's needs effectively.
Records were accessible but kept securely and they were kept up to date and in order.
People's individual preferences had been considered and their likes and dislikes recorded. We also saw that each person had a 'communication dictionary' that aimed to help staff recognise and respond to an individuals chosen form of communication. Staff supported people to attend healthcare appointments depending on their wishes and abilities. One person said, "staff help me to go to the doctors", another said "I went with staff to the opticians yesterday" whilst another said, "I can choose if staff come in with me".
The home was well maintained, warm and clean. People had personalised their rooms and had access to comfortably furnished communal areas. Health and safety checks were completed to ensure people's safety.
Staff were supported to complete training to ensure they had the knowledge and skills to meet people's needs effectively. Staff told us they received regular supervision from their manager and annual appraisals.
People knew how to make a complaint and were provided with regular opportunities to raise any concerns they had about their care and life at the home.
People said that staff are available when they need them and that they feel safe and well cared for at the home. They told us that staff help them to stay healthy and to get medical treatment if they need it. People told us that they like the food provided at the home and that they are able to make choices about what they eat.
People made the following comments about the service they receive:
'I'm happy here - everyone here is very nice to me'
'I like living at the White House. The staff are nice - I like to talk to them'
'I like helping out in the kitchen and cooking the Sunday dinner'
'I like going out for a walk. It does me good. I like going out and about'.