23 April 2015
During a routine inspection
This inspection took place on 23 April 2015 and was unannounced. At our last inspection on 30 April 2013, the service was meeting all the regulations that we inspected.
The White House Nursing Home provides accommodation and nursing care for up to 30 people, including specialist end of life care. At the time of our visit, 29 people were using the service. There was a registered manager in post. 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.
We found that the provider had appropriate policies and procedures in place to protect people from abuse and harassment. Staff were aware of these. People said they felt safe and would be confident reporting any concerns.
Risks were assessed and managed in ways designed to keep people safe from foreseeable harm whilst protecting their rights and independence. The provider had systems to monitor and learn from accidents and incidents. There were enough staff to keep people safe and respond promptly when they needed help. The provider carried out checks to make sure new staff were suitable for the role.
People’s medicines were managed well. Appropriate policies and procedures were in place and staff followed these to ensure they were storing and administering people’s medicines safely.
People and their relatives told us staff had the knowledge and skills they needed to provide effective care. Staff received training and support to achieve this. The service worked alongside other professionals to share information about up-to-date research and guidance so staff were equipped to provide care in line with current best practice.
Staff asked for people’s consent before carrying out care and provided people with the information they needed to give informed consent. The provider complied with appropriate legislation where people were not able to consent. Where restrictions were placed on people as part of their planned care, the provider followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure this was done in such a way as to protect people’s rights.
People gave us positive feedback about the quality and variety of food provided. Meals were balanced and nutritious and people were able to choose from a number of options. Where people were at risk of malnutrition, staff monitored this and took appropriate steps to keep people healthy. Staff worked alongside healthcare professionals, people and their relatives to support people’s healthcare needs.
People and their relatives consistently fed back that staff were kind, respectful and caring. They said staff went out of their way to make them feel supported. Staff demonstrated empathy with people and took an interest in things that were important to them. Staff supported people to express their views and make decisions about their care. People said they felt listened to and that their opinions were respected. Staff used different methods of communication according to what was appropriate for individual people.
People felt that their privacy, dignity and independence were respected. The service worked alongside relevant organisations and used recognised programmes to ensure they were following best practice in caring for people at the end of their lives.
People had care plans that were responsive to their needs because they were personalised and included people’s own views, wishes and aims for the future. People and relatives confirmed that the service continually adapted these with people’s input to adjust to their changing needs.
There was a wide range of group and individual activities designed to meet the needs and tastes of everyone who used the service. The service supported people in such a way as to protect them from the risk of social isolation, including people who stayed in their bedrooms. The service had strong links with community groups, including religious groups, and volunteers who also visited the home regularly. People and their relatives felt that their cultural and religious needs were met.
The service responded promptly and appropriately to concerns and complaints, involving people in discussions about how they should resolve any concerns people had. People and their relatives were satisfied with how the service responded to their concerns.
The service had a person-centred, open and inclusive culture in which people felt confident approaching staff and managers with their feedback and staff were continually encouraged to question and reflect on their practice. People and their relatives commented on the homely and friendly atmosphere within the service.
The provider involved people and those who were important to them in developing the service. They did this by collecting feedback and holding meetings where people could suggest changes they would like to be made.
Relatives felt that the service had a culture of continuous improvement. The provider carried out regular audits of the quality of the service and responded promptly to any shortfalls that were identified. They sought advice from experts in assessing the quality of the service and used their feedback to drive improvement.