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Inspection carried out on 25 June 2018

During a routine inspection

The inspection took place on 25 and 29 June 2018. The first day of our inspection visit was unannounced.

Whitegates 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. Whitegates accommodates up to 37 people within a large adapted building, and specialises in care for older people with physical disabilities and mental health needs, who may be living with dementia. At the time of our inspection, 35 people were living at the home.

A registered manager was in post and present during 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.

At the time of our last inspection in September 2015, we rated Whitegates as Good. At this inspection we found the provider had driven further improvements and the service people received was Outstanding.

People living at Whitegates benefited from the strong person-centred culture within the service. The provider took a genuine interest in people’s personal history, skills, interests and aspirations. Armed with this knowledge, they recommended new ideas and opportunities to people, and went the extra mile in supporting them to achieve things which enhanced their quality of life. They consulted with people and their relatives to ensure they felt listened to and valued. The provider forged and maintained strong links within the local community to enhance the support, opportunities and experiences available to people living at the home.

The provider demonstrated a clear commitment to the promotion of equality, diversity and inclusion within the service. They accessed best practice resources and developed bespoke training to enhance staff’s understanding of, and ability to meet, people’s needs associated with their equality characteristics. The provider’s own systems, policies and procedures had been updated to ensure they were able to fully meet the needs of older LGBT people.

The health outcomes for people living at Whitegates had been enhanced, and unnecessary or recurring hospital admissions avoided, through the provider acting proactively in collaboration with local healthcare services. Their ‘early warning sign system’ and the associated efforts to improve the level of clinical expertise amongst the staff team enabled them to better monitor and respond to any deterioration in people’s health. This was achieved with the support of a range of community healthcare professionals and the provider’s in-house multidisciplinary team.

A firm focus was placed upon people eating and drinking well, and the promotion of health and wellbeing through good nutrition and hydration. The provider had organised a range of events during their ‘awareness month’ on nutrition to generate new thinking and improve practice in this area of people’s care and support.

People felt safe living at Whitegates with the support of friendly, caring and approachable staff and management who were passionate in their desire to enable people to live full, vibrant lives. The provider's robust quality assurance systems and processes enabled them to monitor and drive improvement in the quality and safety of the care and support people received.

Inspection carried out on 8 September 2015

During a routine inspection

This inspection was carried out on 8 September 2015 and was unannounced.

Whitegates provides accommodation and personal care for up to 37 people. At the time of our inspection there were 35 people living at the home.

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 and associated regulations about how the service is run.

People and their families were able to be really involved in the projects to evolve how people were supported and the shaping of the service. People were at the centre of the provider’s core values of individualised care that aimed to provide fulfilment of people’s wishes. There was a positive atmosphere in the home, with people being able to be active part in the day to day running of the service.

People had good relationships with the staff. People were relaxed with staff spending time to reminisce or talk about current news events and the atmosphere of the home was calm and relaxed. People were treated with dignity and respect.

People were supported by staff who were motivated and well trained. They said that staff were kind, knew their health needs and they received support when they needed it. Medicines were managed safely and that people received their medicines in line with their prescription.

People said that they were able to make choices about the food they wanted to eat. They told us that they enjoyed the food. Where recommendations had been made by other professionals regarding their diet or health needs these had been acted upon.

People told us the staff and management were approachable, willing to listen to their views and opinions. People were encouraged to be actively involved in the running of the home through regular meetings and were involved in the recruitment of new staff. They said that if they had any concerns they were able to speak with the registered manager. Feedback from the people that lived there and their relatives was gathered on a regular basis and any areas identified for action were acted upon. A range of audits and checks were also completed regularly to ensure that good standards were maintained.

Inspection carried out on 27 July 2014

During an inspection in response to concerns

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found.

Is the service safe?

The people who lived in the home told us they were pleased with the care provided. They said that their views were respected and listened to.

We saw that there were enough staff to attend to people’s needs.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made and how to submit one.

Is the service effective?

People told us that they were happy with the care they received. They told us that the registered manager and the staff had asked them what their needs were and how they would like them met. One person said, “If you want something they provide it”.

Care records confirmed people’s needs and preferences had been recorded and care and support had been provided in accordance with their wishes.

People said they were able to discuss their personal issues and preferences with staff. They said that staff obtained help for them if they were ill. This meant people were supported to keep in good health, have access to health care services and received ongoing support.

Is the service caring?

People we talked with told us their choices and wishes were respected and they were able to live their lives as they wished. Staff took the time to find out about people’s background. Staff had a good knowledge of people’s needs and how they wished to be cared for. This meant that staff cared about the person as an individual and were concerned about their well-being.

Is the service responsive?

People had been assessed before they moved into the home so that arrangements could be made to meet their needs.

People told us they talked with the registered manager and the staff about what was important to them. They talked the about activities they took part in and their meals. They told us that their care packages had been changed as a result.

Is the service well led?

The management and staff treated people with compassion, dignity and respect. Staff we talked with showed they understood those values as they discussed their role and responsibilities in their work. This meant the service promoted an open culture that was centred on the individual and empowered them to take control of their life as much as they were able.

Inspection carried out on 29 October 2013

During a routine inspection

People told us that they were happy at the home. They described staff as, "absolutely excellent" and, "first class". One person told us, "I bless the day that I found Whitegates". We saw that staff were attentive to people's needs and supported people in a caring and kind manner.

People were asked for their consent before staff provided any treatment or support. Some people were unable to make informed decisions for themselves. Staff knew how to ensure that decisions were made in people's best interests and so were responsive to people’s needs.

People's individual needs were fully assessed, and each person had a personalised care plan to tell staff how to meet their needs. People told us that they received a high standard of care at the home and that they felt safe. One person said, "I don't think they could do anything better".

The home was providing people with a varied and nutritious diet. Drinks and snacks were freely available.

There were effective systems in place for monitoring the quality of the service. There was evidence that risks had been assessed and that steps had been taken to manage any identified risks. This service was well led.

Inspection carried out on 9 November 2012

During a routine inspection

We spent time in two of the lounges, talking with people living at the home and observing how staff supported people. We spoke with some people in their bedrooms and we also spoke with a relative who was visiting. Everyone we spoke to had only good things to say about the service provided at the home. People told us "it's just perfect here" and "I would give it top marks".

We saw that staff were respectful and caring when they supported people. They knew each person's individual needs and preferences. The care records were clear and detailed. They contained the information that staff needed to know about people's care needs.

Staff knew how to keep people safe from the risk of abuse or neglect. There were clear systems in place for reporting any concerns. People told us that they would raise any concerns with the manager, describing her as "very approachable". They said that they were confident that she would resolve any concerns.

There were enough staff on duty to ensure that people's needs were met promptly. People told us that they did not have to wait for assistance. Staff received a range of training to give them the skills and knowledge they needed to carry out their roles.

Records were kept securely, and computerised records were protected so that only authorised people could access them.

Inspection carried out on 21 June 2011

During a routine inspection

We spent time observing staff providing care and support to people living at Whitegates. Staff were polite and respectful in the way they supported people, and people made positive comments about the staff, including “they’re absolutely wonderful, I can’t fault them at all”, “they’re very kind and helpful” and “they seem as though they enjoy their work”.

We spoke to some of the people who live there and their relatives, and they told us how pleased they were with the service provided by the home. People told us that they appreciated the activities provided at the home. One person said “it’s got such a nice atmosphere of calm and peacefulness” and a relative told us “I’d sum it up as a really caring place”.

People told us that they enjoyed the food provided at the home. One person said “the food is lovely, all fresh vegetables, there’s lots to choose from, it’s all nicely cooked”, and another person said “we don’t go hungry here”.

People told us that staff and the manager listened to what they said and that they appreciated the time and effort taken to make sure that they were happy and well supported.