The White House Nursing Home Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff feedback showed they experienced a learning‑focused, open environment that supported continuous professional growth. The registered manager described how incidents, accidents, and safeguarding notifications were reviewed in real time through their governance dashboard. They explained, “Staff report via their handsets and I will review them, take statements and identify any lessons learnt and share them with the team in meetings.” This demonstrated an embedded approach to learning from events to prevent reoccurrence.

Staff consistently described a culture where leaders encouraged development and reflection and used a range of audits including medicines, care plans, falls prevention, and infection control to identify themes and support improvements. Monthly audits such as the “Culture of Openness and Transparency” and “Dignified Care” also reinforced expectations around safe, respectful practice. Learning was shared through daily handovers and regular meetings, ensuring staff were kept updated and informed about changes in people’s needs.

People and relatives told us they were confident the service learned from feedback. One relative said, “They are receptive to things… they listen.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. The service demonstrated clear processes for ensuring continuity of care, including during admission, transfer, and changes in people’s needs.

Transitions into the service were well planned and person centred. The provider ensured the service could meet the person’s needs. They said, “We review each referral and complete an initial assessment in the community… we make all the arrangements including transport and preparing the room.” Families confirmed they felt involved and informed at each stage. One relative told us, “I have a copy of the paperwork and feel included in the planning of her care.”

People told us they felt safe moving between different parts of the service and relatives felt informed. Professionals also reported good collaboration. A healthcare professional noted that communication from the home was “prompt and clear,” helping ensure timely review and intervention when people’s needs changed.

The provider ensured systems and equipment supported safe pathways. The provider demonstrated effective systems for managing safe care and supporting people through transitions and collaboration with healthcare partners ensured people continued to receive coordinated and well-managed support.

The provider worked with people and healthcare partners to understand what being safe meant to them and to protect their right to live in safety, free from abuse, neglect, bullying, harassment and discrimination. Staff concentrated on improving people’s lives while responding appropriately to safeguarding concerns

Staff had a good understanding of safeguarding and how to raise concerns. Training records showed all required staff had now completed safeguarding adults training, following our earlier checks identifying four new staff had yet to complete it. The provider took immediate action once this was identified. Staff told us they felt confident to report concerns, and that managers responded quickly

People and relatives consistently reported they felt safe. One person told us, “Oh yes! I feel safe.” Relatives reinforced this, including one who said, “We feel that safety is taken seriously, and any concerns are dealt with promptly.”

The provider had comprehensive safeguarding policies in place, including policies on managing closed cultures, bullying and harassment, and sexual safety, safeguarding residents and staff. These were up to date and reviewed annually.

The registered manager understood their legal obligations under the Mental Capacity Act 2005 (MCA), and records demonstrated compliance with the Deprivation of Liberty Safeguards (DoLS) procedures.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The provider worked with people to understand what being safe meant to them and involved them in managing risks that affected their lives. Staff supported people to make choices and encouraged positive risk taking where it improved wellbeing. People were treated as partners in decisions about their care, and staff balanced safety with respecting independence.

People were involved in decisions about their day‑to‑day risks and wellbeing. One person explained how staff encouraged independence: “I like to do as much for myself as I can, and we are encouraged to do this.”

Relatives corroborated that staff involved people appropriately. One family member explained how the service discussed the risks associated with their loved one’s eating and mobility, adding, “They definitely know what they are doing… my [relative] is safe here.”

Staff understood how to use risk assessments to adapt care in response to changing needs. Staff used individualised care plans and risk assessments. External professionals confirmed this. A healthcare professional said the service “risk assess and manage those risks with attention to detail and shared information accurately across the team.”

The provider detected and controlled potential risks in the care environment and made sure equipment, facilities and technology supported the delivery of safe care. The service was clean, well maintained and adapted to meet people’s needs, with clear systems for monitoring safety and ensuring prompt action when issues arose.

The environment was safe, clean and suitable for people living in the home. Rooms were personalised with people’s belongings, supporting comfort and familiarity. Corridors were clear of obstruction, bathrooms were clean and cleaning staff were observed working throughout the day. People told us they experienced the home as safe and well maintained. One person said, “It is always clean. My bed is changed regularly. That side of things is good.” Relatives confirmed this, with one stating, “There are never any smells – it is always like this.”

Leaders ensured that all equipment and facilities met regulatory standards. Records showed up‑to‑date certification.

Staff reported they had access to all necessary equipment and that everything was kept in safe working order. One carer told us, “We have access to PPE and equipment is safe, everything here works.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. Staffing levels met the needs of people using the service. A weekly rota reviewed during the assessment showed no gaps, with limited use of agency staff and familiar agency workers used to maintain continuity.

Staff were recruited safely and in line with legislation and these records were held securely on an electronic platform. Paper records were reviewed separately and demonstrated staff received regular supervision and annual appraisals. Staff had access to e‑learning and face‑to‑face sessions appropriate to their role.

People and relatives consistently told us there were enough staff available. One relative said, “There always seem to be enough staff on duty.” People also described staff as attentive and responsive, with one person saying, “I never have to wait very long for someone to come along.”

Staffing arrangements ensured people received continuity of care from staff who knew them well. People told us they recognised staff and valued stable relationships. One person said, “The permanent staff are much better… they know us,” highlighting the benefits of a consistent team.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People told us the home was always clean and hygienic. One person said, “It is always clean". Professionals gave consistent feedback. One said, “I always find the home clean and never smell any bad odours.” These views aligned with our direct observations that the home was clean, odour‑free and well presented.

Environmental cleanliness was consistently managed. We found bathrooms, communal areas and bedrooms clean, tidy and free from odours. Floors were dementia‑friendly and well maintained, and equipment including call bells and hoists were clean and in working order. Weekly cleaning schedules were in place for commodes and were audited regularly.

The provider had a current Infection Prevention and Control (IPC) policy, regularly reviewed and aligned with national standards. Information to support IPC awareness, including sepsis escalation and norovirus prevention, was displayed in staff areas. Observations during mealtimes showed good hand hygiene and PPE practice. Clinical waste was stored correctly. A contract with an external provider ensured compliant disposal of clinical waste, with dedicated receptacles.

The provider always made sure that medicines were managed safely and in a way that met people’s needs, capacities and preferences. Staff worked proactively with healthcare partners to optimise treatment, reduce unnecessary medicines and improve people’s quality of life. Systems were robust, well led and consistently embedded in practice.

People using the service told us their medicines were administered safely and on time. One person said, “All of the medication is done well and on time.” Relatives confirmed they were kept fully informed said, “We are always informed about medication and if my [relative] has been seen by the doctor.” This showed clear communication and oversight.

Medicines were stored, monitored and administered safely. We found the medicines room clean, organised and secure. Medicine cabinets and trolleys were locked; temperatures were checked daily and individual medicines were barcoded and linked to the electronic Medicines Administration Record (e‑MAR). Nurses used handheld devices to record administration in real time, and no medicines errors had been reported in the past 6 months. The registered manager attributed this to a stable, competent nursing team with no agency nurses used for medicines tasks.

People with complex needs were supported safely. For example, one person with diabetes received medicines based on a personalised regimen involving tablets and insulin, with staff ensuring timing and food requirements were met which helped to maximise the effects of medicines. A relative confirmed that PEG‑fed medicines were managed well. The home worked with healthcare professionals to introduce sensor‑based glucose monitoring, reducing the need for invasive finger‑pricking and improving comfort for people living with diabetes.

The provider demonstrated strong medicines governance. Weekly audits were completed by the lead nurse and monthly audits by the registered manager. The e-MAR system provided a daily dashboard highlighting any missed or refused doses, enabling responsive action. Controlled drugs (CDs) were stored securely, countersigned, and checked with no discrepancies identified. PRN (as‑required) medicines had clear protocols reviewed every 6 months. Covert medicines were administered only where appropriate and in line with the Mental Capacity Act 2005, with documented best‑interest decisions involving the GP and family.

The service worked proactively to optimise medicines. The registered manager described a successful reduction of antipsychotic medication for one person, undertaken with the GP. As a result, the person started to engage more with others, took part in communal activities and took more pleasure in enjoying their meals. Professionals reinforced this positive practice. A healthcare professional said the home “demonstrates a good understanding of clinical risk and communicates promptly about changes in residents’ conditions,” supporting safe and proactive care. Training and competency checks were embedded. The provider kept clear records, ensured staff followed policy, and used audits to identify and resolve any issues promptly.

People and relatives consistently experienced medicines management as safe and well‑coordinated. One person explained that if unwell, “I can get paracetamol,” showing responsive support for minor, immediate needs. Overall, the provider had embedded highly effective medicines optimisation systems. Staff followed national guidance, worked well with external professionals and ensured people received medicines safely and in line with their individual preferences and needs.