The White House

Updated 4 December 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

The White House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was unannounced.

What we did

We reviewed the information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information the provider are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people, one relative, one healthcare professional, four staff members including care workers, the registered manager and operations manager. We reviewed a range of records. This included three people’s care records and multiple medications records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, for example, fire safety, health and safety and complaints were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures and staff training.

Updated 4 December 2019

About the service

The White House is a small residential care home providing personal care to people with a learning disability and an autistic spectrum disorder. The service can support up to five people. The care home accommodates four people in one adapted building in the London Borough of Twickenham.

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.

People’s experience of using this service and what we found

People continued to be supported to receive their medicines in line with good practice. People were protected against the risk of abuse, as staff received safeguarding training and were familiar with the provider’s safeguarding policy. Risk management plans were regularly reviewed and gave staff clear guidance on keeping people safe. There were adequate staff numbers available to support people safely. The registered manager was keen to learn lessons when things went wrong, to minimise the risk of repeat incidents.

People continued to receive support from staff that were skilled and knowledgeable in their role. Staff were supported to regularly reflect on their working practices, through one-to-one meetings with the registered manager. Newly employed staff were encouraged and supported to undertake a thorough induction programme. People were supported to maintain their health and had access to healthcare services as and when needed. People had their dietary needs and preferences met.

People, their relatives and a healthcare professional were complimentary about the care and support provided. People were encouraged to maintain and follow their faith and cultural beliefs.

People continued to be treated with dignity and respect. Staff encouraged and supported people to make decisions about their care.

People were supported to access activities that met their social needs, both in-house and in the community. Complaints were investigated and acted on swiftly. Care plans were personalised and gave staff clear guidance on how to meet people’s needs in-line with their wishes. The provider had developed an end of life policy.

The registered manager continued to carry out frequent audits of the service to monitor and improve the service provision. People, their relatives and healthcare professionals spoke positively about the management of The White House. People’s views were regularly sought, through keyworker meetings and questionnaires.

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 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.

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 7 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The White House on our website at www.cqc.org.uk.

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.