White Gables Residential Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (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 was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Each person had a key worker who was supported with guidance to get to know the individual and, where appropriate, their relatives. Relatives described staff as creative and respectful when meeting people’s preferences, including supporting a person who wished to wear the same clothing daily by laundering items overnight.

People and relatives told us care was person‑centred, they were listened to, and their views shaped the care and support provided. A person said, “I am very happy here,” and a relative described the service as, “Exceptional… [Staff] go the extra mile,” noting significant improvements in their family member’s wellbeing. Thank‑you cards also reflected this, including feedback about people regaining mobility and enjoying their daily life.

Care plans clearly set out people’s needs and preferences and had recently moved to an electronic system, which the registered manager was enhancing with more person‑centred detail. Daily records included the care provided by staff, the registered manager said they were in the process of improving these records to demonstrate how people were presenting daily. Handover meetings ensured staff shared up‑to‑date information about people’s wellbeing. Staff knew people extremely well, which we saw reflected in our observations and discussions with staff, people using the service and relatives.

People had access to a broad range of meaningful, age‑appropriate activities that promoted social engagement and prevented isolation. The service was lively and full of laughter. Activities included seasonal crafts, reminiscence, exercises, poetry recitals, drama club and rehearsals, art, music, and one‑to‑one sessions. People told us they chose what they wanted to do, and we saw staff provide social interaction for those who preferred to stay in their rooms.

Photographs and newsletters showed people enjoying activities, and items they created were displayed around the service. Without exception, people praised the activity provision; one person said, “[Activities staff member] is very good… lots of things to do.”

The provider had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People’s care records included their diverse needs and how they were met. Staff training records showed staff had received training including equality, diversity and inclusion, and dementia. A person’s relative told us how the staff were knowledgeable about their family member’s health condition and any effects this may have on people. This had supported the relatives to better understand their family member. There was a low turnover of staff which ensured people received continuity of care from staff who knew them extremely well.

Activities were provided to coincide with cultural and traditional celebrations. For example, Christmas, Valentines Day and Easter. A staff member told us, “You should have seen what they did bonfire night.” They told us in the middle of the lounge materials had been used to make what looked like there was a bonfire, and people had toasted marshmallows.

We saw photographs of people receiving gifts from Santa during Christmas, a staff member told us they had a grotto outside and a person’s relative had agreed to be Santa to give out the gifts. We also saw photographs of a nativity show people had put on, for which they had dressed in costumes, and a donkey had attended to be a part of the nativity, a staff member told us people had rehearsed the show over time, and it had gone well. In addition, staff had also put on a pantomime, Cinderella, for people and relatives to watch. People had made decorations and dressed a Christmas tree for a local annual Salvation Army Christmas tree festival, for which they had won third prize. We saw photographs of people attending the festival, where they could look at the other trees.

There was a wish tree in the service, where people had put what they wanted to do in the community or have access to. These included shopping at a local fashion shop and a shave at a barber. A staff member told us these were doable things, which people could do in their one-to-one activities in the local community. Discussions with a person and staff demonstrated staff had researched a person’s wish and actions being taken to make sure it could be met.

A staff member told us a person had been a librarian, and they managed the books in the service, such as checking them out and in. This demonstrated staff had taken time to get to know people, their interests and life experiences, and supported people to use these to participate in the running of the service, which gave them a sense of ownership and inclusion. The registered manager told us of a person who liked to check the security of the building before going to bed, which was supported.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s care records included how they communicated and how staff were to effectively communicate with them. Where required any important information could be provided in alternative accessible formats. The registered manager told us they had larger print books and Bibles on site. A person had received news on audio electronically, which gave them updates of newspapers and current information. We saw some other people had the daily newspaper delivered. A person asked a staff member if their newspaper had been delivered, the staff member responded, “I have put it in the lounge for you, I know you like doing the crossword.”

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

People’s voices and that of their relatives, were heard in several ways, we found people’s comments and suggestions were valued and used to improve the service. We saw people’s choices and comments were sought and acted on, which demonstrated people were in control of their own lives and what was happening in the service. This included reviews of their own care.

Resident meetings were held, this provided people with a forum to discuss the service, receive feedback about what was happening in the service and to make any suggestions or raise concerns. People had ownership of these meetings where they identified what they wanted to discuss and formulated the agenda. They were kept updated with planned actions and the outcomes.

Where formal complaints had been received, these were investigated, addressed and responded to in line with the provider’s complaints procedure. The registered manager told us actions taken as a result of concerns received, this included increasing the monitoring of oral care and support in the laundry. A staff member told us any concerns, which had not been raised as formal complaints, were acted on immediately to improve people’s experiences. This was confirmed in feedback received from people and relatives who told us any concerns raised were acted on, outcomes fed back and they were confident this would be the case going forward. A relative told us, “I trust them such a big thing to have that trust and for them to have earned it, I trusted them early on.” A person told us, “There are some little things sometimes, but they come to you and make sure it is resolved.” Another person said, “Management are very good keep you up to date and let family know, they don't hide anything, they say if anything's bothering you let us know.”

The management team were a visible presence in the service and known to people and their relatives. Relatives told us the registered manager was available when needed, and if the registered manager was not present, they were confident any information passed to other staff would be passed on and addressed. In addition, relative told us they were kept updated about their family member’s wellbeing and any comments were listened to. Relatives we spoke with felt part of the White Gables ‘family’ and were involved in decisions about their family member’s care, where appropriate.

Relatives were encouraged to give feedback about the care and service provided, all of which, took into account individuals own needs and preferences in how they gave this. Quarterly relative and friend meetings were held, these were in the form of, for example cheese and wine evenings, where people could also spend time with their relatives as a quality social event. The registered manager told us these were held in the evenings, so they were accessible to more relatives. The registered manager and deputy manager attended these meetings and were available to hear any concerns or suggestions, either individually or in groups. Relatives received an email invitation along with an agenda.

Newsletters were provided to relatives and people using the service, which shared information about what was happening in the service, including events and activities. Each newsletter encouraged individuals to provide feedback on the service and the many ways they could do this and gave assurances any feedback would be used to drive improvement.

We saw numerous cards sent to the service thanking them for the care and support provided. One from a relative stated their family member was, “Properly cared for with such love and affections.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The management team and staff told us they had positive relationships and worked in partnership with health and social care professionals to ensure people had access to services to receive the care they required. This was confirmed by people’s records which included support and guidance provided by external professionals who were involved in people’s care. The registered manager told us they had developed links with health professionals to allow them to seek guidance, validation and support in making referrals, such as to mental health professionals. This supported access to service for people in a timely way. Contact with lead district nurse had enhanced partnership working to ensure people receive the care they required. People’s relatives told us they were kept updated when their family member were receiving any healthcare support.

The environment was accessible to people using the service including ramps for entry and accessible bathing facilities. There was a small secure courtyard, people could use, as they chose to.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

People’s preferences were documented regarding the care and support they received, including information from their relatives, where appropriate. The staff supported people to access services where required. Information was provided, for example to hospital staff, to ensure they were made aware of people’s diverse needs, including important information about the person.

Regular visits from local places of worship were undertaken to support people’s spiritual needs, for those who wished to participate. People had the opportunity to visit local places of worship; however, alternatives were provided for those who could not attend or did not wish to attend, including online screening of services.

People’s strengths and abilities were known by staff, and support was tailor made to ensure equality in access, for example to social activity. People were supported to access the community such as fish and chips on the sea front, places which reminded them of their previous work, and shopping. A local town and sea front was within walking distance. A staff member told us how they had used a local community transport service to support people to go out further, however, they were looking at ways to reduce the costs.

Where people chose to not participate in group activities, or were unable to, provision was made for individual social activity and interaction. This demonstrated people had equal access to social interaction when they remained in their rooms as those who used the shared areas. A person’s relative said, “They bring the activities to [family member],” as they chose to stay in their bedroom.

The registered manager told us how, in the relative cheese and wine evenings, they had provided information to relatives about how they could access alternative transport when people were not able to use their bus pass. This had resulted in people being able to go out with their relatives.

A staff member told us how a person was reluctant to accept support with an area of their care, as a result the service had worked with the person, their relatives and GP to seek a solution. An agreement had been made with the GP and plans to discuss this further with the relatives to make the final decision in the person’s best interests. This demonstrated a commitment to ensure people received the care they needed and actions taken to tailor the care to suit people’s preferences and needs.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s records included their decisions about how they wished to be cared for, for example if they became ill or were at the end of their life. We saw several cards send to the service from people’s relatives thanking them for the care and support provided as their family members neared the end of their lives. A person’s relative told us about how their family member’s condition affected them, “Here is like a breath of fresh air, I know that when [family member] is deteriorating we will get there with the support of the home, I have confidence in them.” Another relative told us about their family member whose health was deteriorating, “I honestly think it's because of the care [family member] receives and the love [family member] has for the carers is why [family member] keeps going… this was all very hard but from my point of view they have made it very easy for me considering.”

We saw thank you cards sent to the service regarding the care and support provided to people at the end of their life. One stated, “Thank you all so much for the loving care and fun you gave [family member] in [their] last year of life.”