Archived: The White House

The White House is registered with CQC to accommodate up to 28 people and at the time of this inspection, 23 people were accommodated and there were five vacancies.

We found the following examples of good practice.

Staff received specialist Covid-19 infection prevention and control training.

Fixtures, fittings and high-use surfaces were visibly clean.

Policies and procedures for entering the home were effective in protecting against the spread of infection.

Processes in place for enabling visits to people who used the service promoted the wellbeing of all concerned.

The emotional wellbeing of staff was supported, and staff reported that senior managers had promoted a caring and open-door culture.

Risk assessments had been completed and action taken to ensure individual needs relating to Covid-19 were met.

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. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The White House is registered with CQC to accommodate up to 28 people. At the time of this inspection, 23 people were accommodated, four people were in hospital and the home had one vacancy.

The White House is a large detached property set in its own grounds, with parking space to the front of the home. The home has a private patio area and garden at the rear of the property which is enclosed at all sides. The home is situated in a residential area of Northenden, within easy reach of the motorway network, public transport and local shops.

At our last inspection we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager. 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.

People told us they felt safe living at The White House. Staff received safeguarding training and knew how to keep people safe and raise concerns if they suspected someone was at risk of harm or abuse.

People had comprehensive risk assessments which were reviewed and updated in a timely way to meet people’s changing needs. This ensured staff had access to the relevant information and guidance to mitigate risks.

Staffing levels remained consistent and the home benefited from a stable workforce. People, relatives and staff told us there were sufficient numbers of staff on duty to meet people’s needs.

The management of medicines was safe. There were appropriate arrangements in place to ensure that medicines had been ordered, stored, received and administered appropriately.

The service had a training matrix to monitor the training requirements of staff. Staff received appropriate training, supervision and appraisal to support them in their role.

People were supported in line with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People were encouraged to make decisions and choices about their care and had their choices respected.

People's consent to care and treatment was sought prior to care being delivered.

People were encouraged to maintain a healthy nutritionally balanced diet and had access to sufficient amounts to eat and drink, at times that suited them. People's health care needs were monitored and maintained; people had access to health care services as and when needed.

People continued to receive care and support from staff that were kind, caring and compassionate.

People were treated with dignity and respect and had their independence promoted by staff that openly expressed their fondness for the people they cared for and supported.

Care plans were person centred and tailored to meet people's individual needs. People were encouraged to be involved in the development of their care plans, which were updated regularly to reflect people's changing needs.

A variety of activities were provided and staff demonstrated a good understanding of people’s needs and adapted activities to reflect people’s individual interests.

The provider had a complaints procedure in place and people felt confident in raising concerns or complaints to staff and the registered manager.

Staff told us the home was well-led and a good place to work. We were told by staff, people and their relatives that the registered manager was visible, had an open door policy and was approachable which meant people, their relatives and staff could meet with the registered manager as and when they needed.

There was an effective system for audit and quality assurance to monitor the service provided. Audits or checks were completed by the registered manager on records, including medicines, accidents, risk assessments, care plans and daily records.

Is the service safe?

We spoke with four people who used the service who told us they felt safe and were treated with respect and dignity by the staff. We found safeguarding procedures were in place and staff were able to tell us how they would safeguard the people they supported.

The home had policies in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). No applications had been submitted at the time of our inspection. We spoke with the manager about their knowledge of the Mental Capacity Act and DoLS and what they told us meant they understood the correct protocol to follow in order to make an application, if needed.

The service was safe, clean and hygienic, although in need of re-decoration. The Manager told us they took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. Staff told us they had no concerns about staffing levels. This helped to ensure people's needs were always met.

Is the service effective?

People's health and care needs were assessed with people who used the services or their relatives and health care professionals. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People we spoke with said their care needs were being met. People using the service appeared content and settled and families told us they were able to visit at any time.

Is the service caring?

People were supported by friendly and attentive staff. Staff showed patience and gave encouragement when supporting people. People commented, "I think its very good, staff are very nice." "No concerns about how things are done here." "I'm quite happy here."

Relatives had fedback to the manager via quality assurance questionnaires. Where shortfalls or concerns were raised these were addressed.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People participated in a range of activities inside the service regularly. The home had a dedicated activities coordinator who organised daily activities and events .

There were complaints recorded in a complaints log which we saw the manager had responded to in a timely manner. People could therefore be assured complaints would be investigated and action taken as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had quality assurance systems in place. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving. The manager was a dignity champion and had ensured all the staff had signed up to the dignity in care standards.

Staff told us they were clear about their roles and responsibilities. They felt supported by the manager. One member of staff told us; "I feel supported, we are a good team".

We found that the home was meeting the essential standards we looked at on this inspection and we found people were very well cared for.

We checked whether the provider had improved their processes to ensure that all necessary information was held within staff files. We found that the provider had taken appropriate action and was now meeting the standard on the recruitment and suitability of staff.

"I think it is wonderful. I've been in a few and this is the best one"; "I am comfortable here, they look after me well" and "If I need medicine, staff do it for me".

We completed this compliance review in response to an incident concerning the home. We communicated with our partner agencies including Manchester City Council and the Greater Manchester Police Authority who were also reviewing the home.

Overall we found people were well cared for and given their medicines safely. We found that the provider was meeting the regulations we looked at, with the exception of the regulation which concerned the recruitment of staff where there were minor issues. We have asked that the provider take action to ensure that recruitment records are improved.