The White House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We did not assess all the quality statements within this key question. We did not identify concerns relating to these areas which we judged as being met at our last inspection.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager told us, “People are involved in their care. It is partnership working. They tell me their concerns and how they would like to be supported.’’ Relatives confirmed they were involved as much as possible in the care planning process for their loved one. Care plans were clear and detailed, with information about people’s physical health, wellbeing and communication needs. Communication needs were thoroughly assessed to enhance the quality of people’s care and support. Care plans outlined each person's communication requirements and abilities. Staff supported people with their communication by using different methods and tools, such as photos, symbols, pictures, easy-read formats, verbal and non-verbal methods. Staff told us they had read and understood people’s care plans to help ensure they could meet their needs. Staff informed us, “We use pictures, signs or talk to them. We use a card for one Service user who is non-verbal but can read.’’ and ”We know their behaviour and how they react to things, we know what they need.’’ People’s care plans were reviewed regularly and showed information which had been gathered during a review and highlighted any changes that had been made to people’s care and support. People had behavioural support plans, which helped them to manage and improve their behaviour. These support plans included strategies for staff to encourage and promote positive behaviour, avoid and prevent issues, and respond effectively when needed. The plans were tailored to each individual's needs and focused on promoting their overall well-being.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

People were supported to make healthier choices to help promote and maintain their health and wellbeing. The registered manager told us, “We promote healthy eating with the support of our designated Healthy Eating Champion.” They went on to explain how they offered people healthier menu options, including meat-free choices and reduced-fat meals. They also explained the benefits to people of having a balanced diet and lower-calorie snacks. A person using the service told us, “My best food is chicken casserole. My key worker made it yesterday with carrots and potatoes.’’ People’s health was regularly monitored, and they were involved in completing health assessments and having checks when necessary, with healthcare professionals. A person using the service confirmed that staff frequently accompanied them to their GP and Chiropodist appointments.

The registered manager stated ‘’We work with dietitians and conduct monthly weight checks. Any significant changes in weight or behaviour are escalated to the GP or dietitians. We also monitor trends and themes to ensure appropriate support is provided.’’

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. The provider carried out mental capacity assessments appropriately to check if people using the service could make informed decisions about their care and treatment. They also submitted Deprivation of Liberty Safeguards (DOLs) applications when needed, to ensure that any restrictions on people’s freedom were necessary, in their best interests, and legally approved.

When people lacked the mental capacity to make decisions about their care, the provider had clearly identified their legal representative(s).

All staff had undertaken the mental capacity act training to ensure that they understood the importance of obtaining consent before they delivered care and treatment.

Staff explained things to people in ways they understood, so they could make informed decisions about what they were consenting to. People and their representatives completed consent forms where necessary, and they confirmed that staff sought their consent before providing care and support.