The White House

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. This is the first assessment for this provider at this location which they took over from the previous provider in July 2024. This key question has been rated Requires Improvement. This meant people’s needs were not always met. The service was in breach of legal regulation in relation to care not always being person centred. Some care plans lacked information around people’s life history and preferred routines. Staff were not always able to access people’s care plans. However, there were staff that knew people well and understood their likes and dislikes. The activities provided were meaningful to people. Staff ensured, all those that wanted, were involved in the activities.

This service scored 38 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. We found there was varying detail in people’s care plans around people’s life history, and preferred routines. Some care plans had lots of information whilst others had very little detail. Comments from staff about they learned about people included, “I will ask a senior. They have all the information. They will help” and “I didn’t read care plans properly. The residents tell me about their needs.” However, there were people that would not have been able to tell staff this due to the stage of their dementia journey. One relative told us, “[Person] had a clock, and they never put it up. I would have expected more person-centred care.”

There were staff however that understood and knew people well. Some staff were able to tell us people’s preferred routines and we observed this in practice. When people became anxious or agitated, there were staff who knew how to reassure the person and offer an activity they knew would mean something to them. For example, 1 person would walk with purpose and at times would become agitated with people. A senior member of staff would walk with them and talk to them about things that interested the person. We saw this made had a positive impact on the person.

The staff did not always understand the diverse health and care needs of people, there were staff that lacked an understanding of the needs of people living with dementia. However, support with other care needs was flexible and supported choice and continuity. We saw clinical staff from the GP practice would regularly visit the home to review people’s health needs. Where people were unable to attend external appointments, staff organised for the professionals to come to the service. Staff understood people’s cultural needs. Where people wished, they were supported to access their faith.

The provider had not always supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People and their representatives did have not have access to their care plans and notes as they were in a format that was difficult to share. The care plans and information around the home was not in a format that would be easy for some people, with advancing dementia, to understand. Bedroom doors had no identifiable information on them to help orientate people to the rooms.

The provider had not made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. People told us they had raised complaints about the maintenance issues in their rooms and that this had not been resolved. Relatives told us they had raised complaints about the laundry however a member of staff told these were not recorded. There had been no surveys or resident or relatives’ meetings for people to be able to provide any areas for improvement. The new manager had plans in place to send surveys to people, relatives and staff. However, they also said that most people in the home preferred paper surveys but currently the manager had no access to a workable printer to be able to do this.

The provider did not work well with people to understand and manage risks. Risk assessments relating to the health, safety and welfare of people using the service were not always completed. This meant guidance was not always in place for staff to ensure they supported people in a safe way. For example, where people were at risk of falls, risk assessments were not always in place to mitigate further risks to the person and to maintain their safety. The risks associated with people's behaviours and the strategies to manage this were not always clear in people's care plans. After the visit, the manager had made us aware of concerns raised in January 2025 by a member of staff observing another member of staff not always using moving and handling when supporting people to reposition. However, there were other risk assessments that were completed and updated when a change occurred for example in relation to nutrition and hydration and skin integrity. Staff, in the main, were familiar with the risks associated with people’s care. Staff ensured people had their walking aids left with them.

People’s human rights were not always upheld as they had been living in a poor environment and were always not supported to make decisions for themselves. Although staff had received training in equality and diversity, we found staff were not always treating people as individuals.

However, in other areas staff actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. For example, 1 person had a physical disability, staff had worked with the external professionals and the person to ensure their mobility concerns were addressed. Staff received training in equity, diversity and human rights.

People were not 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. End of life (EOL)care was not required imminently for most people, due to the frailty and older age of most living at the service, this could change very quickly. The only information contained in EOL care plans were limited to whether a person wanted to be resuscitated and who staff needed to contact.