The White House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

Good: This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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.

There was a shared direction and culture that was known by staff and led by the owner of the service along with the registered manager. Staff understood the ethos of the service and how their individual role fitted with others within the service.

All staff training and supervision was built around the rehabilitation culture. One staff member said, “I like sharing an office with [named staff] there is positive teamwork.” Another staff member said, “I had endless conversations with nurses and the manager. If there was a term I came across that I didn’t know they would explain it. For example - water loading; they explained this and how it develops, how it’s treated and what is the outcome”. Staff felt able to seek advice and guidance where needed.

Staff were aware and could explain the rehabilitation model at the service. The rehabilitation model stated, ‘We believe in taking treatment slowly, as our outcome measures demonstrates this gives the best results for people.’ Weight gain or stabilisation being the first goal, using psychological and therapeutic input. The overall aim being to build independence and a life outside of an eating disorder.

Staff told us they felt able to raise concerns and that they would be listened to. Staff had completed whistleblowing training based upon the policy at the service. One staff member said. “They are good people here. They like things done.”

Staff had access to 24/7 mental health support and had access to an App called ‘Yu Life’ for well-being support.

People expressed that not all leaders were approachable. Three relatives/carers believed there was a lack of communication. They were wanting more information on care provided and changes. The sole reliance on online meetings did not suit everyone’s needs.

We were told about regular resident meetings being held and saw the minutes of the last meeting. A request for outdoor laundry drying space had been requested. This had been denied by a staff leader without explanation. This showed a lack of collaboration. Following our feedback to the provider a laundry drying space has now been implemented.

Staff told us they felt valued, and a diverse workforce was present. Staff respected one another, told us they felt supported by the team and reflected on positive staff morale. Staff told us they felt supported and had regular team meetings and supervisions. Staff also told us they felt managers were visible and had good oversight of the team. One staff member said, “I like my supervisions, they are wellbeing based. I like coming to work.” One staff member told us of the reasonable adjustments that had been made in relation to a medical condition.

There were processes in place for staff to be supported with their development, training and ongoing supervision including clinical supervision and maintaining competencies.

Staff told us they felt supported by leaders and confirmed staffing levels were appropriately reviewed based upon the needs of people. Staff were aware of what to do in an emergency, and the procedures to follow. Records were held securely, and staff knew how to access and handle personal information.

There were regular management meetings that review audits, incidents and accident. Actions were clearly assigned and followed up. Audits such as medicines and infection control were in place. Processes for notifying CQC of events was in place and known by leaders of the service.

People had links with the community and where requested attended church regularly. Some enjoyed participation in voluntary work. People were able to access local shopping facilities either independently or with support to purchase toiletries and other personal items.

Staff told us they had positive working relationships with other partners. Online multidisciplinary meetings regarding each person was held on a rotational basis. The person themselves attended if they wished as well as family members. Most family members had visited in person at some point.

Professionals were invited to the online meetings and if they couldn’t attend then a report was submitted.

Leaders that we spoke to told us that they valued the input of other professionals. The service prioritised people accessing the community as part of the services rehabilitation model.

The doctor at The Whitehouse was aware of best practices and keeping up to date with developments and learning through links to relevant national bodies. They said, “I sat in on the Marsipan initial launch, and I’ve had updates and training on MEED.” Marsipan stands for Management of Really Sick Patients with Anorexia Nervosa and has widely been replaced with MEED which stands for Medical Emergencies in Eating Disorders. A member of staff spoke about the systems in place being able to lead to real learning and changes being made. They recounted an incident where someone had left the service without the correct support. The outcome was the person was safe, but changes were made to care planning to show actions to be taken and reduce potential harm if that were to occur again. Improvements had been made to staff access to management advice outside of normal working hours. A duty system had been introduced to lessen leaders being disturbed out of working hours but ensuring emergency advice was available.

The process of accident and incident reports was online and accessed by staff. These incidents had sign off from a senior person responsible once the learning had been understood and changes put in place. In addition, these events were discussed at meetings.

In the entrance was a suggestion box for anyone to feedback comments to leaders.

Leaders had recently created the clinical lead position for the service. This post was created to increase the level of visible clinical leadership at the service. The clinical lead would be present at the site and would provide clinical support to the staff. The clinical lead received regular supervision with the lead clinician at the service.