The White House is a care home which provides accommodation for up to 17 older people who require personal care. At the time of the inspection 17 people were using the service. Some of the people who lived at the service needed care and support due to dementia, sensory and /or physical disabilities.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

We inspected The White House on 20 February 2017. The inspection was unannounced. The service was last inspected in July 2016 when it was found to be meeting the requirements of the regulations.

People told us they felt safe at the service and with the staff who supported them. For example we were told, “In my opinion it is safe,” and “I have never observed anyone being nasty in any way.”

People received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately.

There was enough staff on duty, people did not appear to be rushed, and any help people needed was provided promptly.

Staff training was delivered to a satisfactory standard although some newer staff still needed to complete essential training. When staff started to work at the service they received a comprehensive induction. Staff received regular one to one supervision with a senior member of staff, and an annual appraisal.

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which helped find out if a person was suitable to work with vulnerable adults.

People had access to medical professionals such as a general practitioner, dentist, chiropodist and an optician. People said they received enough support from these professionals. There were not records, however, when people last saw a dentist.

Care was provided appropriately and staff were viewed as caring. For example comments received included, “It is like a hotel. Carers are helpful. They go the extra mile. First class,” “They look after me properly, they are very good” and “The staff are without doubt lovely.”

The service had some activities organised. There was an activities organiser. Activities available included arts and crafts, pamper sessions, and making cards and calendars (for example people made these just before Christmas). The service also had external activities facilitators who visited the service such as a singer and an aroma therapist.

Care files contained information such as a care plan and these were regularly reviewed. The service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, for example using the Mental Capacity Act (2005).

People were happy with their meals. Everyone said they always had enough to eat and drink. People were not provided with a choice of meals, but staff would provide an alternative meal if people did not like what was on offer. We observed that people received enough support when they needed help with eating or drinking.

People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management, or they would ask their relative to resolve the problem. They were sure the correct action would be taken if they made a complaint.

People felt the service was well managed. There were satisfactory quality assurance systems in place to ensure there was a process of continuous improvement.

The White House is a care home which provides accommodation for up to 17 older people who require personal care. At the time of the inspection 17 people were using the service. Some of the people who lived at The White House needed care and support due to dementia and some people had sensory and /or physical disabilities.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

We previously carried out a comprehensive inspection of The White House on 8, 10 and 14 December 2015. At that inspection we identified three breaches of the legal requirements. This related to how medicines were managed; how the service assessed in accordance with the requirements of the Mental Capacity Act, and sought appropriate authorisation where peoples care plans were restrictive; and ensuring care was appropriate and met people’s needs. We subsequently issued three requirements and told the provider to take action to address the three breaches of the regulations. The provider sent the Care Quality Commission an action plan following the publication of the report. We checked to see if the service had made the required improvements identified at that comprehensive inspection.

We carried out this focused inspection to check to see if the service had made the required improvements identified at that comprehensive inspection.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The White House on our website at www.cqc.org.uk

During this inspection people told us they received their medicines on time. Medicines were well organised, records kept to a good standard, and staff had received suitable training to administer medicines. Medicines which were not required, and needed to be returned to the pharmacist, were kept securely, and comprehensively recorded in a returns book.

We also found the service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, for example using the Mental Capacity Act (2005). For example care plans included information about, where appropriate, people’s mental health needs, and their capacity. Where necessary applications had been submitted to the local authority to request people were assessed in accordance with the Mental Capacity Act 2005 and associated Deprivation of Liberty safeguards.

At the comprehensive inspection in December 2016 we found the majority of people were very well cared for. We did have concerns about restrictions placed on one person, and that these had not been assessed and authorised in line with the Mental Capacity Act 2005. At this inspection we judged everyone was well cared for. Suitable care plans were in place, for example, in respect of the person we had previously had concerns about. Comments received from people included “It is a lovely place,” “The staff are very good,” “Everything is okay with me. No problems at all.” A relative told us: “We think it is a safe environment with well-trained supportive staff that are helpful to us at all times in a happy place.”

We could not improve the overall rating from 'requires improvement' because to do so requires the service to demonstrate consistent good practice over time. We will review the rating during our next planned comprehensive inspection which will occur in the next six months.

During our inspection we spoke with the registered manager, seven people who lived at The White House Falmouth, four members of staff, and one person who was visiting the home on the day of our inspection.

People told us the staff were “marvellous” and the food was “lovely”.

We saw every one who lived at The White House Falmouth had a care plan in place which informed and directed staff on how to care for them.

People who lived at the home were protected form the risk of abuse as the registered manager had ensured staff had received training on safeguarding.

Policies and risk assessments relating to the maintenance and health and safety of people who were living at the home, visitors and staff, were up to date and informed staff how to reduce any potential risks.

Opinions and views from people were gained formally and informally in order for the registered manager to monitor the service. People we spoke with were very complimentary of the whole service.

People who lived at The White House were very complimentary of the staff and told us that the staff were “very nice” One person stated they were “well looked after”. One person visiting the home told us that “nothing is too much trouble”.

Care plans informed and directed staff on how to care for the individual and people’s preferences were included. Staff appeared caring and compassionate towards the people that lived at the home however their level of knowledge regarding what people liked was not always represented within the care plan.

We spoke to the member of staff responsible for the medication within the home on the day of inspection. We were told that there was a robust medication system in place for people moving into the home. The care plans documented peoples’ preferences regarding their wishes for staff to administer any medications.

The lounge was being decorated; tools and open pots of paint were seen to have been left unattended whilst the people that lived in the home were present. We discussed this with the manager. A risk assessment was completed whilst we were there and the items were made safe.

We spoke to the manager who told us there was sufficient staff to meet the needs of the people that lived in the home

Staff told us they felt very well supported by the manager, and formal supervisions are held monthly

We spoke with some people living at The White House about the service, and we spoke to staff and relatives. They told us that people have the opportunity to express preferences and make choices. There is a small stable team of care workers that work hard to meet the needs of the people that live there. People said they were happy with the care provided and the kindness and politeness of the care workers. Visitors and relatives told us that they were happy with the care provided.

The White House is a care home which provides accommodation for up to 17 older people who require personal care. At the time of the inspection 17 people were using the service. Some of the people who lived at the service needed care and support due to dementia, sensory and /or physical disabilities.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

We inspected The White House on 20 February 2017. The inspection was unannounced. The service was last inspected in July 2016 when it was found to be meeting the requirements of the regulations.

People told us they felt safe at the service and with the staff who supported them. For example we were told, “In my opinion it is safe,” and “I have never observed anyone being nasty in any way.”

People received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately.

There was enough staff on duty, people did not appear to be rushed, and any help people needed was provided promptly.

Staff training was delivered to a satisfactory standard although some newer staff still needed to complete essential training. When staff started to work at the service they received a comprehensive induction. Staff received regular one to one supervision with a senior member of staff, and an annual appraisal.

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which helped find out if a person was suitable to work with vulnerable adults.

People had access to medical professionals such as a general practitioner, dentist, chiropodist and an optician. People said they received enough support from these professionals. There were not records, however, when people last saw a dentist.

Care was provided appropriately and staff were viewed as caring. For example comments received included, “It is like a hotel. Carers are helpful. They go the extra mile. First class,” “They look after me properly, they are very good” and “The staff are without doubt lovely.”

The service had some activities organised. There was an activities organiser. Activities available included arts and crafts, pamper sessions, and making cards and calendars (for example people made these just before Christmas). The service also had external activities facilitators who visited the service such as a singer and an aroma therapist.

Care files contained information such as a care plan and these were regularly reviewed. The service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, for example using the Mental Capacity Act (2005).

People were happy with their meals. Everyone said they always had enough to eat and drink. People were not provided with a choice of meals, but staff would provide an alternative meal if people did not like what was on offer. We observed that people received enough support when they needed help with eating or drinking.

People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management, or they would ask their relative to resolve the problem. They were sure the correct action would be taken if they made a complaint.

People felt the service was well managed. There were satisfactory quality assurance systems in place to ensure there was a process of continuous improvement.