About the service:

• White House is a residential care home providing personal care for up to nine people with learning disabilities.

• At the time of the inspection it was providing a service to nine people.

• White House is a large, detached house located near the village of Datchet, just four miles east of Slough town centre. It comprises two single bedrooms on the ground floor and five single bedrooms on the first floor, with communal bathrooms. The building also contains a large lounge and a dining area leading to the kitchen, and a laundry area. Patio doors lead from the dining room to spacious gardens, where there is also a summer house. An annex building provides fully self-contained accommodation for two further adults.

People’s experience of using this service:

• The service responded and went the extra mile to address people’s needs in relation to protected equality characteristics. For example, the service took extra steps to accommodate religious and cultural needs people living at White House.

• The service understood the needs of different people and groups of people, and delivered care and support in a way that met these needs and promoted equality.

• The service took innovative steps to meet people’s information and communication needs over and above complying with the Accessible Information Standard.

• People received individual, tailored care and support which led to exceptional outcomes. Care and support met people’s needs, and reflected their diversity, preferences and choices. Feedback from people and their family carers always reflected very responsive care and support.

• People were safe and staff knew how to keep them safe from harm. The provider had a recruitment process to ensure they had enough staff to support people safely. People received their medicines as prescribed. Staff followed infection control guidance and had access to personal protective equipment.

• Staff had the skills and knowledge to meet people's needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People's nutritional needs were met and they received enough to eat and drink to ensure they had a healthy diet. People accessed health care when needed.

• People received care and support in a caring environment which promoted their privacy, dignity and independence. The provider took steps to make sure people could be involved in decisions about their care and support.

• People's support needs were assessed regularly and planned to ensure they received the assistance they needed. People's support was individualised. People were supported to take part in a range of activities. People's interests, preferences, likes and dislikes were known to staff. The provider had a complaint process which people were aware of and were able to voice any concerns.

• The provider had systems in place to investigate and monitor accidents and incidents. The registered manager understood their legal requirements within the law to notify us of all incidents of concern, deaths and safeguarding alerts. The registered manager sought and shared knowledge and ideas, which contributed to improving the service and ensuring up-do-date best practice was followed.

Rating at last inspection: Rated Good overall (last report published 16/12/2016).

Why we inspected: This was a planned inspection to check that this service remained Good.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The location is part of the CHOICE group, who run care homes for people with learning disabilities and autism spectrum disorder. White House was a large, detached house located near the village of Datchet, just four miles east of Slough town centre. At the time of the inspection, the service offered support to eight adults with moderate to severe learning disabilities and associated complex needs. The registration allowed for nine adults to be accommodated.

There were two single bedrooms on the ground floor and five single bedrooms on the first floor, with communal bathrooms. The building included a large lounge and dining area leading into the kitchen and laundry area. The patio doors led from the dining room into spacious gardens, where there was also a summer house. An annex building provided fully self-contained accommodation for two further adults.

At the time of the inspection, there was 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.

Since registration under the Health and Social Care Act 2008 on 8 December 2010, White House has maintained compliance with the relevant regulations at each inspection by us. The most recent inspection was a routine planned visit on 16 January 2014. This inspection checked four outcomes, all of which were found compliant. This inspection is the first visit under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the first rating under the Care Act 2014.

People were safeguard from abuse and neglect. There was a robust system in place to ensure that people’s safety was maintained.

Risks for people were assessed, mitigated, documented and reviewed. Appropriate records were kept and readily available to demonstrate this to us at the inspection.

The building and premises risks were assessed and managed to ensure people, staff and visitor safety at all times.

Enough staff were deployed to support people. Care workers we spoke with were satisfied that there was sufficient staff and that they did not place people at risk when they were busy. Our observations showed that the service was busy at times, but overall calm and relaxed and staff were dedicated to the people they supported.

Medicines were safely managed. We examined the handling of people’s medicines during our inspection and found that people were safe from harm. Storage of medicines was correct. The community pharmacist audited the safety of medicines management at White House and found only a small number of improvements were needed.

Staff were knowledgeable and competent. They received appropriate levels of training, supervision and performance appraisal. Relevant subjects were used to teach staff about caring for people with learning disabilities. This included the management of aggressive behaviour and dealing with people’s epilepsy.

The service followed the requirements of the Mental Capacity Act 2005 (MCA). The recording of consent and best interest decision meant the service complied with the MCA Codes of Practice. There was clear information at the service regarding people’s applications, reviews and expiry dates for standard DoLS authorisations.

People received nutritious food which they enjoyed. Hydration was offered to people to ensure they did not become dehydrated. Snacks and treats were available if people wanted or chose to have them. People assisted with shopping and cooking and had the right to choose their own meals.

The found the service was caring. We observed staff were warm and friendly. As staff had worked with most people over an extended period of time, they had come to know each person well. Many of the people who used the service had lived there for long periods o

The service used person centred care records that described each person well. People told us they were involved in writing and reviewing them.

People accessed a wide range of activities. One person said "I'm always doing things", whilst another person told us "I like going out. I go shopping, and see my mum all the time".

People told us they felt safe and happy with the support they received and told us they would tell staff if they had any worries.

We saw positive interactions between people and staff. We saw that people were making their own choices throughout our visit.

Staff we met were knowledgeable about safeguarding and how to keep people safe.

The provider visited the service regularly, in order to carry out a variety of quality audits and checks.

There were seven people living at White House at the time of the inspection. We met and talked with three people and made observations. We reviewed relevant documents. People had comprehensive care plans which we found to be person centred and to facilitate the delivery of effective care and support. People who used the service had access to a range of educational, occupational and leisure activities.

People were positive about both the home and the staff. One person told us: "It's a good place and I like it". Someone else said: "Staff are good." How are they good? "The way they help you". People told us they felt safe at the home and described the support they needed.

We observed positive interaction between people and staff supporting them. We saw that people who used the service were involved in making decisions. They told us that they would tell the staff if they had a concern. We saw that documents, including health related forms, were available in accessible formats which facilitated people's understanding.

The provider ensured that people had their comments and complaints listened to and acted upon, without the fear that they would be discriminated against for making a complaint. People's complaints were investigated fully and resolved, where possible, to their satisfaction.

We interviewed three residents in some depth, and we looked at their care plans with them, assisted by the deputy manager. People told us they were happy with the support they received at this home and enjoyed the social and learning opportunities that were available.

People said they were involved in, and consulted about their care plans. Residents showed us that they had signed to demonstrate their agreement to these, and told us they were involved in any reviews. They confirmed that staff were respectful towards them, and that their families were made welcome and were encouraged to be involved.

All three residents said they felt safe at this home and whilst they had no complaints at present, they told us they would know who to speak with if they had any concerns.