About the service: White Plains Care Home is a purpose built home for older people situated just outside the village of Denham. The home is set within eight acres of landscaped grounds overlooking the private Denham air field. The service provides accommodation and personal care for up to 38 older people. The service does not provide nursing care. At the time of our inspection there were 37 people using the service.

People's experience of using this service: The service was extremely caring and placed considerable importance upon staff taking time to build and maintain compassionate relationships with people, their relatives and friends. People and their relatives were very positive about and caring culture of the service and felt highly valued and involved in the development of the service.

People were supported by a staff team who understood their needs exceptionally well. Care planning documentation was extremely thorough and clearly identified people’s diverse needs, preferences and choices.

The service worked hard to arrange creative activities and events to meet people's individual interests. People at the end of their life were supported in accordance with their wishes and with great sensitivity.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Healthcare professionals told us the service was very effective at co-ordinating people's health and wellbeing with positive outcomes. Staff received appropriate training and support to ensure they could carry out their roles effectively.

The service had systems in place to promote safety and prevent avoidable harm. Medicines were administered in accordance with people's agreed care plans and management protocols were understood and followed by staff. People's risk assessments addressed their needs and clearly identified hazards, level of risk and safe measure.

The service provided strong leadership to a motivated staff team who felt valued by the registered manager. The service had effective quality assurance processes to measure, document, improve and evaluate the quality of care. There was evidence of continuous learning and improvement to develop dementia strategies to meet people's needs.

Rating at last inspection: At the last inspection the service was rated “good” (16 April 2016).

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

Follow up: We will continue to monitor the service to ensure that people receive safe, high quality care.

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

White Plains Care Home is a purpose built home for older people situated just outside the village of Denham. The home is set within eight acres of landscaped grounds overlooking the private Denham air field. The service provides accommodation for up to 38 older people. The service does not provide nursing care. At the time of our inspection there were 34 people using the service.

The inspection took place on 3 and 4 February 2016 and was unannounced.

The service had a registered manager supported by a deputy 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.

We saw people were well cared for, relaxed and comfortable in the home. One relative said when they visit staff always made them feel welcome, and offered refreshments.

People and relatives were consistently complimentary about the staff and their skills. One relative said, “They all know the residents very well, and they know what they need, and know what they’re doing. The manager makes sure they are on the ball. When the manager is not here the deputy manager makes sure the standards and consistency is the same”.

Care records were personalised and up to date and accurately reflected people’s individual care and support needs. Care plans detailed how individuals were to be supported. People’s needs were assessed and their care plans reviewed and revised in line with their changing needs

The staff we spoke with were positive about the availability and quality of training provided and they told us that they had received training that enabled them to meet people’s needs effectively. A member of care staff told us, “The dementia training really helped my learning and understanding, and gave me confidence”. Staff told us they felt supported to do their job, and had regular informal and formal supervisions.

During our visits people were supported to take part in activities, and the home made excellent use of volunteers, students from the international college, and community projects to support the activities This ensured residents continued to lead a stimulating life.

The home was a member of NAPA (National Activity Providers Association) and the activity co-ordinator is undertaking additional training to enhance and develop their expertise and skills

A visiting GP stated that the home was fantastic, well managed and that staff make prompt and appropriate contact and act on clinical advice. The doctor visits weekly and said they find the staff caring, and compassionate. The home provides a wide range of support and care including end of life care. The GP said they are able to offer continuity of care as many of the residents moving to the home are local people, and the surgery have recommended White Plains.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People were protected against the risks of potential harm as the provider had arrangements in place to identify and manage suspected abuse. We found 95% of staff had current safeguarding training. We spoke with members of staff who were knowledgeable around safeguarding issues and were able to explain their roles and responsibilities in regards to safeguarding people.

People told us they felt safe within the service. We saw people were provided with ‘welcome packs’ which provided information on who they could speak to if they had concerns about their care. The provider had arrangements in place to ensure where people were deprived of their liberty, this was done in a lawful way.

Is the service effective?

The provider undertook regular audits to ensure the quality of the service provided. We found adequate numbers of staff available to support people with their needs. Staff told us they felt supported by management to undertake their roles. We found the home to have a high standard of cleanliness. Where people had specific dietary needs, these were met in line with their care plan. Recruitment procedures were in place to ensure the suitability of staff.

Is the service caring?

One person told us “I love it here.” Another person told us “The staff are very pleasant and helpful.” We observed lunchtime and saw staff were responsive to people’s needs if they identified or when they asked for assistance. We observed positive staff interactions throughout our visit. We saw relatives were involved in peoples care and people’s life histories were recorded as part of their care plan. People were offered a choice of hot and cold drinks throughout the day in accordance with their preferences.

Is the service responsive?

We saw peoples care plans and risk assessments were reviewed monthly to ensure they were reflective of their current needs. Where people’s needs changed, these were updated accordingly in the care plans. Regular reviews where undertaken to ensure people where happy with their care. We saw the service had a local GP who visited weekly to ensure people’s health needs were met. Arrangements were in place to deal with foreseeable emergencies to ensure the welfare of people who used the service.

Is the service well-led?

The provider undertook regular audits to ensure the quality of the service provision was monitored and acted upon. One person told us “The manager is very approachable.” Staff told us they felt supported in their roles which enabled them to deliver high quality care. We spoke with staff who were knowledgeable about people’s needs and how best to support them.

People we spoke with were generally complimentary about the service and the care provided. A person described the staff as "Genuinely very good." One person told us "I am very happy and enjoy myself here...I have no complaints." This was echoed by another person who said "They take good care of me. I am well fed and all the staff here are very thoughtful and caring." Another person said "I am so happy that I wouldn't want to be anywhere else."

We reviewed four people's care records. We saw each file had a consent form and a care plan agreement which was signed by the person or by their family representative to give their consent to receive care from the provider.

We found there were enough qualified, skilled and experienced staff to meet people’s needs. People told us staff were always available to attend to their needs and that they did not need to wait very long for a staff to respond to their call bells. One person told us "I press the button and they come to me immediately."

We found staff received appropriate professional development. People in the home were happy with the staff who looked after them. They felt safe and well looked after. People described the staff as "Kind, caring and very understanding" and "I find the staff very kind and terribly helpful."

People we spoke with did not have any complaints about their care. Records were kept of complaints received at the service and how they had been responded to.

"In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this locationat the time of the inspection. Their name appears because they were still a Registerd Manager on our register at the time."

We spoke to seven people who were using the service and three relatives. People said the care was “excellent.” Relatives said they were happy with the care their family members were receiving.

People we spoke with said they were provided with choices at meal times. Relatives were complimentary about the meals provided. One relative said, “My mum is fussy about her food. However, she has not once complained about the food.”

People said their bedrooms were cleaned daily. All areas of the home and the surrounding grounds were appropriately maintained. People told us there were always enough staff available to help them.

We found people received the appropriate care and support that met their needs. The service ensured people were provided with adequate nutrition and hydration. There were sufficient staff to ensure people’s health and welfare needs were appropriately met. The environment was appropriately maintained to promote people’s safety and wellbeing. The service ensured records were appropriately maintained and held securely to protect people’s safety.

People said that the home provided them with choices and staff respected their privacy and dignity. They said that staff enabled them to maintain their independence and to be part of the local community. For example, staff arranged outings to places of interest such as the museum and a dog’s trust.

People could not remember if they had an assessment prior to admission into the home.

People told us when their relatives visited the home staff made them to feel welcome. They said that staff provided them with refreshments.

People said that they felt safe living in the home. They said that the home had provided them with information on how to make a complaint. However, they have never had to make a complaint.

People said that they were registered with a GP. They said if they became unwell staff sought medical attention promptly.

People told us that their medication was reviewed regularly by the GP and that they received their medication at the right time.

People said that staff were trained appropriately to meet their needs and staff spoke to them appropriately.

People told us that their views were sought about the care provision.