White Lodge Care Home

Updated 4 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Our inspection was completed by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

White Lodge Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. White Lodge Care Home is a care home [with/without] nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager has been in post from February 2022 and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we already held and had received about the service since the time of the last inspection. We sought feedback from the local authority safeguarding team, commissioners and other professionals who work with the service. We checked information held by the fire service, environmental health officer, Companies House, the Food Standards Agency and the Information Commissioner’s Office. We checked for any online reviews and relevant social media, and we looked at the content of the provider’s website. We contacted Healthwatch for information. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who use the service and 11 relatives. We observed people’s care and staff interaction with them. We spoke with the home manager, deputy manager and care workers. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We asked staff on shifts to provide their views. We reviewed a range of records. This included multiple people’s care records, 2 personnel files and medicines administration records. A variety of records relating to the management of the service, including policies and procedures were also reviewed. We took digital images of the premises and equipment. We wrote to the to the home manager and nominated individual after the inspection to request further information and evidence. We received mul

Updated 4 February 2023

About the service

White Lodge Care Home is a residential care home providing accommodation and personal care to up to 23 people. The service provides support to older adults, some people living with dementia and people with physical disabilities. At the time of our inspection there were 16 people using the service. There were 14 staff employed.

The care home accommodates people across three floors. Each person has their own bedroom; some people have ensuite bathrooms and toilets. There are shared communal areas including a dining room and three lounge rooms.

People’s experience of using this service and what we found

Some risk assessments for premises and equipment were completed but others had lapsed or were not followed through. Risk assessments for personal care were satisfactory. Not enough staff were always deployed to ensure the safety of people and ensure they received support in a timely way. People received their medicines appropriately, but improvements were needed to storage, checks and disposal of medicines. The infection prevention and control required improvement due to personal protective equipment storage, and lack of robust cleaning procedures. Most incidents and accidents were logged and there were some lessons learned processes evident. Care workers were patient and kind to the service users, especially those with behaviours that challenge and those walking with purpose. Safeguarding events were logged and referred to the local authority however improvement is required.

There is a schedule of audits in place. Various audits were completed but did not always pick up shortfalls. However, where requirements for improvement were identified by the home manager, they were added to an action log and progress on the actions was documented. There were staff meetings held to discuss various issues. Staff training was up to date and there were regular supervisions and performance appraisals. There have not been any staff surveys, however there were staff meetings. There were relatives' meetings and surveys were sent out to gather feedback. The provider failed to obtain the documents required as part of the regulation and schedule for 'fit and proper persons'. The nominated individual, whilst present in the location several times per week, was reliant on the home manager and deputy manager for ensuring compliance with regulations and standards. The nominated individual did not thoroughly examine the practices of the management team to check if there was good governance. Some documents were not able to be found or located, and they were often referred to as being stored elsewhere but not produced when requested. The home manager and deputy manager worked well together, and staff appeared satisfied working at the care home. People and relatives were satisfied with the care provided.

People were supported to have maximum choice and control of their lives and staff supported /did not them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was good (published 3 August 2019).

Why we inspected

We received concerns in relation to medicines, infection control, staffing and leadership. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

The provider has already taken some action to mitigate the risks to people because of our inspection.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for White Lodge Care Home on our website at www.cqc.org.uk.

Recommendations

We made a recommendation about the prevention of falls at the service.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.