CQC report explained · a nursing home
What the CQC found at The White Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safe medicines management, suitable risk assessments, safe recruitment and a clean environment.
- Effective?
- Good
- People's needs were assessed and care was delivered by trained and supported staff. People were supported with eating, drinking, healthcare access, consent and least restrictive care.
- Caring?
- Good
- Staff were observed to be kind, calm and patient. People were treated with dignity, involved in decisions and supported to remain as independent as possible.
- Responsive?
- Good
- Care plans were personalised and reviewed regularly. People had communication support, activities, community links and timely responses to call bells and complaints.
- Well-led?
- Good
- Inspectors found open and supportive leadership, regular audits and meetings, and action taken in response to feedback. The improvements made since the previous inspection had been maintained.
What inspectors found, April 2020
The White Lodge was rated Good; inspectors found safe, kind and personalised care, with clear improvements since the previous inspection.
Inspectors visited on 25 and 26 February 2020. The first day was unannounced. They spoke with five people using the service, ten relatives, nine staff and three visiting professionals. They also checked care records, medicines records, staff files and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that medicines were managed safely, staff were recruited and trained properly, and people were treated with kindness, dignity and respect.
The home had improved from Requires Improvement at the previous inspection, when there were multiple breaches of regulations. Inspectors found that the provider had completed its action plan and was no longer breaching the regulations. They found that the improvements had been maintained.
Safe medicines
Medicines were administered, stored and recorded safely. The home used audits, pharmacist advice and regular GP reviews.
“People's medicines were administered, stored and managed safely.” from the report
Kind and respectful staff
Inspectors saw staff being gentle, patient and respectful. Call bells were answered promptly and staff knew people's preferences.
“Staff were calm and patient and we observed call bells being answered promptly.” from the report
Personalised care
Care plans included people's likes, dislikes, communication needs and abilities. They were reviewed monthly or when needs changed.
“People's care plans were personalised, thorough in detail and reviewed monthly or when people's needs changed.” from the report
Activities and social life
People could take part in clubs, groups, events and outdoor activities. The home also had accessible grounds and a café.
“The activities team was growing and they had added to their repertoire of games, events, clubs and groups.” from the report
Improved leadership
Inspectors found effective management, regular quality checks and an open culture. The improvements from the earlier inspection had been sustained.
“All quality assurance and monitoring documents were thoroughly recorded and analysed with action plans in place for each area of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How have you maintained the improvements that followed the previous inspection and action plan?
- 02How do you check that care plans are still reviewed monthly and updated when people's needs change?
- 03How many permanent staff are currently employed, and how often are agency staff used?
- 04Which activities and clubs are currently available, particularly for people living with dementia?
- 05How are medicines audits and GP or pharmacist reviews followed up if they identify a problem?
This inspection reviewed all five CQC questions and checked whether improvements following the previous inspection had been maintained. This explanation was written from the published report of 8 April 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2019
Requires Improvement; inspectors found important improvements in safety and management, but these had not yet been shown to last.
This was an unannounced, focused inspection on 27 March 2019. Two inspectors and an expert by experience spoke with people, relatives, managers and staff. They reviewed six care plans and records about how the home was run.
The home had improved since the previous inspection. Risk assessments, staffing, medicines, infection control and safeguarding arrangements were better. People and relatives generally said they felt safe and that the home was improving.
The overall rating remained Requires Improvement. Safe and Well-led were both rated Requires Improvement. The home was no longer breaking the regulations identified at the previous inspection, but the CQC said more time was needed to make the improvements consistent and lasting.
Improved risk management
Care plans contained suitable risk assessments, including for falls, choking, malnutrition and pressure ulcers. Actions to reduce risks were recorded and followed.
“Care plans contained appropriate risk assessments which kept people safe whilst maximising their independence.” from the report
Staffing had improved
Inspectors observed enough staff during the visit. Recruitment of permanent staff was continuing and agency use had reduced.
“There were sufficient staff to meet people's needs according to the provider's dependency tool (DICE) across all three floors.” from the report
Medicines were managed safely
Medicines were stored, recorded and restricted appropriately. There were also suitable arrangements for medicines given when needed.
“There were suitable arrangements in place for storing and recording medicines that required extra security and access to medicines was restricted to authorised staff.” from the report
Better quality monitoring
The home had introduced several levels of checking, including regular internal audits and reviews of individual care records.
“The provider had quality assurance processes in place with several levels of oversight checks.” from the report
Improvements not yet proven to last
needs fixingThe home had made the immediate changes required after the previous inspection, but the CQC wanted evidence that these changes would continue over the longer term.
“However, more time was required to ensure these improvements were embedded and sustained in the longer term.” from the report
Inconsistent leadership
needs fixingThe Well-led rating remained Requires Improvement because management and leadership did not always support consistently high-quality, person-centred care.
“Service management and leadership was inconsistent.” from the report
- 01How are you checking that the improvements in risk assessments and incident recording are continuing?
- 02What is the current balance between permanent and agency staff, and how are staffing levels checked when people's needs change?
- 03What evidence can you show that audits lead to lasting improvements rather than one-off actions?
- 04How are complaints recorded, answered and shared with staff so that problems do not happen again?
- 05What has changed in the management team since the previous inspection, and how are you monitoring leadership consistency?
This was a focused inspection of Safe and Well-led only; the other three question ratings were not reassessed in this report. This explanation was written from the published report of 7 June 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The White Lodge
6 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- November 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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