CQC report explained · a residential care home
What the CQC found at White Lodge & St Helens
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by safeguarding procedures, risk assessments, suitable staffing and safe recruitment. Medicines were managed safely overall, but some staff competency checks were overdue.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. People and relatives nevertheless told inspectors that care was kind, comfortable and based on people's preferences.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The report says people received individual care and that their views were listened to.
- Well-led?
- Good
- Inspectors found clear management arrangements, useful audits and a culture where people, relatives and staff could give feedback. Staff said the home was becoming more settled after earlier management changes.
What inspectors found, December 2022
White Lodge & St Helens was rated Good; inspectors found safe, kind care and effective management, with some medicines checks needing attention.
This was an unannounced, focused inspection on 16 and 17 November 2022. One inspector spoke with people, relatives and staff, and checked care records, medicines records, recruitment files, staffing rotas, incident records and quality checks.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe recruitment, suitable risk assessments and safe medicines systems. People and relatives said people felt safe, comfortable and well cared for by staff who knew them.
Some medicine competency checks for staff were overdue. The medicine room could also become too warm, although a fan was used and the home planned to buy air conditioning. The overall rating remained Good, but this was not a full inspection of all five areas.
Staffing and safety
Inspectors found enough staff on duty and observed staff responding promptly to people's needs. Recruitment checks were completed before staff started work.
“There were enough staff on duty to ensure people's safety.” from the report
Person-centred care
Staff knew people well and supported them in ways they preferred. Inspectors found care was individual and people were treated as individuals.
“People received individual, person centred care from staff who worked well together as a team for the benefit of people living at the home.” from the report
Risk management
Risks were assessed and reviewed, with detailed guidance for staff. Emergency evacuation plans were in place and shared areas were free from hazards.
“Risk assessments were personalised, detailed and gave staff clear guidance on ensuring people were supported safely.” from the report
Management and improvement
The home used audits, spot checks and incident reviews to monitor quality and share learning. People, relatives and staff felt listened to.
“There were effective systems in place to ensure views from visiting health professionals, people, relatives and staff were fully considered and acted upon.” from the report
Overdue medicines checks
needs fixingSome elements of medicine competency checks were overdue for some staff. The manager said these would be completed immediately after the inspection.
“Staff had received competency checks to make sure their practice remained safe, however for some staff, some elements of these checks were overdue.” from the report
Medicine room temperature
needs fixingThe medicine room occasionally became too warm. A fan was being used, and the home said it would buy a small air conditioning unit.
“Occasionally the medicine room became too warm, there was a fan in the room to manage the temperature when this happened.” from the report
Recent management changes
minorThe home had experienced a high level of management change during the previous year, which had unsettled staff. Inspectors found staff were becoming more settled by the time of the visit.
“During the previous year the service had gone through a high period of change regarding their management team. This had led to some unsettlement with the staff team.” from the report
- 01Have all medicine competency checks been completed and brought up to date since the inspection?
- 02Was the planned air conditioning installed, and how are medicine room temperatures now monitored?
- 03Are staffing levels still adequate, and how much agency staff is currently being used?
- 04What are the current ratings or evidence for Effective, Caring and Responsive, which were not inspected during this visit?
- 05How has the home maintained stability in the management team since the period of change described in the report?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection published on 11 July 2018. This explanation was written from the published report of 2 December 2022 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, July 2018
Rated Good; inspectors found kind, safe and personalised care, with some records needing immediate correction.
This was an unannounced comprehensive inspection on 23 and 24 May 2018. Inspectors spoke with people, relatives, staff and health professionals. They observed care and checked care records, medicines, staffing, training, the building and management systems.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and well cared for. Inspectors found enough staff, suitable training, safe medicine storage, personalised care and a friendly culture.
There were some problems with records and the environment. Five malnutrition assessments had been completed incorrectly, some fluid records were not totalled, some cream body maps were missing, and one care plan was out of date. The manager took immediate or planned action during the inspection.
The previous inspection in February 2017 had found shortfalls in staffing and quality checks. Inspectors said the provider had made a large number of improvements, including increasing staffing, expanding activities and introducing quality monitoring systems.
Staffing improved
Inspectors found enough staff on each shift to provide safe, individualised care. This was an improvement on the previous inspection.
“Throughout this inspection we observed there were enough staff on shift to ensure people received safe, individualised care that promoted and maintained their well being.” from the report
Kind and respectful care
Staff knew people's preferences and treated them with patience, warmth and respect. Inspectors saw people being supported without being rushed.
“Staff interacted with people in a friendly and unrushed manner and were able to explain how people preferred their care to be given.” from the report
Personalised activities
The home used people's histories and interests to plan activities. There was a full daily programme, including music, entertainers, quizzes, puzzles and gentle exercise.
“Activities covered a wide range of subjects and included visits from independent entertainers, musicians and the opportunity to take part in quizzes, puzzles and gentle exercises.” from the report
People could raise concerns
People knew how to complain and felt confident that concerns would be listened to and dealt with.
“People's views were sought. They felt they could raise a concern if required and were confident that these would be addressed promptly.” from the report
Improvement since the last inspection
The provider had increased staffing, expanded activities and introduced a wider range of quality checks after shortfalls were found in February 2017.
“At this inspection we found the provider had made a large number of improvements to ensure compliance with the regulations.” from the report
Malnutrition assessments
needs fixingFive malnutrition assessments were completed incorrectly. The manager acted immediately and introduced a revised system, but this was a safety-related record-keeping weakness at the time of inspection.
“We checked five of these assessments and found they had been incorrectly completed.” from the report
Covert medicines records
needs fixingFor three people receiving medicines hidden in food or drink, there was initially no record that a pharmacist had confirmed the medicines were safe to crush or disguise. The manager contacted a pharmacist during the inspection and obtained detailed records.
“There was not a record showing the pharmacist had advised the medicines were safe to be crushed or administered in food and/or drink.” from the report
Incomplete fluid records
needs fixingSome people's daily fluid records had not been totalled. Inspectors said this could make it difficult to identify a risk of dehydration, and the manager said this would be raised with staff.
“We observed some people's fluid records had not been totalled up at the end of each day.” from the report
Care records not always current
needs fixingOne person's care plan did not reflect their current health needs. It was updated immediately after inspectors raised this.
“One person's care plan had not been updated to reflect their current health needs.” from the report
Missing cream body maps
minorSome people did not have completed body maps to guide staff when applying prescribed creams. The manager said these would be completed as soon as possible.
“However, some people did not have completed body maps in place.” from the report
Unpleasant odour
minorInspectors noticed a strong unpleasant odour in some areas when they arrived. The manager said work was already under way to address it.
“When we started the inspection we noticed some areas of the home had a strong unpleasant odour.” from the report
- 01How are you now checking that malnutrition assessments are completed correctly?
- 02How do you confirm that medicines given covertly are safe to crush or mix with food or drink?
- 03How do you make sure fluid records are totalled and acted on when someone may be at risk of dehydration?
- 04How often are care plans and cream body maps checked and updated?
- 05What action was taken about the unpleasant odour found in some areas of the home?
This was an unannounced comprehensive inspection covering the premises, care and all five CQC questions, and it also checked improvements required after the February 2017 inspection. This explanation was written from the published report of 11 July 2018 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 White Lodge & St Helens
4 rated inspections over 7 years: the service has held its Good rating throughout.
- December 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- April 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 January 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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