CQC report explained · a residential care home
What the CQC found at Whitestone Lodge
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2023
Rated Inadequate and placed in special measures; inspectors found serious safety and leadership failures despite kind staff and enough staff on duty.
Inspectors visited on 20 and 26 July 2023. The first visit was unannounced and the second was announced. They spoke with people, a family member and staff, and checked care, medicines, recruitment and management records.
The home was not safe or well-led. Risks were not always assessed or managed. Medicines records were unsafe, staff training was incomplete, complaints were not properly handled, and records were often missing, inaccurate or insecure.
Inspectors also found some positive care. Staff were kind and respectful, people had enough food and drink, activities were offered, and there were enough staff on duty. However, these positives did not outweigh the serious shortfalls.
The overall rating fell from Requires Improvement at the previous inspection to Inadequate. The home was placed in special measures. CQC said it would monitor progress and re-inspect, usually within six months.
Kind staff
People and relatives described staff as kind, patient and respectful during care and support.
“People and family members complemented staff on their kind and caring approach.” from the report
Staffing levels
Inspectors found enough staff on duty to meet people's needs. Recruitment checks, including DBS checks, were completed.
“There were enough staff on duty to meet people's needs.” from the report
Activities and visitors
People were offered individual and group activities, outings and support to keep in touch with family and friends.
“People were offered both one to one and group activities, including arts and craft and gentle exercises.” from the report
Environment
The building had communal areas, adapted facilities and personalised bedrooms to support mobility and independence.
“The environment was decorated to a good standard throughout and there were aids and adaptations to help people with their mobility and independence.” from the report
Unmanaged risks
seriousSome health conditions did not have risk assessments or clear management plans. Monitoring of fluids, equipment and emergency evacuation needs was also incomplete.
“Risks to people's health, safety and welfare was not assessed, monitored, and managed.” from the report
Medicine safety
seriousPRN medicines did not always have the right guidance or administration records. The report says this could affect safe intervals and safe use.
“Medicines were not always managed safely.” from the report
Staff training
seriousThere were significant gaps in staff training. Staff carried out clinical observations without training on how to recognise deterioration and escalate concerns.
“Staff did not receive the necessary training and support for their roles.” from the report
Care planning
needs fixingSome people had no initial assessment or care plan, and plans were not always updated when needs changed. People and families were not always involved.
“There was a lack of a person-centred approach to planning people's care.” from the report
Complaints
needs fixingThe complaints procedure had not been reviewed since 2015. Several complaints were not recorded, so there was no evidence that they had been properly investigated or answered.
“The provider failed to put in place and operate an effective complaints procedure.” from the report
Poor oversight
seriousAudits and checks did not identify or fix important problems. The provider had not made enough improvement after the previous inspection.
“The systems in place for assessing, monitoring and improving the quality and safety of the service were inadequate.” from the report
- 01What immediate changes have been made to assess and manage each resident's health and safety risks?
- 02How are PRN medicines now recorded, and how do you make sure they are given at safe intervals?
- 03Which staff have completed the training needed for residents' specific health and mental health needs?
- 04How are residents and families now involved in creating and reviewing care plans?
- 05What action has been taken in response to the warning notice and the previous inspection findings?
This inspection looked at all five key questions and infection prevention and control, following concerns about people's safety and the leadership of the home. This explanation was written from the published report of 27 September 2023 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 2022
Whitestone Lodge was Rated Requires Improvement; inspectors found kind and effective care but weaknesses in records, reviews and management checks.
The inspection was unannounced and took place on 18 and 24 May 2022. One inspector spoke with people, family members, staff, the manager and provider, and checked care plans, medicines records and management records.
People and families spoke positively about the care. Inspectors found enough staff, a clean home, good support with health needs, kind interactions and care that was generally personalised.
There were important gaps in record keeping and care plan reviews. Some records did not show that risks were being monitored, medicines records were not always complete, and checks on the quality and safety of the home had not been done routinely.
The overall rating was Requires Improvement. Effective, Caring and Responsive were rated Good. Safe and Well-led were rated Requires Improvement. This was the first inspection since the service registered under a new provider name.
Kind, respectful care
People and families described staff positively. Inspectors found that staff built good relationships, respected people's dignity and took time to get to know them.
“It was clear from observations we made and comments from people and family, that staff chatted with people and took time to get to know them.” from the report
Enough staff
Inspectors found there were enough staff to meet people's needs. People and families said staff were available and did not seem rushed.
“There were enough staff to meet people's needs and keep them safe.” from the report
Clean and infection-aware home
The home was visibly clean and hygienic. Staff had infection-control training, enough protective equipment and arrangements for safe visiting during COVID-19.
“The home was visibly clean and hygienic.” from the report
Good health support
Staff recognised changes in people's health and referred them to health and social care professionals in a timely way. They acted on advice received.
“Staff completed referrals to appropriate services when people's needs changed and acted upon advice given by external professionals” from the report
Out-of-date and incomplete risk records
seriousSome care plans and risk assessments had not been reviewed since January 2022. Records did not always show that required monitoring, such as food intake or movement, had been completed.
“We found no evidence that people had been harmed. However, there was a failure to ensure that records relating to risk assessment, monitoring and management were in place, up-to-date and person-centred.” from the report
Medicine records
needs fixingRecords did not always show where pain patches had been placed, making it unclear whether sites had been rotated. Plans for medicines given when needed did not always explain clearly when they should be used.
“However, recording of topical medicines such as pain patches were not always completed accurately to show where they had been placed.” from the report
Weak management checks
seriousAudits and checks were not being completed regularly enough to identify problems or make sure care quality improved. Accidents and incidents were recorded, but managers were not analysing them for patterns.
“Governance systems were not routinely used to check the quality and safety of the service or formally engage with people, family members or staff.” from the report
Staff training and supervision
needs fixingStaff had not received training in some relevant areas, including diet and nutrition, oral hygiene and challenging behaviours. Formal staff supervision had not taken place since the previous manager was in post.
“Staff had not received training in areas such as diet and nutrition, oral hygiene and challenging behaviours.” from the report
No registered manager at the inspection
needs fixingThe home had been without a registered manager since September 2021. A new manager had started during the inspection but had not yet registered with CQC.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01How have you made sure every care plan and risk assessment is now reviewed and kept person-centred?
- 02How do you record monitoring such as food intake, movement to prevent pressure sores and the use of pain patches?
- 03What regular audits and checks are now in place, and who reviews accidents and incidents for patterns?
- 04Have all staff received training in diet and nutrition, oral hygiene and behaviours that staff may find challenging?
- 05Has the new manager registered with CQC, and have staff supervision and appraisal meetings restarted?
This was an unannounced inspection of the care home covering all five key questions, including infection prevention and control; it was the first inspection since registration under the new provider name. This explanation was written from the published report of 5 July 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.
Every inspection of Whitestone Lodge
4 rated inspections over 8 years: the service has slipped, from Good to Inadequate.
- September 2023Inadequatecurrent ratingdown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2022Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- October 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2020
Registered with the Care Quality Commission on 10 June 2020.
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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At least 100 live-in carers within about an hour of Knowsley
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 91 can care for a couple. 10 years' experience on average.
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.