20 July 2023
During an inspection looking at part of the service
Whitestone Lodge Care Home provides accommodation and personal care for up to 20 people in a converted building over two floors. At the time of our inspection 20 people were living at the service.
People’s experience of using this service and what we found
Risks to people’s health, safety and welfare were not always assessed, monitored, and managed to ensure their safety. A risk assessment had not been completed to determine the risk level and whether a risk management plan was needed for people with conditions which posed a potential risk to their physical and mental health.
Checks on the safety of the environment, utilities and equipment were not consistently completed. Records lacked instructions on the required frequency of checks, location of checks and who was responsible and had completed them.
Staff were confident about recognising and reporting abuse, however, a significant number of staff had not updated their safeguarding training. A number of allegations of abuse were raised with the relevant local authority, however, there were no records maintained to enable us to review what immediate action was taken to safeguard people.
There were no records to show an initial assessment of some peoples’ needs and choices had been completed prior to their admission to the service. Assessments were not always completed, and care plans were not always updated following a change in people’s needs.
Staff were not always appropriately trained for their role to enable them to meet people’s needs. There were significant shortfalls in the completion of training for staff. Staff were carrying out tasks without the right training, skills, and knowledge.
There was a lack of a person-centred approach to planning people’s care. Care plans were not in place to guide staff on people’s needs and choices and how they were to be met. Outcomes recorded in some peoples care plans were not personalised.
The providers complaints procedure was not up to date and there was a lack of response to complaints received about the service. Complaints were not acknowledged, investigated, responded to, and used to improve the quality of care.
The provider lacked understanding of their role and responsibilities and regulatory requirements. The provider failed to act on and make improvements following the last inspection. There were no clear lines of responsibility for ensuring oversight of auditing systems and processes. Audits and checks were inconsistent and ineffective, they failed to identify risk and bring about improvements. Records relating to people’s care and the management of the service were not always maintained, accurate and securely stored.
Staff were caring and kind towards people when providing them with care and support.
Rating at last inspection and update
The last rating for this service was requires improvement (published 5 July 2022).
Why we inspected
The inspection was prompted in part due to concerns received about people’s safety and the leadership of the service. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection.
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 Whitestone Lodge on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to people’s safety, staffing, complaints and the governance and leadership of the service.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or varying the conditions of the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.