Archived: White Lodge

White Lodge is a four-bedded residential care home that was providing personal care to people who have a learning disability, sensory impairment and physical disability and health care needs. There were four people living at the service at the time of the inspection.

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

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The culture in the home was not risk adverse. People received their medicines as prescribed and there were safe medicines administration systems in place. The home was clean and tidy, and staff were trained in infection control. The provider had processes in place to learn from incidents and accidents and to ensure that the people were supported safely.

We observed sufficient staffing levels during the inspection and saw staff were unhurried in their interactions with people. The provider had appropriate policies and systems in place to protect people from abuse. Staff received regular support and supervision and were trained to meet the needs of people living at the service.

Comprehensive care plans mostly identified people's needs and the choices they had made about the care and support they received. The provider supported staff to deliver care and support in line with best practice guidance and to support good outcomes for people. The service worked with other organisations to ensure they delivered joined-up care and support and people had access to healthcare services when they needed it. People were encouraged to maintain a healthy, balanced diet, based on their individual dietary needs.

There was a strong emphasis on person-centred care. Staff were friendly and caring when supporting people. Staff spoke about people with genuine interest and affection. Staff understood that some people had difficulty communicating their needs and wishes and proactively supported them using their preferred communication methods. People were supported using their preferred communication methods to be involved in making decisions about their care.

People were supported with individualised activities. The provider was proactive in their exploration, and use, of technology to support people to maintain contact with friends and family, their independence and to be engaged.

The provider had an ‘open-door’ culture and staff were positive about the registered manager. The registered manager demonstrated an open and positive approach to learning and development. There were robust quality assurance procedures in place to help drive ongoing improvements. Staff were encouraged to regularly feedback about service delivery and share ideas and suggestions on how the service could be improved.

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 20 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service is situated in the residential area of Bordon. All the people living at White Lodge had either no independent mobility or it was restricted by physical disability. There were a range of suitable adaptations and mobility aids specifically designed to support people both in the service and community.

At the last inspection the service was rated good. At this inspection the rating remained good.

We carried out a comprehensive inspection of White Lodge on 21 May 2017. This was an announced inspection. We told the provider two days before our inspection visit that we would be coming. This was because we wanted to make sure there would be staff and people to speak with and access to records.

Most people had lived at the White Lodge for several years and staff knew the people they supported well. The registered manager took an active role in the running of the service. They were supported by a core staff team who had worked at the service for some time.

People had complex needs with limited verbal communication skills so we spent time observing people and their interactions with staff. The atmosphere at White Lodge was calm and friendly. Interactions between staff and people were kind and supportive. Staff described to us how they worked to support people to make day to day choices and enable people to lead a quality of life within the constraints of individual disabilities.

There were sufficient numbers of suitably qualified staff to keep people safe. Recruitment practices helped ensure staff were fit and appropriate to work in the care sector. Staff received an induction when they first started work which included training in areas identified as necessary for the service. This included training in safeguarding and staff knew how to recognise and report abuse. They were confident the registered manager would take any concerns they had seriously.

The premises were well maintained, pleasant and spacious. People’s bedrooms had been decorated and furnished in line with their personal preferences. Risks associated with the environment had been identified and action taken to minimise them.

People were supported to do things they enjoyed and keep in touch with those people who were important to them. Risks to people's safety were understood by staff and people benefited from receiving care and support which took into account their health and welfare. Staff understood what actions to take if they had any concerns for people's wellbeing or safety. Risk assessments had been developed to minimise the potential risk of harm to people who lived at the service. These were kept under review and were relevant to the care and support people required.

While people had complex needs which affected their ability to communicate their likes and dislikes, staff took the time to find out about the person. This meant people living at White Lodge were supported to lead fulfilled lives which reflected their individual preferences and interests.

There were enough staff available to make sure everyone was supported according to their own needs. Staff told us they loved their jobs and felt they had all the support they needed to carry out their role. They told us, “Been here for many years and seen the changes for the better. Everybody has a really good quality of life and lots of opportunities to enjoy that life,” and “It’s a very special job and I love it.”

Everybody living at White Lodge required support to take their medicines. Where required people were supported to take their medicines so they would remain well. Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required to administer medicine safely.

Staff were observed to be very attentive and available to people. They did not restrain people or prevent them from doing what they wished. For example one person wanted to have a ‘lie in’. Staff respected this but ensured the person was checked regularly for their comfort.

We observed staff encouraged people to engage in meaningful activity and spoke with them in a friendly and respectful manner. Where a person was upset staff members were able to engage with them and focus on another activity and give them some ‘space’ for down time. This helped calm the person in their own time. It demonstrated staff knew the person well and how to manage an event in a calm and controlled way.

There were systems in place to record accidents and incidents and take appropriate action when required.

Where people did not have the capacity to make certain decisions, the service acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff had a good understanding of the principles of the legislation and training was updated as necessary.

People had access to healthcare professionals and their healthcare needs were met. The service had responded promptly when people had experienced health problems. People were treated with dignity and respect and independence was promoted wherever possible.

There was clear and open communication between the registered manager and staff, so staff knew what was expected of them. Checks were undertaken on the quality of the care by the registered manager and overseen by the operational manager in order to ensure the service was operating safely, effectively and was responsive and well led. These areas formed the principles by which the service operated. The registered manager and provider made sure there was a focus on continuous development of the home.

We found people's care and support were effective and based on thorough assessments and detailed plans. Care and support were delivered effectively and in a caring manner. People consented to their care, and staff were aware of the procedures to follow if people did not have capacity to make decisions. Staff took suitable precautions to maintain standards of cleanliness and hygiene and to protect people from the risk of the spread of infection. People received their medicines when they needed them and there were effective procedures to store and record medicines in a controlled way.