Archived: White Lodge Centre

White Lodge Centre is a domiciliary care agency providing personal care to 21 children and younger adults who may have a learning disability, autism or physical or sensory impairment. The service was based as part of a larger service which included other day centre activities, short term respite care and a combination of other services regulated by Ofsted.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The registered manager admitted the standard was not quite as high as the previous inspection. She had a long period of leave and had recently returned to manage the service two months before the inspection. However, the standard was still good in all areas and people’s responses throughout the inspection were noted to show limited impact of this change since the last inspection.

The correct numbers of staff were being deployed to the correct amount of people receiving support. Staff shortages were being addressed by recruiting new staff and safe recruitment processes were in place for this process. Any impact on people using the service due to shortages were being addressed as quickly as possible.

People and relatives told us they felt safe. The provider had a safeguarding policy and staff knew what signs to look for and who to contact if they saw signs of abuse. People had risk assessments to identify possible risks and advise staff on how to manage them.

Staff were supported with regular training to ensure their knowledge remained of a high standard to meet the care needs of the people they were supporting.

People were supported with maintaining their health and had support to access health care professionals. Care plans were personalised and people were encouraged to make choices. Staff got to know people well and understood their preferences.

Staff were kind, compassionate and caring. They treated people with respect and dignity by giving them choice and promoting their independence.

The registered manager was open to suggestions from people, relatives and staff and was committed to making improvements. There was a complaints procedure in place.

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 outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 Outstanding (published 10 February 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 inspection took place on 13 December 2016. We gave the provider 48 hours' notice because they provide a domiciliary service and we wanted to make sure someone would be available.

The last inspection took place 16 September 2013 when we found no breaches of Regulation.

White Lodge Centre is a domiciliary care agency providing personal care and support to children and young people living in Surrey. The children and young people had a range of different disabilities including autism, physical disabilities and learning disabilities. The service provides support with personal care, learning independent living skills and pursuing leisure and social activities. At the time of the service 25 children and young people were using the service. The provider was in the process of extending the service to offer support to young adults aged 18 to 25 years.

White Lodge Centre was run by a provider of the same name who was a charitable organisation. The provider ran a number of different services for children, young people and adults from the same site. These included a nursery, holiday play schemes and a short stay unit which were all registered and inspected by Ofsted, various therapy services and a resource centre for adults. The different services could use the facilities at the site, which included a sensory room, a hydrotherapy pool, outdoor and indoor play equipment and an accessible kitchen.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

The parents of the young people and children using the service were happy. They felt the staff were well trained, caring, kind and knew the needs of their relative well. The provider had gained feedback from the young people and they had shown they were happy with the support they received and liked the staff.

People were safe. The staff ensured that people felt safe and protected. They assessed risks to people's well-being. Medicines were administered in a safe way by trained staff. There were procedures designed to protect people from abuse and the staff had a good understanding of these.

People were able to make choices about their care and support and these choices were respected. The parents and guardians had been involved with planning and reviewing care and had consented to this in accordance with the requirements of the Mental Capacity Act 2005. The staff had a good understanding of people's health and nutritional needs and worked in partnership with the families, schools and other professionals to make sure needs were well met.

The staff were well trained and supported. They were able to contribute their views about the service and ask for additional training if they needed. There were enough staff to support people and they were recruited in a way which ensured they were suitable to work with vulnerable children and young people.

The young people received support and care which was extremely person centred. Care packages were developed with the young person and considered their preferences and what they wanted to achieve from the service. Their achievements were rewarded and they were helped to plan and fulfil their own goals which took account of their interests as well as changes in their lives as they grew into young adults. The provider was very responsive to identified needs planning and providing additional services where the local authority, parents or young people had made a specific request.

The registered manager was involved with the day to day care and support of the young people. They worked alongside staff and had an excellent knowledge of the people using the service and their families. They were committed to continuous improvements, encouraging people using the service, families and staff to analyse the work and be involved with planning for the future. The provider was very caring and demonstrated genuine commitment towards the young people and their families, looking at ways to offer support for young adults who had used the service as a child.

Feedback from the local authority and other professionals was very positive about the provider, the registered manager and the service for each person.

The provider had thought of innovative ways for encouraging the young people to contribute to their care planning, to feel involved and to feel valued.

Parents told us that staff asked for their consent before providing any care or support. One parent told us they had 'No issues' about consent.

We saw that children's and young people's care needs were assessed and recorded in their support plans and that care was regularly reviewed. Parents told us that they were happy with the care their children received. Parents told us the care was 'Excellent' and 'Overall it is very good'.

We looked at six staff training and supervision records and noted that all staff had received up to date training. We saw that four of the six staff had received recent supervision and dates were booked for future supervision meetings.

We saw that the provider had systems in place to monitor the quality of their services. We spoke with parents who told us that they were able to give feedback. One parent told us that they completed a survey a few months ago and that White Lodge Centre 'Communicates well'.

We saw that the provider had a complaints policy and that information about how to complain was available to people in a format that met their needs. We noted that complaints and concerns were recorded and dealt with appropriately.

We looked at care records and spoke with parents and carers of children and young people who received personal care. Parents and carers told us that staff treated their children with respect and dignity. One parent said 'Yes, they do, absolutely'.

We saw that care records were up to date and people told us they had been involved in planning their children's care and that staff reviewed care plans regularly.

We saw that infection control systems were in place and staff were trained in infection control procedures. Parents and carers told us they had no concerns about cleanliness. One parent told us 'Yes. Hygiene is observed. They leave everything clean and tidy'.

We looked at six staff records and saw that staff had received mandatory training and that most training was up to date. For example, infection control, fire safety and moving and handling.

We noted that not all staff had received regular supervision. We were told that bank staff did not receive appraisals however, we noted that all permanent staff had received a recent appraisal.

The registered manager told us that there were no complaints at the time of our visit. However, we were informed by a parent of a problem that had not yet been resolved and they were very dissatisfied.