Whitestone Lodge

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last inspection we rated this key question inadequate. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was previously in breach of the legal regulation in relation to governance. Not enough improvements were found at this assessment, and the service remained in breach of this regulation.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. For example, the provider did not always promote a positive and inclusive culture through learning following events or through formal supervisions with staff about their performance, training and development.

Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty. For example, due to previous breaches in service provision, we were not fully assured the provider had consistently maintained effective oversight of the service. The provider and registered manager continued to lack some understanding about their responsibilities in relation to risk management and governance.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. For example, staff told us they were confident about speaking up and felt they would be listened to. Family members told us they would confidently speak up on behalf of their relative.

The provider valued diversity in their workforce. For example, staff told us they felt valued and included. A member of staff provided an example of when they were supported to work flexibly to fit in with some personal circumstances.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. For example, although the quality and frequency of checks and audits had improved since the last inspection, there remained a lack of overarching governance, accountability and oversight. The provider and registered manager lacked understanding about their responsibilities to notify CQC about allegations of abuse. Other events such as accidents and incidents were not analysed to identify establish the cause and if any lessons could be learnt and shared with staff to prevent a recurrence. The provider and registered manager did not always identify and mitigate risks to people’s safety. For example, people were placed at risk of entering areas of the home which were unsafe and when we discussed this with the provider, they dismissed this as a potential risk to people’s safety. There was a lack of individual formal staff supervisions and appraisals to ensure staff received support, guidance, and ongoing development for their role and an annual review of their performance.This was a breach of Regulation 17 (good governance).

The provider not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. However, people’s care records evidenced partnership working with external healthcare professionals including dieticians and community nursing teams.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. For example, learning did not take place following events such as accidents and incidents. No analysis of accidents and incidents had taken place with the goal of improving future incident management and preventing recurrence. The provider had an action plan detailing areas for improvement, however, they had been heavily reliant on partner agencies including the local authority quality and improvement team for its development and implementation. Although improvements had been made since our last inspection progress had been slow and was ongoing.