This inspection took place on 22 November 2017 and was unannounced. The last Care Quality Commission (CQC) comprehensive inspection of the service was carried out in July 2015. At that inspection we gave the service an overall rating of ‘good’.

Since that inspection, services operated by the provider had been subject to a period of increased monitoring and support by commissioners. As a result of concerns raised about other locations operated by the provider, the provider is currently subject to a police investigation. There have been no specific safeguarding or criminal allegations made about White Lodge. However, we used the information of concern raised by partner agencies about this provider to plan what areas we would inspect and to judge the safety and quality of the service at the time of the inspection. Since May 2017, we have inspected a number of Sussex Health Care locations in relation to concerns about variation in quality and safety across their services and will report on what we find.

White Lodge is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. White Lodge accommodates eight people with a learning disability in one adapted building. At the time of this inspection seven people were using the service.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC 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 2008 and associated Regulations about how the service is run. At the time of this inspection the registered manager was absent from the service. The provider had put arrangements in place to ensure there was adequate day to day management of the service in the registered manager’s absence. They had also increased their monitoring of the service to check that these arrangements remained appropriate.

Some aspects of the service had deteriorated since our last inspection, resulting in the overall rating for the service changing from ‘good’ to ‘requires improvement.’ Staff had not received all the support they needed to deliver effective care to people. They were not provided with training to meet the specialist needs of people using the service. Staff had supervision (one to one meetings) with senior staff to help them improve their working practices and the quality of support provided to people However they told us the frequency of these meetings could be improved.

Systems in place to assess, monitor and review the quality and safety of the service, were not always effective. The provider had not identified or addressed issues we found about some aspects of the service. They had not used learning from recent inspections of other Sussex Health Care locations to improve working practices at White Lodge. However checks of other aspects of the service had been undertaken to ensure these areas continued to be well managed and safe. The provider had plans to address some of the shortfalls we found but it was too early at this time to judge how these would lead to improved outcomes for people.

Some parts of the environment were clean and hygienic. However some areas of the environment would have benefited from additional and more thorough cleaning. There was a lack of personalisation in communal areas such as the living and dining room, but people’s rooms had been decorated and personalised to their preference. The provider had continued to maintain a servicing programme of the premises and the equipment used by staff to ensure those areas of the service covered by these checks did not pose unnecessary risks to people. After our inspection the provider arranged for a deep clean of the environment to be undertaken. They also sent us their

We visited White Lodge on July 2015. The inspection was unannounced. This was the first inspection of the service with this provider.

The service provides residential care and support for up to eight adults with a learning disability or learning spectrum disorder. At the time of our inspection seven people were using the service.

The service had a registered manager. 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 2008 and associated Regulations about how the service is run.

People at the service felt safe. Staff understood their personal responsibilities to report abuse and had completed relevant training. People’s needs were supported with appropriate risk assessments. There were sufficient numbers of staff to meet people’s needs and safe recruitment procedures were followed. Medicines were managed safely.

People were supported by staff with the knowledge and skills they required to carry out their role. Mental capacity assessments were completed to establish each person’s capacity to make decisions. Where it was necessary to deprive people of their liberty to deliver care and support the service had applied for authorisations under the Deprivation of Liberty Safeguards. People consented to care and support. People were supported to have a healthy diet and to maintain good health.

People and relatives commented positively about staff. People and their representatives were supported to express their views and were involved in making decisions about care and treatment. Staff respected people’s privacy and dignity.

People received personalised care. Care plans were person centred and covered a range of social and healthcare needs. Care plans and associated risk assessments reflected people’s needs, goals and preferences. People were encouraged to take part in activities to enhance their lives and reduce the risks of social isolation and loneliness. The service sought, listened and learned from feedback.

Staff spoke positively about the management team who had an open door policy if people, visitors of staff wanted to speak with them. The service had formal and informal systems of audits and reviews to monitor and assess the quality of service they provided.