CQC report explained · a residential care home
What the CQC found at Waterloo Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, medicines were handled safely, staffing met people's needs, and infection control arrangements were effective.
- Effective?
- Good
- This key question was not inspected during this visit. Ratings for key questions not inspected were taken from the previous inspection when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. Ratings for key questions not inspected were taken from the previous inspection when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this visit. Ratings for key questions not inspected were taken from the previous inspection when calculating the overall rating.
- Well-led?
- Good
- Inspectors found effective audits, clear staff responsibilities and a positive culture. People, relatives and staff spoke positively about the management.
What inspectors found, September 2022
Waterloo Care Home rated Good; inspectors found safe, kind care and better management than at the previous inspection.
Inspectors visited without warning on 16 and 17 August 2022. They spoke with people, relatives and staff, observed care, and checked care plans, medicines records, recruitment files and management records.
The home was rated Good for safe care and for being well-led. Inspectors found that risks, medicines, staffing, safeguarding, fire safety and infection control were managed safely. People and relatives described kind care and an approachable manager.
The rating improved from Requires Improvement at the previous inspection in 2019. The provider had fixed the earlier record-keeping problems and was no longer in breach of Regulation 17.
Risks and medicines managed
Risk assessments gave staff clear instructions, and medicines records matched stock balances. Staff were trained to administer medicines safely.
“Medicines records were complete and matched stock balances.” from the report
Kind and respectful care
People and relatives said staff knew people well. Inspectors saw staff treating people with dignity and respect.
“Staff interacted with people in a kind and considerate manner, treating them with dignity and respect.” from the report
Improved management
Audits were up to date and used to identify actions and improvements. The earlier record-keeping breach had been resolved.
“Improvements had been made and quality assurance systems were operating effectively.” from the report
Positive culture
People, relatives and staff described the home as supportive and approachable. Visiting arrangements and contact with families were maintained during COVID-19 restrictions.
“People, relatives and staff spoke positively of the culture within the home.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you check that the improvements to care records are being maintained?
- 02How do you make sure staffing levels remain right when people’s needs change or agency staff are needed?
- 03How are people’s medicines reviewed, especially where someone administers their own medication?
- 04What activities and community links are now available following the appointment of the activity coordinator?
- 05How do you use feedback from people and relatives to make further improvements?
This was a focused inspection of Safe and Well-led; the other key-question ratings were not inspected during this visit and the report says previous ratings were used to calculate the overall rating. This explanation was written from the published report of 10 September 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2019
Rated Requires Improvement; inspectors found kind, person-centred care but gaps in risk records and quality checks.
This was an unannounced inspection on 19 and 20 June 2019. Inspectors spoke with people, relatives, managers and staff. They reviewed care files, staff records, medicines records, audits, complaints and the building.
People were generally treated with kindness and respect. Staff understood people's needs, supported their choices, provided suitable food and helped people take part in activities and community visits. Medicines, staffing and infection control were found to be safe.
The main problems were incomplete or out-of-date risk and care records. Managers' audits had not found these gaps. The home was rated Requires Improvement overall, with Safe and Well-led also Requires Improvement. Effective, Caring and Responsive were rated Good.
Kind and respectful care
People and relatives described staff as caring and friendly. Inspectors saw staff give calm reassurance and respect people's privacy and choices.
“People and their families spoke positively about the care.” from the report
Medicines
Medicines were ordered, stored and given by trained staff. Records included allergy information and guidance for creams and as-needed medicines.
“People had their medicines ordered, stored and administered by staff trained in the safe administration of medicines.” from the report
Staffing and training
Recruitment checks had been completed, staffing levels met people's needs and staff received induction and ongoing training.
“People told us their call bells were answered in good time.” from the report
Personalised support
Staff knew people's backgrounds, interests and preferences. People were supported to join activities and take part in their local community.
“People received person centred care by staff who had a good knowledge of people's care needs and lifestyle choices.” from the report
Risk records were not up to date
seriousSome risks, including falls, skin problems, malnutrition and swallowing, had not been reviewed or fully linked to care plans. The report said there was no evidence anyone had been harmed, but this reduced assurance about safety.
“Records relating to risks to people had not always been completed or updated.” from the report
Quality checks missed record gaps
seriousAudits had not identified that care plans and risk records were incomplete or overdue for review. This was a breach of Regulation 17.
“Accurate, complete and contemporaneous records were not kept about their care and treatment of people.” from the report
Dementia-friendly layout
minorThere was limited signage to help people living with dementia find their way. The colour of some furniture and flooring could make it harder for people with visual or cognitive impairments to move around safely.
“There was limited signage to aid people living with a dementia orientate themselves around the home.” from the report
Some care records conflicted
needs fixingRecords did not always reflect changing care needs, and a summary used at daily handovers was not accurate until it was updated during the inspection.
“Records were however not always reflective of people's changing care needs and different sources of record keeping were conflicting.” from the report
- 01How have you made sure every person's risk assessment is reviewed when their health or circumstances change?
- 02How do you now check that care plans and daily handover summaries are accurate and consistent?
- 03What action have you taken in response to the Regulation 17 breach, and can you show us the latest audit results?
- 04What changes have you made to signage, flooring or furniture to help people living with dementia or visual impairments move around safely?
- 05How do you ensure staffing levels continue to meet people's needs, especially during the additional 4pm to 10pm shift?
This was an unannounced inspection that considered all five CQC questions, with the previous Good ratings for Effective, Caring and Responsive retained and Safe and Well-led downgraded to Requires Improvement. This explanation was written from the published report of 25 July 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Waterloo Care Home
3 rated inspections over 6 years: the service has held its Good rating throughout.
- September 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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