CQC report explained · a residential care home
What the CQC found at Waterloo House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, August 2022
Waterloo House is rated Requires Improvement; inspectors found kind, responsive care but risks, premises and management systems needed improvement.
This was an unannounced focused inspection on 5 July 2022. Inspectors spoke with people, relatives, staff and health professionals. They reviewed care records, medicines records, staffing information, training records and policies.
People said they felt safe and cared for. Staff were described as kind and skilled. Medicines were managed safely, staffing levels were considered sufficient, people's health needs were supported, and activities and relationships were encouraged. The responsive rating was Good.
There were important problems with the building, fire safety, risk assessments, care records and management checks. The home had been served a fire enforcement notice covering nine areas of non-compliance. The overall rating fell from Good at the previous inspection to Requires Improvement.
Staffing and recruitment
People said there were enough staff and that staff responded promptly. Recruitment checks were completed and the home did not use agency staff.
“People told us they felt that there were sufficient staff on duty at all times. People told us, and we saw, staff responded in a timely manner when people called for assistance.” from the report
Medicines
People received medicines as prescribed. Staff were trained and records were completed appropriately.
“People received their medicines as prescribed by their doctor. Staff were competent in the safe management and administration of medicines.” from the report
Health support
Staff worked with health professionals and made timely referrals when they had concerns about people's health and wellbeing.
“Staff were proactive in making timely referrals to health professionals when they had concerns around people's health and well-being.” from the report
Activities and relationships
People were supported to follow their interests, go out, and keep in touch with relatives and friends.
“People were encouraged to be involved in the interests and activities that they enjoyed.” from the report
Action after inspection feedback
The manager acted promptly on the garden access risk by installing a temporary ramp and a new handrail, and updating risk assessments.
“The manager promptly acted on feedback from the inspection to ensure that people were not placed at unnecessary risk” from the report
Incomplete risk assessments and care guidance
seriousSome falls risks had not been assessed. Care plans did not always explain how staff should support people when they became anxious or distressed, which could lead to inconsistent care.
“People's risk in areas such as falls had not always been assessed.” from the report
Weak management checks
seriousThere were no formal audits, and records were sometimes inaccurate or not detailed enough. The provider's systems had not identified several problems with risks, the environment and fire safety.
“The providers systems and processes had not identified that daily care records were not sufficiently detailed and did not always accurately report on the care and support provided by staff.” from the report
- 01What work has been completed to address the nine fire safety failures and the fire enforcement notice?
- 02Has the temporary garden ramp been replaced with a permanent safe solution?
- 03How are falls risks and risks linked to anxiety or distressed behaviour now assessed and recorded?
- 04What formal audits are now in place to check care records, incidents, risks and the condition of the premises?
- 05Who is currently responsible for managing the home, and has the manager applied to become registered with CQC?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected, and the overall rating also used the previous rating for any key question not inspected. This explanation was written from the published report of 20 August 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, December 2020
Waterloo House was rated Good; inspectors found safe, well-managed care, with some staff training and management arrangements still being followed up.
This was a focused inspection after management changes. It took place on 17 November 2020, with a video call on 16 November. One inspector spoke with eight people and five staff, and reviewed care, staff and management records.
The home was rated Good for Safe and Well-led. People said they felt safe and were happy with the service. Inspectors found suitable safeguarding, risk assessment, medicines and infection control arrangements. Staff were described as kind and helpful.
The home had systems to monitor quality and manage accidents, care records and medicines. Some recently recruited staff had not yet completed safeguarding training. The manager had applied to register with CQC, but the application was still being assessed.
This inspection only assessed Safe and Well-led. The other three ratings were not assessed during this visit. The overall rating remained Good, the same as at the previous inspection.
People felt safe
People said they felt safe and were confident staff would respond if they raised a concern.
“People we spoke with said they felt safe.” from the report
Safe medicines systems
Medicines were stored securely, records were complete and staff had appropriate training. Inspectors also saw respectful support when people took their medicines.
“Medicine records were fully completed and were tidy.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infection during the pandemic.
“We were assured that the provider was using PPE effectively and safely.” from the report
Positive atmosphere
Inspectors observed a warm and friendly atmosphere. People and staff spoke positively about the management and the staff team.
“On the day of the inspection visit, we felt there was a comfortable, warm, friendly atmosphere at the service.” from the report
Quality monitoring
The home used checks covering areas such as care planning, maintenance, accidents, cleanliness, staff training and medicines.
“There were suitable systems to check standards about care planning, maintenance, accidents and incidents, cleanliness, staff training and medicines.” from the report
Safeguarding training
needs fixingMost staff had safeguarding training, but some recently recruited staff had not. The manager said there was a plan to complete this training.
“The majority of staff received safeguarding training, although some of the staff recruited recently had not.” from the report
Manager registration
minorThe manager was not registered with CQC at the time of the inspection. An application had been submitted and was being assessed.
“The current manager was not registered with the Care Quality Commission.” from the report
Night-time bedroom checks
minorOne person disliked staff opening their bedroom door during night checks. The manager said the procedure would be reviewed and people might be able to opt out where risks were low.
“One person told us they did not like staff opening their bedroom door at night, when completing night time checks.” from the report
- 01Have all recently recruited staff now completed safeguarding training?
- 02Has the manager's CQC registration application been approved?
- 03What changed after the review of night-time bedroom checks?
- 04How are people involved in decisions about activities and going out?
- 05How does the home keep relatives updated when visits are restricted?
This was a focused inspection of Safe and Well-led, including infection prevention and control; Effective, Caring and Responsive were not assessed and their ratings were not given in this report. This explanation was written from the published report of 16 December 2020 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 House
7 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- August 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2020Goodstayed GoodSafe: GoodWell-led: Good
- January 2019Goodstayed GoodWell-led: Good
- April 2018Goodup from Requires improvementSafe: GoodEffective: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- December 2016Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 20 April 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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9 live-in carers within about an hour of Plymouth
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
8 can care for a couple. 9 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.