CQC report explained · a residential care home
What the CQC found at Waterloo House Rest Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2020
Waterloo House Rest Home Limited is rated Good after improvements, with safe care and stronger management found.
This was a focused inspection on 14 July 2020. One inspector reviewed information, spoke with people, relatives, staff and managers, and checked medicines, risk records, staffing and management records.
The home supported 36 people at the time, within a 40-person residential care service. Inspectors found medicines were managed safely, risks were assessed, staffing was sufficient, and infection prevention arrangements were in place.
People and relatives described kind, approachable staff and said the home felt safe and comfortable. The home was also found to have clearer management responsibilities, better checks and a positive, open culture.
The overall rating changed from Requires Improvement to Good. This inspection only directly assessed Safe and Well-led. The other ratings were carried forward from the previous comprehensive inspection.
Medicines safety
Medicines management had improved since the previous inspection. Records and practices were checked daily, and staff had training and competence checks.
“There had been improvements to the way medicines were managed.” from the report
Enough staff
Inspectors found staffing levels were sufficient to meet people's needs. Staff were allocated to floors so they were nearby.
“There were enough staff deployed to meet people's needs.” from the report
Infection control
The home had protective equipment available, staff training and an infection control lead. Inspectors found national infection prevention guidance was being followed.
“The service followed the latest national guidelines relating to the prevention and control of infection.” from the report
Improvements since last inspection
The management team had been strengthened and there were clearer lines of auditing and accountability. Premises improvements included redecoration and a new passenger lift.
“There were now clear lines of auditing and accountability which had led to improved practices, for example in medicines management and care recording.” from the report
When-required medicine instructions
minorInstructions for when-required medicines were in place but inspectors said they could be more detailed to support a consistent approach. The manager said this would be addressed.
“although these could be more detailed to ensure a consistent approach.” from the report
- 01How detailed are the current instructions for when-required medicines, and how do you check staff follow them consistently?
- 02How are daily medicine checks recorded and reviewed now?
- 03How are individual risk assessments kept up to date when a person's needs or independence change?
- 04How do you make sure staffing levels remain enough on each floor, including during busy periods?
- 05What progress has been made with the planned electronic care recording system?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 7 August 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.
What inspectors found, May 2019
Waterloo House Rest Home Limited was rated Requires Improvement; inspectors found kind, personalised care but ongoing medicines and management problems.
Inspectors visited without notice on 26 February and 6 March 2019. They spoke with people, relatives, staff and health professionals. They reviewed five care records, medicines records for all 25 people living there, and records about quality and safety.
The home was rated Good for Caring and Responsive. People were treated kindly, involved in their care and offered activities and choices. Food was generally well received, and staff worked with health professionals.
The home was rated Requires Improvement for Safe, Effective and Well-led. Inspectors found medicines were not always given as prescribed, records were incomplete and some staff applied creams without training. Risks, complaints and quality checks also needed better recording or follow-up.
The overall rating stayed at Requires Improvement, the same as at the previous inspection published in August 2018. Improvements had been made in staffing, training, mental capacity law and the building, but the provider still needed to show that improvements were consistent.
Kind and respectful staff
People said staff treated them with kindness and compassion. Inspectors saw positive interactions, patience and support for privacy and dignity.
“People told us they were comfortable with staff and treated with compassion and kindness.” from the report
Personalised care and choice
Care plans recorded people's histories, preferences and hobbies. People could make choices about daily routines and how they spent their time.
“People's care was tailored to meet their needs. Life histories had been completed to support this.” from the report
Activities and involvement
The home offered a range of activities and was developing more, including activities for people living with dementia. People and relatives were involved in care decisions and service meetings.
“The new enrichment officer was working to ensure a variety of events and activities, including for people living with dementia, was available.” from the report
Improved staffing arrangements
Inspectors found enough staff, quick responses to call bells and safer recruitment checks. Staff had training, supervision and appraisals.
“There was enough staff and call bells were answered quickly.” from the report
Food and healthcare support
People had food and drinks suited to their needs, with support when required. Staff worked with healthcare professionals to support people's health.
“People had enough food and fluids specifically tailored to meet their individual needs from trained staff who supported people when necessary.” from the report
Medicines were not always safe
seriousPeople did not always receive medicines as prescribed. Medicines records were incomplete, some creams were applied by untrained staff and the medicines policy was missing procedures.
“Medicines were not always managed safely and people had not always received their medicines as prescribed.” from the report
Risks needed updating
needs fixingSome people's risk assessments had not been updated when their needs changed. Equipment also briefly blocked corridors, including areas near fire exits.
“Risk people faced in their day to day lives had been assessed, however, we found some updates required.” from the report
Quality checks missed problems
needs fixingThe home's audits and checks had not always identified issues found during the inspection. These included medicines, care records and mattress settings.
“Audits and checks completed in the service had not always identified the issues we had during the inspection.” from the report
Some records were incomplete
needs fixingFinancial records did not always account for receipts, and some care decisions and complaints outcomes were not fully documented. The provider said it would address these issues.
“There had been seven complaints logged and responded to since our last inspection, however conclusions were not easily found.” from the report
Smoking room affected corridors
minorPeople reported smoke escaping from the smoking room into corridor areas. Inspectors recommended that the provider review its smoking procedures.
“Some people complained to us about the smoke escaping into corridor areas from the smoking room.” from the report
- 01What changes have been made to ensure every medicine is given as prescribed and every medicines record is completed correctly?
- 02How do you check that staff are trained and authorised before applying prescribed creams?
- 03How are people's changing risks reviewed and recorded, especially after an incident or change in health?
- 04How do you now make sure audits identify problems with medicines, care records and equipment?
- 05How will you prevent smoke from the smoking room entering corridor areas?
This was an unannounced planned inspection covering all five CQC questions, including the premises and care, and it followed up improvements requested after the previous inspection. This explanation was written from the published report of 1 May 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 House Rest Home Limited
6 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- August 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Waterloo House Rest Home Limited →
- May 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Waterloo House Rest Home Limited →
- August 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- February 2016Inspected but not ratedSafe: Requires improvementWell-led: Inadequate
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: OutstandingResponsive: GoodWell-led: Requires improvement
- February 2015
Report published without a new overall rating.
- October 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- August 2011
Registered with the Care Quality Commission on 3 August 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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