CQC report explained · a residential care home
What the CQC found at Waterside House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm, with enough staff and suitable risk assessments. Inspectors recommended clearer guidance for some 'when required' medicines.
- Effective?
- Good
- People could access health professionals and staff had training and support. People had choices about food and drink, and consent and best-interest processes were in place.
- Caring?
- Good
- Staff treated people with dignity, respect and kindness, and supported independence and involvement in decisions. Inspectors found one occasion when a person's religious beliefs were not followed.
- Responsive?
- Good
- Care plans reflected people's needs and preferences, and people had access to activities and support with communication. Some end-of-life wishes were not recorded.
- Well-led?
- Good
- Audits and feedback systems were used to monitor quality and make improvements. There was an acting manager while recruitment for a permanent manager was ongoing.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and personalised care, with some improvements needed for medicines guidance, religious beliefs and end-of-life wishes.
This was an unannounced inspection on 11 December 2019. Inspectors spoke with 13 people, seven relatives and staff. They observed care and checked care plans, medicines, complaints, safeguarding records, audits and training information.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were supported by enough staff, received their medicines safely and had access to health professionals. Inspectors found staff to be kind, respectful and familiar with people's needs.
Inspectors identified three areas for improvement. Guidance for some 'when required' medicines was not detailed enough. One person's religious beliefs were not followed in practice. Some people did not have their end-of-life wishes recorded, including cultural and spiritual preferences.
The previous overall rating was Good, but Safe had previously been Requires Improvement. Safe improved to Good because staffing had improved and people did not have to wait long for support.
Enough staff
Staffing had improved since the previous inspection. Inspectors observed that people did not wait long for help and requests were dealt with quickly.
“Our observations confirmed people did not wait for support and requests were dealt with swiftly.” from the report
Kind and respectful care
People and relatives described staff as caring and respectful. Inspectors saw patient and caring interactions.
“There were caring interactions between staff and people and staff were patient with people if they could not respond straight away or repeated what they had already said.” from the report
Personalised support
Care plans recorded people's needs and preferences. Staff knew people well and were observed following their preferences.
“People had care plans in place which detailed their needs and preferences, so staff knew how people liked to be supported.” from the report
Access to activities
People could take part in a range of activities, go out and maintain relationships. The home had two activity coordinators.
“The home had two dedicated activity coordinators who worked with people to provide a range of activities to chose from.” from the report
Quality monitoring
The home used audits and reviews to check care plans, medicines, health changes and incidents. Inspectors found these systems helped identify improvements.
“Systems were in place to monitor the service and identify areas for improvements, such as for medicines, care files, oversight of health conditions and the environment.” from the report
Guidance for 'when required' medicines
needs fixingSome instructions did not give enough detail about when these medicines might be needed for people who could not explain this themselves. Inspectors made a recommendation to improve the guidance.
“Some guidance about when they might be needed for people who may not be able to verbally tell staff could be more detailed which we discussed with staff.” from the report
Religious beliefs
needs fixingInspectors saw one person being given food that did not meet their religious beliefs. They recommended systems to make sure all staff knew and followed people's beliefs.
“However, we observed one person not being supported in line with their religious beliefs.” from the report
End-of-life wishes
needs fixingSome people nearing the end of their lives did not have their wishes recorded. This included cultural and spiritual preferences, creating a risk that care might not follow their wishes.
“People did not always have their end of life wishes recorded in a plan, despite some people nearing the end of their life.” from the report
- 01How do you now record and check each person's religious, cultural and spiritual preferences, including food choices?
- 02How are 'when required' medicines explained and recorded for people who cannot tell staff when they need them?
- 03How do you record people's end-of-life wishes, including their preferred care, cultural needs and spiritual preferences?
- 04Who is currently managing the home, and what is the progress with appointing and registering a permanent manager?
- 05How have staffing levels and call-bell response times been monitored since this inspection?
This was an unannounced planned inspection covering all five CQC questions and both the care and premises; the previous Safe rating of Requires Improvement improved to Good. This explanation was written from the published report of 6 February 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 2017
Rated Good overall; inspectors found kind, responsive care, but staffing levels meant some people waited for support and the safe rating was Requires Improvement.
The inspection was unannounced and took place on 22 and 27 March 2017. Inspectors spoke with people living at the home, relatives, staff and managers. They observed care and checked care records, medicine records, staff files, complaints and other management records.
The home was rated Good overall. Care was rated Good in the effective, caring, responsive and well-led areas. People were supported by trained staff, received help with food and health needs, and were treated kindly and with respect.
Safe care was rated Requires Improvement. Inspectors found that staffing levels were not always enough on two units. Some people waited for care, especially at night, at weekends and during mealtimes. The home started reviewing staffing and staff deployment during the inspection.
Kind and respectful care
People and relatives spoke highly of the staff. Inspectors saw warm, positive interactions and support that protected people's dignity.
“People were supported by staff that were kind and caring.” from the report
Choice and independence
People were supported to make day-to-day choices and to keep doing things for themselves where possible.
“People were supported to make choices about their care and support and staff promoted their independence.” from the report
Skilled staff and health support
Training, induction and supervision helped staff meet people's needs. Staff sought advice from health professionals and followed it.
“People were supported by staff that had the knowledge and skills to meet their needs.” from the report
Improving management
The home's quality checks were being used more consistently than at the previous inspection. The manager began work on staffing and deployment during the visit.
“At this inspection we found the systems in place to monitor quality were used consistently to drive improvements.” from the report
Not enough staff at some times
seriousInspectors found insufficient staffing on two units. Some people had to wait for care, particularly at night, at weekends and during mealtimes.
“We saw there were times when people had to wait for their care and support and where staff were unable to provide the care at the time the person needed it.” from the report
Medicine count recording errors
needs fixingSome staff did not follow the instructions for daily medicine counts and made recording errors. Extra checks were introduced during the inspection.
“some staff had not followed the instructions correctly for this and had made some errors with recording.” from the report
Some people lacked social contact
minorInspectors saw that a few people with advanced dementia spent a considerable time without interaction. The home introduced individual contact by activity staff during the inspection.
“a couple of people had spent considerable time without interaction from staff during our observations.” from the report
- 01What staffing levels are now in place on each unit at night, at weekends and during mealtimes?
- 02How do you check that people are not waiting too long for personal care or other support?
- 03What was the outcome of the review of people's dependency levels and staff deployment?
- 04How do you now check daily medicine counts and prevent recording errors?
- 05How are people with advanced dementia offered regular individual social contact?
This was an unannounced inspection covering all five CQC questions, and it also checked progress on staffing and quality assurance improvements requested at the previous inspection. This explanation was written from the published report of 9 May 2017 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 Waterside House
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 2010.
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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