CQC report explained · a residential care home
What the CQC found at Watford House Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2023
Watford House Residential Home is rated Good; inspectors found people were safe and well supported, with further work needed on incident records and resident feedback.
This was an unannounced focused inspection on 16 and 21 March 2023. Inspectors checked whether improvements had been made after the previous inspection, which had found breaches about safe care and good governance. They spoke with people, relatives and staff, and reviewed care, medicine, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safer medicine systems, suitable risk assessments and effective infection control. Staff understood safeguarding and people's legal rights, and people said they felt safe.
Management and quality checks had improved. People, relatives and staff spoke positively about the management. However, the home was still developing its recording and analysis of accidents and incidents, and some people had not been formally asked for feedback.
Safer medicines
A new electronic medicines system had reduced medication errors. Medicines were stored and disposed of safely, and records supported the use of medicines prescribed as needed.
“A new electronic medication system was in place which had supported improvements to reduce the numbers of medication errors.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Recruitment checks were completed before staff started work.
“There were sufficient numbers of staff to meet people's needs.” from the report
People felt safe
People told inspectors they felt safe, and staff had training to recognise and respond to abuse concerns.
“People told us they felt safe living at Watford House.” from the report
Improved management checks
The home had improved its audits and other checks on quality and safety. The provider was no longer in breach of the previous governance regulation.
“Governance systems had been improved and were now used effectively to manage and oversee the quality and safety of the service.” from the report
Approachable managers
People and relatives said managers were approachable and dealt with issues. Staff also spoke positively about management and morale.
“People and their relatives told us they thought Watford House was a nice, happy place to live where the managers were approachable and responsive.” from the report
Incident records
needs fixingFurther work was still being done to improve accident and incident records, so managers could fully analyse what happened and show how learning was used.
“Further work was being completed around the recording of accidents and incidents to ensure the management team were able to fully analyse occurrences and evidence continued learning.” from the report
Resident feedback
minorSome people said they had not attended resident meetings or been formally asked for their views. The manager planned to develop better ways to gather feedback and share the results.
“Some people said they had not attended resident meetings or were not formally asked for feedback about the home.” from the report
- 01How are accidents and incidents recorded, reviewed and used to prevent similar events happening again?
- 02How will residents be asked for feedback if they do not attend formal meetings?
- 03How will you tell residents what action was taken after feedback?
- 04What were the findings from the previous inspection's Effective, Caring and Responsive ratings, which were not checked during this visit?
This was a focused inspection of Safe and Well-led to check improvements after the previous inspection; the other key-question ratings were carried forward from the last comprehensive inspection. This explanation was written from the published report of 22 April 2023 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, March 2022
Rated Requires Improvement; inspectors found risks involving the building, medicines records and quality checks.
This was an unannounced focused inspection on 1 March 2022. It followed concerns about people's safety. Inspectors looked only at Safe and Well-led, including infection control and COVID-19 vaccination requirements.
Inspectors found blocked fire exits, missing or unsuitable fire signs, exposed hot pipes and radiators, and unsafe window restrictors. Some hazardous products and prescribed items were left where people could access them. Medicines records did not show reliably that prescribed creams, supplements and pain patches had been given as directed.
The home had enough staff at the time of the inspection. Staff understood safeguarding procedures and people said they felt safe and involved. However, quality checks had failed to identify or correct important safety problems.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe was rated Requires Improvement, and Well-led remained Requires Improvement. The provider said it had removed immediate risks after the visit, and CQC requested an action plan and said it would monitor progress.
Safeguarding and care risks
Staff knew how to recognise and report abuse. Care risk assessments covered areas such as mobility, skin condition and weight loss.
“People were supported to identify and mitigate risks associated with their care and support.” from the report
Staff availability
Inspectors found enough staff to support people promptly. People spoken with did not report delays.
“People were supported by enough staff who were available to safely and promptly assist them.” from the report
Infection control arrangements
Inspectors were assured about several infection control arrangements, including PPE, testing, visiting and managing outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Approachable management
People, relatives and staff described the management team as approachable and supportive. Residents' meetings were used to gather feedback.
“All those we spoke with said the management team was approachable and they felt supported by them.” from the report
Fire and building safety
seriousFire exits were blocked and fire signs were missing in places. Exposed hot metalwork and unsafe window restrictors also created risks of burns or falls.
“These issues put people at risk of harm in the event of fire.” from the report
Medicines records
seriousRecords did not show consistently that prescribed creams and supplements had been given. There was also no system to record where pain patches were applied.
“The provider could not evidence people received their medicines as prescribed.” from the report
Weak quality monitoring
seriousRegular checks had failed to identify or fix the safety and medicines-recording problems. This was a breach of good governance.
“The provider had ineffective systems to monitor the quality of the service they provided.” from the report
Recruitment checks
needs fixingThe provider did not consistently check that new staff had the right to work in the UK, although references and DBS checks were completed.
“The provider did not consistently follow safe recruitment processes when employing new staff members.” from the report
- 01Have all fire exits been cleared, and are fire signs now in place throughout the building?
- 02What has been done to cover hot pipes and radiators and make all window restrictors safe?
- 03How are cleaning products, drinks thickeners, creams and toiletries kept away from people who may accidentally ingest them?
- 04How do you now check and record prescribed creams, supplements and pain patches?
- 05What action plan was sent to CQC, and what evidence can you show that the identified problems have been fixed?
This was a focused inspection of Safe and Well-led only, with infection control also checked; Effective, Caring and Responsive were not assessed. This explanation was written from the published report of 24 March 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.
Every inspection of Watford House Residential Home
7 rated inspections over 7 years: the service has improved, from Inadequate to Good.
- April 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Watford House Residential Home →
- March 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Watford House Residential Home →
- July 2021Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- May 2019Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2016Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- January 2016InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 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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