CQC report explained · a nursing home
What the CQC found at Watlington and District Residential and Nursing Home
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- Inspectors found enough staff, safe medicines practice, suitable safeguarding arrangements and regularly reviewed risk assessments. Accidents and incidents were recorded and used to reduce risks.
- Effective?
- Good
- People's needs were assessed before admission and care plans followed relevant guidance. Staff were trained and supported, people received suitable food and drink, and the home worked with health professionals.
- Caring?
- Good
- People and relatives described staff as kind and helpful. Inspectors saw people treated with dignity, involved in daily choices and supported to remain as independent as possible.
- Responsive?
- Outstanding
- Care was tailored to people's histories, interests and relationships. Staff provided varied activities, supported important family occasions and helped people using reablement services work towards returning home.
- Well-led?
- Outstanding
- Inspectors found committed leadership, a positive and inclusive culture, strong staff support and effective quality checks. People, relatives and staff were involved in developing the home.
What inspectors found, April 2019
Watlington and District Residential and Nursing Home was rated Outstanding; inspectors found safe, kind care with especially strong activities, personal support and leadership.
This was a planned inspection on 7 March 2019. Inspectors reviewed earlier information, spoke with people, relatives, staff and health professionals, looked at seven care files and other records, and observed care.
The home was rated Good for Safe, Effective and Caring. Inspectors found suitable staffing, safe medicines systems, reviewed risk assessments, trained staff, good food choices, access to health professionals and respectful care.
It was rated Outstanding for Responsive and Well-led. Staff tailored care to people's lives and interests, supported family relationships, organised varied activities and helped some people return home after hospital care. Inspectors also found strong leadership, staff support, community links and systems for improving the service.
The overall rating was Outstanding. The previous rating was Good at the comprehensive inspection published in August 2016. A focused inspection was also published in March 2017.
Personalised care
Staff took time to understand people's histories, preferences and goals. They made considerable efforts to help people remain independent and maintain important relationships.
“People were recognised as individuals and were supported by staff who valued people for their uniqueness.” from the report
Activities and family life
The home offered activities for individuals and groups, including events involving relatives and the wider community. Staff also helped people take part in important family occasions.
“Staff went to exceptional lengths to ensure people had access to a wide range of activities that met their individual needs.” from the report
Support to return home
People leaving hospital received rehabilitation support aimed at helping them return to their own homes. Health professionals gave very positive feedback about the results.
“The service went to exceptional lengths to support people to achieve their goals in order for them to return home.” from the report
Kind and respectful staff
People and relatives were very positive about staff's kindness. Inspectors saw people treated with dignity and supported to make their own choices.
“Without exception people were treated with dignity and respect.” from the report
Strong leadership
The management team promoted an open, inclusive culture and involved people, relatives and staff in developing the home. Quality checks were used to monitor and improve care.
“There was a strong commitment to continuous improvement which was driven by the management team.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you meet my relative's individual needs, interests and life history when planning their care?
- 02What activities would be suitable for my relative, and how could they stay involved with family and community life?
- 03If my relative needed rehabilitation after hospital, how would you support their goals and possible return home?
- 04How would you manage my relative's medicines, risks, mobility and changing health needs?
- 05How do you keep the new electronic care plan up to date and make sure all staff follow it?
This was a planned comprehensive inspection covering all five CQC questions, and the report says the previous overall rating was Good. This explanation was written from the published report of 19 April 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.
What inspectors found, March 2017
Rated Good; inspectors found that earlier problems with food and drinks had been put right.
Inspectors visited the home without notice on 16 February 2017. They spoke with people living there, relatives, staff, nurses, the kitchen assistant and the registered manager. They reviewed care plans, staff files and records about food and drinks.
The inspection followed concerns found in June 2016 about nutrition and hydration. At this visit, people received food and drinks that met their needs. Staff followed dietary plans, monitored food and fluid intake where needed, and supported people to eat and drink at their own pace.
The home was rated Good overall. The only question rated in this report was Effective, which was also Good. Inspectors found staff had suitable knowledge and training, supported people's decision-making rights, and received supervision and further development.
Respectful mealtimes
People were offered choices and supported in a calm, respectful way. Staff adapted support when someone was unsettled or changed their mind about a meal.
“People who required support to eat and drink were supported in a respectful manner at a pace that suited them.” from the report
Staff skills and support
Inspectors found staff had the training and knowledge needed for their roles. Staff also received regular supervision and appraisals.
“People were supported by staff who had the skills and knowledge to carry out their roles and responsibilities.” from the report
Mental capacity rights
Staff understood how to support people who could not make particular decisions themselves. Care records showed capacity assessments and best-interest decisions where needed.
“People were supported in line with the Mental Capacity Act 2005 (MCA).” from the report
Earlier food and drink shortfalls
seriousThe previous inspection found that nutrition and hydration arrangements were not always safe or reliable, including problems with special diets, monitoring and timely support. Inspectors said these problems had been improved by this visit.
“These concerns were breaches of Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.” from the report
- 01How do you check that each person's special diet and swallowing guidance is followed at every meal?
- 02How do you record and review food and fluid intake for people who need monitoring?
- 03How do you identify and respond to weight loss, and how often are weights reviewed?
- 04How do you make sure people who eat in different parts of the home receive timely support?
- 05What checks have been made since this inspection to confirm that the improvements to nutrition and hydration have continued?
This was an unannounced follow-up inspection checking whether earlier nutrition and hydration requirements had been met; the report gives a rating only for Effective, with no new ratings for the other four questions. This explanation was written from the published report of 14 March 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 Watlington and District Residential and Nursing Home
3 rated inspections over 3 years: the service has improved, from Good to Outstanding.
- April 2019Outstandingcurrent ratingup from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
Read what inspectors found at Watlington and District Residential and Nursing Home →
- March 2017Goodstayed GoodEffective: Good
Read what inspectors found at Watlington and District Residential and Nursing Home →
- August 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 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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