The visit took place on 30 December 2014 and was unannounced. We last inspected the service on 8 August 2013. At our previous inspection the provider was not meeting the law in relation to consent to care and treatment, staffing and records. Following our August 2013 inspection the provider sent us an action plan to tell us the improvements they were going to make. During this inspection we looked to see if these improvements had been made. We found that improvements had been made in respect of the issues previously identified.
Waterside House is registered to provide accommodation and support for 60 people. At the time of our inspection there were 39 people living at the service for long and short stays. The service contained four units, although only three of these units were in use at the time of our inspection.
There was a registered manager in post at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People we spoke with were complimentary about the service and its staff, describing them as kind and caring.
The service was clean and well- presented. People were happy with the level of cleanliness maintained by staff. However, we found that staff did not consistently wear personal protective equipment when handling food.
We found that medicine records were not always completed, which meant it could not be demonstrated that people had received this medicine as prescribed. Medicines were otherwise stored and used as per the prescriber’s or manufacturer’s directions.
Staff knew how to identify and report abuse. Staff were recruited in a safe way, which meant they were of appropriate character to care for people. There were enough skilled staff to support people safely.
Records showed that people were assessed to establish their ability to make decisions for themselves, where necessary. However, decisions that had been made in people best interests, where they were not able to make the decision for themselves, were not recorded.
We found that people were supported to eat and drink. We saw that robust records of people’s intake of food and drink were not always maintained to demonstrate this had been provided consistently.
We saw some staff using techniques which ensured people understood and could effectively communicate choices they wished to make. These included the use of visual aids. However, some staff did not use these techniques, although they would have aided communication with the people they were speaking with.
People’s health was supported with appointments with external healthcare professionals. These included appointments to promote people’s health in the context of conditions they had, such as diabetes.
People’s care records were personalised. Care records were regularly reviewed to ensure they were up to date. This meant that staff had access to the latest guidance on how to support people.
Most staff supported people’s dignity, privacy and independence and encouraged people to complete tasks safely for themselves. However, we saw some examples of staff failing to support people’s dignity by ensuring information about their needs was kept private.
Staff demonstrated that they knew people’s preferences and what was important to them. We saw staff supporting people to participate in activities they enjoyed. Staff communicated with people’s relatives to ensure they were kept up to date with developments and that issues were discussed as appropriate.
Care planning took into consideration people’s spiritual needs and important relationships. We saw people being supported in a way which took into account their cultural preferences and diversity.
Although no-one we spoke with told us they had raised a complaint; the provider demonstrated that they dealt with complaints in line with the advertised complaints procedure.
The provider undertook audits concerning the quality and standards of care at the service in order to improve the service provided. A new registered manager and deputy manager had been recruited since our last inspection. While some improvements were on-going, staff were positive about the changes the new management team were implementing in improving people’s experience of the service.