Waters Edge Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People told us they felt safe. Risk assessments were in place to guide staff how to manage risks to people and staff understood how to manage these risks. A safeguarding policy was in place and staff understood how to raise safeguarding concerns. People were able to make choices and decisions regarding their day to day lives. Mental capacity assessments were in place when needed and where people lacked capacity, decisions were made in people’s best interests. Deprivation of Liberty Standards (DoLS) applications had been made where needed and staff understood how DoLS authorisations applied to people’s care and support.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff understood how to keep people safe. Staff were knowledgeable about the safeguarding policy and all staff knew they could access it in the reception of the home. Staff understood the types of abuse and knew when they should raise safeguarding concerns. One staff member told us, "The types of abuse are physical, emotional, sexual, financial, medicated abuse." Most staff knew how to whistle blow. Where they didn't, they told us they'd check the safeguarding policy or look on the internet to find out. Staff told us they'd be comfortable whistleblowing. One staff member told us, "If I did see something, I would whistle blow straight away. I'm in care for a reason, I love my job and my residents. I'm not shy about whistleblowing." Staff were confident that the management of the home would raise safeguarding concerns when needed. Staff understood how the mental capacity act applied in keeping people safe. One staff member told us, "I've had mental capacity training. Always assume capacity, don't take for granted that people don't have capacity, see if they can retain information." Staff were able to tell us what Deprivation of Liberty Safeguards (DoLS) meant for people and where to find information regarding people's DoLS authorisations. The registered manager told us staff had safeguarding training and the safeguarding policy was kept in reception as a reference. The registered manager told us they had full oversight of safeguarding concerns. Most safeguarding concerns were escalated to the registered manager via accident/incident form and the registered manager completed a daily summary that was shared with their seniors to ensure a higher level of oversight. The registered manager submitted safeguarding referrals when needed following review of the accident/incident pack completed by staff and seniors.

We observed staff safely supporting people with transfers in line with their care plans. We observed staff support one person with a stand hoist transfer. Staff spoke to them throughout to put them at ease and used the equipment safely. Staff provided hand held support to people in a way that maintained their safety and in line with their care plans. People's mobility aids were labelled to ensure they used the correct piece of equipment to maintain their safety. Equipment we saw also appeared in good condition. People were supported to eat and drink safely in line with their care plan. Where people were at risk of malnutrition, they were supported by staff to eat and drink. We observed staff ask people for consent and give them time to make their own decisions.

People were safe. All people we spoke with told us they felt safe. One person told us, "I feel safe here, I can't rate staff highly enough." People told us they felt safe when being supported with moving and handling. One person told us, "I feel safe when the staff are helping me up and down from my chair." People told us they felt safe when staff supported them with their personal care needs being met. One person told us, "I felt really safe in the shower when the staff helped me." People told us staff observed them when needed to ensure their health needs were managed safely. Where one person's skin was at risk of breakdown, they told us, "Several times, the lady with the blue uniform has checked my skin, I haven't even called her."

We viewed staff training records and all staff had completed safeguarding training. Where staff required a safeguarding training update, the registered manager assured us this would be completed within a week. People's care records clearly recorded whether people did or did not have capacity to make specific decisions. Care records also guided staff to support people in the least restrictive way. Where people lacked capacity and support was provided in their best interests, care records guided staff how best to support people. For example, one person did not always want support with personal care, and care plans guided to staff with what strategies to use. People had mental capacity assessments in place when needed. Mental capacity assessments were decision specific and involved the person fully in the assessment. Mental capacity assessments followed the two stage test of capacity and clearly considered whether people were able to retain, weigh up and understand information related to the decision. Best interest decisions were in place where people lacked capacity.

People's risks were managed safely. Where people had risks related to the mobility, they told us staff encouraged them to move safely. One person told us they were not supposed to walk independently and if they tried to do so, staff members always reminded them they needed to wait for support. Where people's skin integrity was at risk, they told us staff supported them to manage this risk. One person told us staff checked regularly on their skin. Another person told us photos had been taken and they had been referred for a GP check as their skin had become sore. One person also told us their skin was at risk so staff kept an eye on it and applied creams and spray and if this didn't address it, they referred to district nurses. People's continence risks were managed safely by staff. One person told us that they had been having some difficulty with continence needs, so staff had addressed this and they had been prescribed laxatives. Another person had a catheter that became blocked. They told us the staff were monitoring this and sorted it out and escalated where there were issues.

People had risk assessments to determine the risk level they were at for each specific risk - these scored the risk and determined if they were low, medium or high risk. Risk assessments were in place for risks including pressure care, falls, PPE, diabetes and nutrition. Where risks had been identified by the risk assessment, care plan documentation provided thorough guidance for staff how to manage and mitigate risk to them. For example, where one person was diabetic, their care plan provided clear guidance regarding the foods the person should and should not eat and the signs staff should look for indicate a hypo or hyperglycaemic episode. Where another person's skin integrity was at risk, their care plan guided staff to complete wound assessments, wound care plans and body maps. They also provided guidance regarding minimum fluid intakes and guided staff when to escalate concerns around fluid intake. Where risks had been identified, daily records were also completed. For example, where a person was at risk of falls they were had regular observation. We checked people's daily records and found observations were being undertaken in line with people's care plans/risk assessments. We also saw records where bowel movements had been monitored for people who had risks related to their continence and fluid intake had been recorded for those at nutritional risk or where their skin integrity was at risk. From records we viewed observation and monitoring was carried out in line with their care plans/risk assessment on the majority of occasions. PEEP's were in place that were personalised and guided staff how to support people and manage risk to them in the event of an emergency.

We observed people being supported safely to transfer using stand hoists and handheld assistance. We also observed people being supported to eat and drink safely in line with their care plan. We observed staff members being present at all times in the communal lounges to observe people and keep them safe. Where people were at risk of falls, we saw staff encouraging people to sit down or wait for support to walk when needed. The culture amongst staff was focused on keeping people safe.

Staff we spoke with knew people well and understood their care needs and how to manage risks to them. Staff understood where to find information on people's risks. One staff member told us, "Information regarding people's risks would be in their individual care plans. Managers keep this up to date." Staff told us they always ensured 1 staff member was in the communal areas at any one time to ensure people's safety was maintained. Staff understood how to mitigate risk to people falling and told us how they observed people every 30 minutes following a fall. One staff member told us, "We put people on 30 minute observations if they are at risk of falls to keep them safe, there's always someone sitting in the lounge with people and where people's behaviour can be aggressive, we monitor the corridor and see where they are at all times." Staff understood how to manage people's risks related to their skin integrity. One staff member told us, "If people's skin is at risk, we do pressure relief and use barrier creams. We just make sure they’re being repositioned." Staff told us risks regarding people were shared during handover to ensure staff were fully updated and knew how to keep them safe. The registered manager told us risks were shared at daily handovers and they visited the floor each day to ensure they were made aware of any change in risks to people.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.