Waterside House

Updated 2 July 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience telephoned people who received a service from Waterside House and their relatives on 10 June 2021.

Service and service type

This service provides care and support to people living in 'supported living' settings, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. However, at the time of inspection the registered manager was not available for work.

Notice of inspection

We gave 24-hour notice so we could clarify the services COVID-19 Personal Protective Equipment (PPE) practice for visiting professionals and identify persons who were shielding so we could respond accordingly.

Inspection activity started on 8 June 2021 and ended on 11 June 2021. We visited two supported living properties on the 8 June 2021. From 8 June 2021 to 11 June 2021 we continued to review evidence remotely and spoke with people who use the service and staff.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authorities with whom the service works. On this occasion the provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with five people at the two supported living properties we visited. We spoke by telephone with two people who used the service and nine people’s relatives. During the inspection we spoke with the interim manager, the strategic lead, programme manager for quality assurance, two team leaders and eight support workers.

We reviewed a range of records. We reviewed some of the documentation remotely by asking the provider to send us key information prior to meeting with them. We reviewed two people’s risk assessments and multiple health and safety records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.

Updated 2 July 2021

About the service

Waterside House is a supported living service providing personal care to people aged 18 and over with learning disabilities and/or autism provided by Trafford Metropolitan Borough Council. The supported living service provides supported accommodation to 22 people in seven supported living accommodation properties.

People's experience of using this service and what we found

We received positive feedback from people and their families and staff who were enthusiastic about the value of the service in people's lives. We found the provider had addressed the areas of negative feedback which were raised during our last inspection.

Significant improvements had been made following the previous inspection in October 2020, this included improvements to promote the safety and wellbeing of people and the staff who supported them. They had

enhanced their quality assurance processes, drawing from best practice guidance to provide better oversight. There was a positive focus on learning from mistakes and ensuring action was taken.

New and improved systems and processes had been introduced for the reporting and recording of issues related to safeguarding and accidents and incidents. The management team and wider staff group fully understood their individual and collective responsibilities in this area.

Staff training and the quality of risk assessments and care plans had improved. In particular, the provider had invested in developing skills and resources to ensure the staff team were equipped to provide compassionate care to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported

this practice.

Medicines were managed safely, and greater oversight was introduced with new medicines auditing tools.

Improvements had been made to Infection prevention control (IPC) practices. Personal Protective Equipment (PPE), hand sanitisers and posters with key messages were at the entrance to the two supported living settings we visited. Any visitors to the service had to show a negative COVID-19 test 30 minutes prior to visiting. Staff were responsible for daily cleaning of all areas of the service including frequently touched and high reach areas. All staff had completed training in infection prevention and control.

Further work was still ongoing in respect to changing the culture at the service and the provider adopted the key principles of 'Right support, Right care, Right culture'. However, a small number of staff we spoke with were not familiar with this key guidance. We have made a recommendation within the well-led section of this report.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Significant work had commended to ensure the support people received was outcome based, to allow people to focus on goals and priorities within their life and what they would want to achieve. People are treated as individuals and care were provided flexibly in line with their preferences. The management team and staff of Waterside House shared a renewed passion for supporting people which shapes the culture across the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 7 December 2020). The provider completed a detailed service improvement plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

A decision was made for us to inspect, examine and follow up what improvements had been made since the last inspection. Due to the COVID-19 pandemic, we undertook a focused inspection to only review the key questions of Safe and Well-led. Our report is only based on the findings in those areas reviewed at this inspection. The rating from the previous comprehensive inspection for the Effective, Caring and Responsive key questions were not looked at on this occasion. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from inadequate to good. This is based on the findings at this inspection.

This service has been in Special Measures since October 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.