Waterloo House

Updated 21 April 2020

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 team consisted of two inspectors on day one and one inspector on day two.

Service and service type

Waterloo House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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.

Notice of inspection

This inspection was unannounced. We informed the provider of our plan to return for a second day.

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 authority and professionals who work with the service. 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. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with four people who used the service and four relatives about their experience of the care provided. We spoke with nine members of staff including the registered manager, deputy manager, team leader, care workers, the chef and domestic.

We reviewed a range of records. This included three people’s care records, multiple medication records, risk assessments and high dependency charts. A variety of records relating to the management of the service, including minutes of staff meetings, audits and quality assurance records were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and the service improvement plan.

Updated 21 April 2020

About the service

Waterloo House is a residential care home providing personal care and accommodation to 31 people aged 65 and over at the time of the inspection. The service can support up to 35 people in one adapted building.

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

The provider was not registered to support people with mental health needs but one person living at Waterloo House needed this type of support. Staff were not trained in this area of care and an important incident involving this person had not been reported to us. Since joining Waterloo House, the registered manager developed a service improvement plan and understood the importance of continuous learning to drive improvements. There was a culture of openness and honesty and new systems for quality assurance and been introduced. Staff enjoyed working at Waterloo House and caring for the people who lived there.

People were supported by staff who understood how to keep them safe from avoidable harm and abuse. There were enough staff to meet people’s needs. Risks to people were assessed with clear guidance for staff to help manage them, and staff spoken with could identify when people may be at increased risk due to their health conditions or mobility. Effective infection control measures meant Waterloo House was kept clean, fresh and hygienic. Accidents and incidents were recorded and monitored to identify what actions could be taken to reduce the risk of them happening again. Medicines were managed safely and only staff who received training in medicine competency were allowed to administer medication.

People’s needs were assessed and used to develop care plans for specific health conditions and risks. Staff received training, induction and a period of shadowing to equip them with the knowledge and skills needed to support people safely. Staff could explain how they used their training to help look after people living with dementia including visual choices and techniques in safe hand holding during personal care. People accessed external healthcare promptly because staff monitored their health for signs of change and made relevant referrals when needed. Improvements were being made to the internal design and decoration of the premises and the garden.

People were supported by kind and caring staff who knew them well. Staff had time to understand people’s needs to support them safely and enjoyed spending meaningful time with people learning about their past and their families. The provider valued people’s views and their participation in care planning. New ways of encouraging opinion was being promoted and results of questionnaires were displayed throughout the home.

People received care that was personalised because their preferences were identified as part of care planning. Further improvements were planned in this area of practice. A new lifestyle and wellbeing coordinator was employed to maximise the availability of time available for people to spend engaged in meaningful activity. There was a variety of activities to suit individual needs including baking, smoothie making and crafts, as well as singers who regularly visited the home and annual garden parties. Information packs for people, relatives and visitors was displayed throughout the home providing information on the complaints process, quality assurance, and the role of CQC in response to feedback from relatives.

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.

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

Rating at last inspection

The last rating for this service was good (published 9 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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