We carried out a review of the data available to us about Waterloo House Care Home Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Waterloo House Care Home Limited, you can give feedback on this service.
We found the following examples of good practice.
• A process was in place to support safe visiting to the home. This included booking in advance the use of a designated room which contained a Perspex screen. Visitors were required to complete a health questionnaire, lateral flow test and have their temperature taken. Personal protective equipment (PPE) including a face mask, gloves and apron were provided to all visitors to wear during visits.
• A designated area of the home had been identified for staff to change into uniform and put on and take off their PPE at the start and end of each shift. Staff were observed wearing PPE including, face masks, gloves and aprons and disposing of used items safely in clinical waste bins.
• Internal training had been provided to all staff including how to wear, put on and take off PPE safely. In addition, staff had completed training to enhance their knowledge of COVID-19 and safe practice. The registered manager completed checks to monitor staff practice at work.
• The home was visibly clean with no mal odour. Housekeepers and care staff supported with maintaining hygiene and cleanliness at the home and completed cleaning schedules to reflect this.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that showed serious risks or concerns.
This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
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Safe
Systems and processes to safeguard people were in place, with risk assessments and detailed care plans. Staff had good knowledge of how to support people and report any concerns. Processes for medicines management were in place and medicines were correctly administered. The registered manager shares lessons learnt from internal and external sources. There were infection control and prevention processes in place.
Effective:
Staff had received all training relevant to their role to safely meet the needs of people living in the service. All staff had completed either health and social care diplomas (HSC) or national vocational qualifications in care (NVQ). Some staff had also completed specialist training such as champion pathways and dementia awareness. Staff supported people to have maximum choice and control of their lives in the least restrictive way possible; the policies and systems in the service supported this practice. Some people had relatives who acted as Lasting Power of Attorney (LPA) to make decisions on their behalf. Appropriate tools were used for the management and monitoring of nutrition and other needs. Staff had put new initiatives in place since the last inspection. These initiatives looked at hydration and falls monitoring to try and find patterns and look for ways to reduce the number of falls.
Caring:
Staff were very caring and kind and interacted with people well. People and relatives gave positive feedback about the service, the team and the support received. Staff showed respect in the language used and attitude towards people which showed they cared in a way that maintained people’s dignity.
Responsive:
Staff offered people a choice of main activities which they could change if they did not wish to join in. People responded positively to the entertainment of live music and a pat dog that visited on the day of the inspection. People were able to make complaints and raise concerns. People also gave feedback about the service in other ways such as annual surveys. We had really positive feedback from people and relatives around how the team and the registered manager had supported people receiving end of life care. Staff were observed working well together on the day of inspection to meet peoples changing needs.
Well-Led:
We received extremely positive feedback from the team, people and relatives about the registered manager. The registered manager had a clear vision and goals for business development. The registered manager had good governance and auditing systems and very clear monitoring in place. Outcomes of audits were used by to effect change and improvements to practices and the environment.
Further information is in the detailed findings below.
Waterloo House Care Home Limited provides residential and personal care for up to 24 older people and people with dementia care needs. At the time of our inspection, the service was providing support to 23 people.
The service did not have a registered manager, but a manager was in place who was going through the registration process. 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 felt safe. Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse and people had risk assessments in place to enable them to be as independent as possible.
Effective recruitment processes were in place and followed by the service and there were sufficient numbers of staff available to meet people’s care and support needs
Medicines were administered safely.
Staff members had induction training when joining the service, as well as regular ongoing training.
Staff were well supported by the manager and had regular one to one supervisions.
People’s consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met.
People were able to choose the food and drink they wanted and staff supported people with this.
People were supported to access health appointments when necessary.
Staff supported people in a caring manner. They knew the people they were supporting well and understood their requirements for care.
People were involved in their own care planning and were able to contribute to the way in which they were supported.
People’s privacy and dignity was maintained at all times.
People were encouraged to take part in a range of activities and social interests of their choice.
The service had a complaints procedure in place and people knew how to use it.
Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed
Is the service safe?
People told us they felt safe. They were cared for in an environment that was safe, clean and hygienic. People's needs had been assessed, and risk assessments described how any identified risks to people were minimised. The recruitment practice was safe and thorough, and the provider took action to ensure staff competence.
Is the service effective?
People's health and care needs were assessed and care plans were in place. They were happy with the care provided and their needs had been met. Staff had received training to support people with various care needs, including those living with dementia. The staff used various assessment and monitoring tools such as the Malnutrition Universal Screening Tool (MUST) and the Waterlow score, to ensure positive care outcomes for people using the service.
Is the service caring?
People were supported by kind and attentive staff. It was clear from our observations and from speaking with the staff, that they had a good understanding of the needs of the people they supported. People told us the staff were caring. One person' s relative said, "The staff are very caring and understand people's needs well. I find this is a home from home."
Is the service responsive to people's needs?
We observed that staff responded promptly to people's needs. We saw that care plans had been updated when people's needs had changed, and that referrals had been made to other health and social care professionals when required. The service took account of individual preferences, and people were supported to access a variety of activities of their choice.
Is the service well-led?
The service had a registered manager in post. We saw that the provider had effective systems to assess and monitor the quality of the service they provided. They regularly sought the views of people using the service and their representatives, and took account of these to improve the service.
We reviewed the systems in place for managing people's consent to their care and treatment. We looked at three care plans and spent time observing and talking to the people who lived at the service. People were always consulted about the help they needed and staff sought consent before undertaking any interactions. People told us "The staff are marvellous. We have a lot of fun here." Another person told us, "I feel safe."
We reviewed the system in place for managing people's nutritional needs and found that the service was part of the food first award monitored by the local NHS trust. People's needs were assessed and plans were in place to ensure they received adequate food and fluids.
We looked at infection control systems to keep people safe from healthcare acquired infections. The system was robust and staff were knowledgeable about maintaining cleanliness and managing soiled items. People were protected by these actions.
There was a system in place for monitoring the quality of the service. Areas such as fire and electrical safety were addressed and people's care plans and placements were reviewed. Maintenance checks were carried out and the manager and the provider met monthly to discuss areas for development.
People said they were able to make day to day choices about what they did and when. They enjoyed the company of the pet cat and budgerigars in the lounge area. They said they enjoyed the lively atmosphere and liked to join in the various activities. One person said "We have lovely parties here and everyone is so kind. They really care about us." Another person said "I like to go back to my room after tea and watch TV. They always take me back in time for the programme I like to watch."
We observed that on a one to one basis consent was verbally sought by staff before engaging in any activity or care.
A relative told us "It may not look like a posh hotel but the care is so good." She also said "I can go home from here knowing he is safe and well cared for."
There was a robust system in place to manage the medication administration covered by a medication policy, locked storage and trained staff.
People using the service told us that there were always staff to help them. They were able to call staff for assistance and they did not have to wait for help.
We spoke with relatives and people living at the service who said they knew how to complain and if needed would speak to the manager.
We also spent time observing the care that was being provided. We saw that staff and people living at Waterloo House had warm, caring relationships and enjoyed each other's company. Staff were attentive to people's care needs and treated people with dignity and respect.