Archived: Waterbank Road

Updated 15 December 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Waterbank Road 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

We gave a short period notice of the inspection. This was because the service is small and had a particular layout. We needed to discuss with the registered manager the arrangements for inspecting the service taking in to account requirements under COVID-19 such as social distancing.

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. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service and one relative about their experience of the care provided. We spoke with four members of staff including the registered manager and three support workers. We spoke with three health and social care professionals and received written feedback from a fourth.

We reviewed a range of records. This included two people’s care records and three people’s medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits and training records, were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at additional records relating to the governance of the service.

Updated 15 December 2021

About the service

Waterbank Road is a residential care home providing personal care to 4 people with mental health conditions at the time of the inspection. The service can support up to four people. Waterbank Road was divided in to three self-contained flats each with their own bathroom and kitchen facilities and one large en-suite bedroom. There is a communal kitchen, small courtyard garden and staff office.

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

While most environmental risks were responded to, we found further improvements were required regarding fire and water safety. We have made a recommendation about the management of water systems in the service. Written risk assessments did not always fully explore and assess identified risks to people. Staff recruitment files did not evidence all information required under the law. The registered manager took immediate action to address this when it was brought to their attention. We were not confident staffing levels fully met the needs of people living in the service. This was because of variable feedback from staff regarding this and our observations during our visit. A system was in place to provide oversight of incidents that occurred. Individual incidents were analysed but there was no analysis of incidents overall for themes and/or patterns.

A system was in place to provide oversight of incidents that occurred. Individual incidents were analysed but there was no overall analysis of incidents to identify themes and/or patterns. There were no provider level audits of the service. The governance system overly relied on the registered manager’s experience and expertise and this did not contribute to a robust governance system. The audit system in place was not fully effective at identifying and improving areas for improvement within the service.

People received their medicines safely and as prescribed. Staff took a proactive approach in supporting people to manage their medicines. Staff had received training in adult safeguarding and there had been no known safeguarding incidents in the service in the last year. Effective infection control measures were in place, including in relation to COVID-19.

There was a clear focus on staff learning and development. Health and social care professionals praised the knowledge and support provided by staff. This helped deliver good quality outcomes for people. People’s health needs, including in relation to their nutritional needs, were met.The physical environment met people’s needs although we identified some areas required some decorating and enhancement. People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by kind, caring, and compassionate staff. There was a strong relationship-based approach within the service. People were supported to discuss and make decisions regarding their care. People’s independence was supported, staff had a good understanding of people's individual needs in relation to this.

People received support that was individual to their needs and wishes. People were involved in creating and discussed their care plans and how their needs should be met. Where complaints had been raised these had been dealt with openly and honestly in collaboration with people.

There was a strong person-centred and empowering culture. These values were clearly embedded within the service and staff team. The registered manager had a reflective, open, and honest approach. Where issues had been raised during the inspection, they took a proactive approach to address these. Links to other services had been developed to help the service grow and progress. A development plan was in place to support this. People and staff were engaged and listened to regarding 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

This service was registered with us on 15/5/2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on the fact the service required a rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.