Waterhall Care Home

Updated 24 February 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our

regulatory functions. This inspection was planned to check whether the provider is meeting the legal

requirements and regulations associated with the Health and Social Care Act 2008.

We received information from the provider and other healthcare professionals informing us of an increase in the number of people using the service and staff testing positive with COVID – 19.

This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 9 February 2021 and was unannounced.

Updated 24 February 2021

About the service

Waterhall Care Home is a residential care home providing personal and nursing care for up to 56 older people. They also work in partnership with Milton Keynes Hospital to provide rehabilitation (step down) care. At the time of the inspection the service was supporting 50 people.

The home is situated over three floors (the ground floor is leased to the Primary Care Trust and falls under a separate registration from Waterhall Care Home).

The home offers permanent, respite and rehabilitation (step down) care. One of the areas specialises in providing care to people living with dementia. Each floor offers recreational, quiet and dining areas and there is a secure garden with several seating areas.

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

The registered manager and staff team continued to provide people with an exceptionally personalised service. People received excellent high-quality care from a dedicated staff team that were caring and compassionate and often went the extra mile. The staff team were fully committed to treating people with dignity and respect, and person-centred care was at the very heart of the service.

The whole of the staff team were extremely passionate about providing people with support that was centred around individual needs. Staff worked closely and creatively with people, this enhanced people's quality of life, boosted self-esteem, and promoted and protected people’s overall wellbeing.

People received exceptional compassionate end of life care that was planned with people and their families, in advance and centred around their individual wishes, spiritual beliefs and cultural needs. Relatives and health professionals all commented how impressed they were with the knowledge of staff and their attention to detail when providing end of life care that fully respected people's diverse needs and human rights.

A culture of being open and transparency was embedded in the service. The service worked closely with other healthcare professionals. The registered manager was extremely pro-active in encouraging ideas and feedback from people using the service, relatives, staff and other professionals, to continually drive up improvement. A robust system of quality monitoring checks and audits were used to continually review all aspects of the service and timely action was taken in addressing areas identified for further improvement.

People benefitted from receiving care from a stable staff team that continually worked towards the provider's vision and values in providing high-quality person-centred care. There was a shared commitment to ensuring strong links with the community and an emphasis on enhancing people's lives through the provision of meaningful, imaginative activities and opportunities.

Staff were extremely positive about the support they received from the registered manager, saying their leadership style, inspired them to take a strong pride in their work and deliver a high-quality service.

The whole of the staff team invested time in really getting to know people. Through this they were able to identify and respond appropriately to behaviours that had the potential to place people at risk of harm. Staff were skilled in anticipating behaviours and discreetly intervened to subtly dispel potential incidents. They provided interventions that soothed and calmed people and lowered incidents of distress.

Accidents and incidents were responded to following the providers procedures and used as learning opportunities to reduce the risk of repeat incidents. The registered manager ensured all serious incidents were reported to the relevant authorities and the Care Quality Commission (CQC).

Staff understood their responsibilities to report any unsafe care. Robust and safe recruitment checks were carried out to ensure suitable staff were employed to work at the service. The staffing arrangements ensured people were provided with support as needed. Staff worked at a relaxed pace and spending time with people was their priority, this was embedded in the culture of the home.

Medicines systems were organised, and people received their medicines when they should. The Nursing and care staff responsible for administering medicines received training to ensure they had the competency and skills required to safely administer medicines. Our observations and review of records showed that staff followed current good practice protocols for the safe ordering, receipt, storage, administration and disposal of medicines.

Staff had the skills, knowledge and experience required to support people with their care and social needs. They were well supported by the registered manager and had regular one to one supervision and annual appraisals.

Nutritional assessments were carried out and food and drinks were provided based on people's individual needs and preferences. Soft and puréed meals and thickened drinks were provided for people at risk of choking. All meals and snacks were fortified. Mealtimes were a social experience staff and people using the service often took their meals together.

Staff worked closely with other professionals within the multi-disciplinary team to ensure people's health and well-being needs were fully met and to ensure that where possible, any rehabilitation goals were met.

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.

The environment met people's diverse needs. Dementia friendly signage aided in signposting people to independently orientate themselves around the home. There were points of interest around the environment to support people to independently navigate their way around, both inside and outside of the home. A range of sensory items were available for people to engage with.

Information was made available for people, relatives and others in accessible formats on how to raise any concerns or complaints. The registered manager and the provider promoted a culture of being open and transparent and took all concerns brought to their attention seriously. This meant people received safe, compassionate care, and any lessons learnt were used to continually develop 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

The last rating for this service was outstanding (published 5 April 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.