Waterloo House Rest Home Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Staff worked well together to involve people in decisions around their needs. People were involved in decisions around their care and were supported to manage their health and wellbeing. Staff understood the principles of the Mental Capacity Act and sought consent from people. Where people had a lasting power of attorney, they were involved in decision making and people could access the support of an advocate if needed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff worked well together and people were involved in decisions around their care and were supported to manage their health and wellbeing. Staff worked with people, and their relatives where appropriate, to involve them in assessing their needs and developing care plans. People were involved in reviews of their care and told us they received care that was appropriate to their needs. One person said, “When I came here, they spoke with me and my power of attorney about the sort of care I needed and the care I didn’t need.”

Staff and managers were aware of the processes for assessing, and meeting people’s needs and were observed to following care plans and risk assessments.

Records showed that people’s needs were appropriately assessed and reviewed following changes in needs or incidents.

People felt involved in care planning and the assessment of their needs. People’s needs were assessed using recognised tools, such as the Malnutrition Universal Screening Tool and the Waterlow calculator to assess skin integrity and the risk of developing pressure sores. On person said, “They involved us, we have just reviewed the care package and everything was fine.”

Managers and staff were aware of the importance of using recognised assessment tools and how to involve people in the assessment, planning and delivery of their care so their views and preferences were included in care plans.

Processes were in place to make sure people’s views and preferences in relation to their care was sought and acknowledged. Care was observed to be delivered in line with guidance.

Overall, people’s experience was positive. Staff worked as a team and with other professionals to share information about people’s needs and preferences. Hospital passports were in place which supported information sharing if people were moving between the home and hospital. One relative said, “Staff work well together, they pass over information constantly and the handover days to night is very effective.”

Staff told us staffing levels were good and management were always on hand to support the staff team and people, comments also included, “We work as a team and support each other” and “I was impressed with the team promoting choice, dignity and independence and ensuring people were happy are happy the care.”

One healthcare professional working within the home told us, “When residents have moved from another care home they have settled in so well and have done really well because of the efforts of the staff team treating them as individuals.” Key stakeholders told us staff and leaders took the time needed to get to know people well. They said staff provided enough information to support decision making and were aware of people’s wishes and preferences. They also said the management team communicated well.

Effective processes were in place to ensure everyone worked effectively to support people. Information about people’s changing needs were shared during handover meetings when staff shifts changed and there were regular staff meetings. Daily flash meetings included updates on people’s needs and any actions that needed to be taken, for example in relation to hospital appointments.

People were supported to manage their health and wellbeing in a way which maximised their independence and choice whilst balancing risks of falls, for example, which could impact their future needs. People had the opportunity to register with the link GP for the home or remain with their previous GP practice. A relative said, “There is access to other services such as chiropodist, GP hairdresser etc.”

A link GP practice was in place for the home, which meant a GP visited on a weekly basis to ensure people’s needs were met. They told us, “I am always aware which residents need to be seen prior to attending the ward round so I can bring the notes in advance which is very helpful.”

Processes were in place to ensure referrals were made to health care professionals as needed. We received positive feedback from a healthcare professional in relation to how well staff knew people and how well they communicated any concerns or updates about people's health and wellbeing.

Staff worked with people to monitor and improve their health and wellbeing. One person explained the improvement in their condition since moving to the care home and said, “Within two weeks there had been a remarkable improvement in my condition, look no further than the home.”

Staff and managers explained about the positive relationship with the link GP surgery who they worked with to monitor and improve people’s clinical outcomes and ensure people’s choices and expectations around healthcare were met.

Processes were in place, and followed, to monitor people’s health and wellbeing. This included monitoring food and fluid intake and nutrition and dehydration risk, skin integrity and pressure ulcer risk. Action was taken to develop risk management plans were needed and to involve healthcare professionals if required.

People provided consent, where they had the capacity to do so, in relation to medical care, social care and consent to care and support. One person spoke with us about being involved in decisions around their care and treatment together with their power of attorney. People were also able to access the support of an advocate if needed.

Staff understood the principles of the Mental Capacity Act. The management team said, “I have been working hard on MCA and bring it up in supervisions with the staff regularly” and “If people can’t make decisions, we have to make them in their best interests, people can make an unwise decision if that’s their decision and they have capacity.” Feedback from staff included, “I make sure to follow the mental capacity act when looking after people by using person centred care and always offering choice.” Staff had attended training.

Capacity assessments and best interest decisions were completed when needed. It was evident the staff understood that people may have the capacity to make one decision but not another due to the nature and complexity of the decision to be made. When necessary, Deprivation of Liberty Safeguards (DOLS) had been applied for and had either been authorised or were waiting assessment.