Watford House Residential Home

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. People’s needs were assessed and care and support was delivered in line with current standards to achieve effective outcomes. People’s rights for seeking their consent and respecting their choices were upheld.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People felt staff understood their needs well. Relatives told us there were opportunities for them to be involved in planning and reviewing their family members’ care. One relative told us, “Initially, the social workers met with me and my siblings, and we discussed everything. There’s lots of paperwork but we had a meeting with [the manager] and we went through everything.” Another relative told us, “I’ve sat in reviews with my [family member’s] key worker, who knows them well, and gone through the care plan and risk assessments, as a review. It’s all up to date and relevant to [my family member] and their current needs.”

Leaders and senior staff completed pre-admission assessments and followed a ‘moving in’ policy as part of a person’s admission to the service. The registered manager consulted the staff team prior to any admission to check with staff they felt able to meet people’s needs and would consider if Watford House Residential Home was the most appropriate setting for the person. Leaders completed checks on new admissions and used reflective practice should anything have gone wrong to help develop the ‘moving in’ policy. They completed regular checks for the initial week to obtain their feedback and check all assessments had been completed. Staff told us they were informed of people’s needs and risks through. Senior staff told us they had recently received training to support them in completing risk assessments. Staff explained they had 2 handovers a day and an 11 o’clock meeting, this provided them with updates on how people were doing and any changes in their needs.

People’s needs in relation to nutrition and hydration were assessed using a range of assessment tools to ensure their needs are reflected and understood. This information was easily available for staff to refer to when supporting people, including an up-to-date board within the kitchen which covered Malnutrition Universal Screening Tool (MUST) score, International Dysphagia Diet Standardisation Initiative (IDDSI) levels for Speech and Language Therapy (SALT) modified diets and diabetic/prediabetic information. Care plans showed a range of nationally recognised tools were used to inform people’s care and support, such as Waterlow and MUST scores. Care plans were in place for people’s holistic needs, from physical health to mental health and emotional wellbeing. Care plans and risk assessments were generally reviewed monthly, or as people’s needs changed and evidence was seen that people and their relatives were involved in the reviews. For example, following a fall, a person’s falls risk assessment was reviewed. This meant any changes in this risk were identified and actions identified to mitigate these. Relevant professional advice was included accurately within care plans, and copies of original reports or assessments were available for reference, for example SALT reports.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

Where people lacked capacity to make specific decisions about their care and support, records showed staff followed the principles of the Mental Capacity Act 2005 (MCA). For example, mental capacity assessments were in place for specific decisions, including medicines or the use of specialist equipment. Where people lacked capacity, best interest decisions were held with relevant people, including relatives to make sure the decision was least restrictive and, in the person’s, best interests.

Relatives felt their family members’ rights and choices were respected. One relative told us, “People have the freedom to move within their areas in the building and [my family member] can ask to go elsewhere if they want to.” Another relative said, “At the time, if [my family member] is in a receptive mode, you can explain and they understand and ask questions. They will forget quickly but they have been involved as much as possible.” Relatives told us staff communicated well with their family members to help ensure their involvement and choice in their care. For example, one relative said, “[My family member] has been prescribed a hearing aid and glasses but won’t wear either. They can see okay but their hearing is poor. When staff speak to them, they always say their name first and make sure they are looking at them before they speak. They touch their hand and get down to their level. When they are working with them, they’re very focused on them, not chatting between themselves; it enables [my family member] to respond.

During our on-site assessment of the service, we observed staff followed best practice in ensuring consent was sought. Staff explained any care and support they provided so people were informed of staff actions. For example, when supporting people to mobilise around the home in their wheelchairs.