Waterfield House

Updated 15 May 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

Waterfield House 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 did not have a manager registered with the Care Quality Commission. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. There was a manager in post and their registered manager application was being processed.

Notice of inspection

This inspection was unannounced.

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

Inspection activity started on 27 April 2021 and ended on 7 May 2021. We visited the service on 27 April 2021. We spoke with four people who used the service and one visiting health care professional. We also spoke with the manager, the regional operations director and seven staff members, including administration, domestic and care staff. We observed the interactions between people using the service and staff.

On the 7 May 2021 we fed back our findings from the inspection to the manager and the regional operations director. On the days in between our visit and feedback, we asked the manager to send us records relating to the service, which were reviewed remotely, and we asked for feedback from 20 people’s relatives and 18 staff.

We reviewed a range of records. This included sections of care plans and risk assessments for seven people and medication records. We looked at the staffing rota and training records. A variety of records relating to the management of the service, including audits and monitoring tools were reviewed. We received feedback about the service from four relatives and four staff members.

Updated 15 May 2021

About the service

Waterfield House is a residential care home providing personal care to 42 older people at the time of the inspection, some people were living with dementia. The service can support up to 76 people in one adapted building.

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

Since our last inspection a new manager was in post. People, staff and relatives were complimentary about the manager. Improvements had been made since our last inspection, including in staffing, staff morale and governance systems. The manager told us about their plans to further drive improvement in the service.

Systems were in place to provide people with a safe service. Risks were being assessed and guidance was provided to staff in how to reduce risks to people using the service. Staff were trained in safeguarding and the systems in place were designed to reduce the risks of abuse.

The service was clean and hygienic. There were infection control processes in place, including risk assessments and procedures relating to COVID-19. Relatives told us how they could visit their family members. Systems were in place to limit risks to people and visitors by, for example, personal protective equipment (PPE) and testing.

Medicines were managed safely, and people received their medicines when required.

The management team were regularly reviewing the staffing levels and call bell response times to reduce the risks of people not being provided with the support they need in a timely way.

There were systems to monitor the service provided and where shortfalls were identified they were addressed, and lessons learned to drive improvement. Improvements had been made in how people’s care was recorded and monitored.

Improvements had been made in how people were asked for their views of the service and these were being listened to and acted on.

Staff told us how the manager was supportive, and the staff team were strong and committed to providing a good service. We were told how the team had pulled together during the pandemic which had strengthened relationships with the staff and people using 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 and update

The last rating for this service was requires improvement (published 25 November 2020). There were two breaches of regulation relating to governance and staffing levels. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

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.

We carried out an announced inspection of this service on 5 October 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in staffing and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Waterfield House on our website at www.cqc.org.uk.

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.