About the service Waterfield House is a residential care home providing personal care to 54 older people, some living with dementia, at the time of the inspection. The service can support up to 76 people in one adapted building.
People’s experience of using this service and what we found
There had been changes in the management of the service since our last inspection. We found a breach of regulation regarding governance. The key question Well-led was rated requires improvement at our last inspection. At this inspection, Well-led had not improved to good and Safe had deteriorated from good to requires improvement.
People were asked for their views about the service in meetings and surveys. However, where people had raised issues in the last five meetings about staffing levels and food, prompt action had not been taken to address their comments regarding staffing.
We found shortfalls in the staffing levels in the service. People were not always provided with the support they needed in a timely way. We found a breach of regulation regarding staffing. The provider updated us on the action they had taken and were taking to address this.
Improvements were needed in records, to show people received the care and support they needed, including if they had enough to drink each day and ensure staff received the guidance they needed to meet people’s needs.
The current infection control systems in place reduced the risks to people. There had been no outbreak of COVID-19 in the service. Prior to our inspection, there had been a contagious outbreak, which was not COVID-19. During our inspection, we found improvements had been made to reduce future risks.
Staff were trained and understood their responsibilities in keeping people safe from harm and abuse. Risks to people were assessed and measures in place to reduce the risks.
The service had systems in place to learn from incidents and use them to drive improvement. A programme of audits were undertaken.
People received their medicines when they needed them. Medicines management was monitored and audited to ensure any shortfalls could be quickly identified and addressed.
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 good (published 16 November 2018).
Why we inspected
We received concerns in relation to staffing, care provided, record keeping, leadership and a contagious outbreak raising concerns about infection control processes. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.
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 coronavirus and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Waterfield House on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service. We have identified breached of regulation in relation to staffing and governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.