Watermoor House

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 people's care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. The findings and outcomes of the Quality Statements we assessed found Watermoor House did not always carry out effective and person-centred care. Some subjects which needed the most improvement were in assessing needs, delivering evidence-based care and treatment, monitoring and improving outcomes and supporting people to live healthier lives. The findings and outcomes of the Quality Statements we assessed found the service did not always carry out effective and person-centred care. The provider had introduced systems to ensure people’s care plans and risk assessments were being developed with the inclusion of the people, their relatives, and staff. However, these were not always completed enough to give a clear understanding of people’s needs. People and relatives had not always been involved in this process. There were arrangements to support people to receive care and treatment in an appropriate way. Staff and leaders were working towards ensuring people were at the centre of their care.

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.

We spoke with 4 people about their experience of living at the service. People we spoke with told us while they were not aware if they were being involved in planning their care, staff provided them with everything they needed. We spoke with 4 relatives of people who lived at the service. One relative told us “[person] needs changed as their condition progressed and became advanced. They [staff] were very accommodating. Communication was great.”

Staff we spoke with explained they would need to read the care documentation on both the old and new electronic systems as well as the handover sheet and speak to their colleagues and senior carer to ensure they had all up-to-date information and risks were not being missed.

Care documentation in the old electronic system and in the new electronic system was available to staff and contained details on how to support people. We saw on the new electronic system not all care documentation was person-centred or contained information such as baselines for people, or guidance for staff on how to support people who might become distressed.

There were shortfalls in how risk to people’s care and support needs were managed while the care documentation was being migrated onto the new digital system. Handover sheets did not always contain robust information for staff to access. We saw a concern was identified on a handover sheet which detected a person’s pressure area had broken skin. This was followed by a GP visit. However there was a lack of follow-up information for staff on how to ensure the risk of further deterioration was to be reduced. There was no information signposting staff where to find further instructions. There was an additional staff member who came on duty in the late afternoon, during a period of peak activity. They received a short verbal handover, and had access to the electronic alert system, but they did not receive a full handover until the night shift handover, two hours into their shift. This meant there was a risk they may not be made aware of information about peoples changing needs.

People we spoke with were happy with how their needs were being met. One person we spoke to with us ‘The food is very good, its homely and very nicely cooked.’ People felt staff supported them.

There were some shortfalls with the registered manager working in line with current standards. We spoke with the registered and deputy manager, they were not aware of the requirement for the Accessible Information Standard to be in place under the Health and Social Care Act 2012. This meant information may not always be supplied in line with the requirements of the Standard.

We spoke with the registered manager and deputy manager about the support they received from external professionals. They explained how they were working with them to, for example, organise extra training. The managers told us “We’re quite lucky here because we have got quite good access and good relationships.”

Feedback received from care professionals was positive. They told us even though the managers were new they are working well together. Managers were also working with partner agencies to reduce hospital admissions.

People told us they always got to see a health professional whenever they wanted to. We saw evidence of support being offered in a suitable and timely manner to a person who was moving from the service. Family members of people living at the service were positive about the level of communication, for example when people had to go to the hospital. One family member told us “The staff at the Home communicated with me – they kept me up-to-date.”

We saw evidence people were receiving support with regular routine checks such as eye tests. Evidence we looked at showed the service worked with external professionals about a person needing to have a medicines review, an action after an incident.

People were not always empowered and supported to manage their own health, care and wellbeing needs by staff who understood their needs and preferences. Staff we spoke to were not always aware of the importance of promoting good outcomes to reduce the need for future care. People were not always involved in regularly reviewing their health and wellbeing needs where appropriate and necessary.

People and relatives we spoke with were happy with the level of support provided by the service. One person we spoke to told us "They [staff] help me to stay independent." A relative we spoke to told us "The staff all seem very capable and competent and caring."

We saw evidence which supported people to be involved and engaged in activities of their choosing and this information was presented in accessible ways. We saw evidence the activity programme was available in the newsletter, on a picture board and the lounge had a hearing loop and signage.

Staff were not always provided with robust information in care documentation to ascertain what a person’s baseline was to be able to identify signs of deterioration. The managers were aware of this and were working with external professionals to address this by implementing a nationally recognised tool to support staff in recording people’s condition and introducing falls champions. These systems were still being applied and therefore we could not assess the impact as it was on-going.

Although we saw evidence some people were involved in their care plan reviews, feedback from people in relation to this was mixed. People we spoke with were not aware of being involved in their care plans. They told us staff spoke to them but could not recall being involved in reviews about their care needs.

Staff we spoke with did not always feel there were enough opportunities for them to raise concerns about people’s health and wellbeing. One staff member we spoke with told us as not all staff attend staff meetings it may be difficult to get their voice heard. Another staff member we spoke with was unsure how to escalate concerns, for example, when someone’s mobility needs changed.

The service had a system to record people’s Lasting Power of Attorney information and Respect forms were being completed, which recorded people's wishes about hospital treatment. We saw evidence some people had read their own care documentation and consented to them.

We spoke with 4 people who live at the service and they unanimously told us staff ask for their consent when delivering support. One person told us “They do ask me what I want.”

Staff and leaders were aware of the principles of the Mental Capacity Act 2005 and how and to ensure people were given enough information to make informed decisions. One staff member told us “They have a right to know what’s going on at any point, and they also have the right to disagree.” Staff understood the principles the principles of best interest decision-making.