Watson House

Updated 18 December 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by one inspector.

Service and service type:

Watson House is a 'care home’ which can accommodate up to seven people in one adapted building.

The service had a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

This inspection was unannounced.

What we did:

What we did before the inspection

Prior to the inspection the provider sent us a Provider Information Return. Providers are required to send us information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We reviewed information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law.

We wrote to eleven health and social care professionals to gain their feedback about working with the provider. We received feedback from seven professionals in response.

During the inspection

We spoke with five people, who were able to give us limited feedback. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the registered manager, the deputy manager and four care staff.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and supervision. A variety of records relating to the management of the service, including policies, procedures, audits, incident reports and risk assessments was reviewed.

After the inspection

We spoke to four relatives to gain their views about their family members experience of receiving care and living at the service.

Updated 18 December 2019

About the service:

Watson House is one of eight separate residential care homes within Purley Park Trust Estate. Watson House provides personal care and support for up to seven people who have learning disabilities and associated conditions, such as autistic spectrum disorders.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service had been registered with CQC prior to the publication of Registering the Right Support, in 2017. The provider recognised that the need to ensure the service did not reflect the characteristics of a ‘campus style development or congregate setting model’, which would not be in line with the principles of this best practice guidance.

The eight homes were situated on a residential street, surrounded by public residential areas. There were no restrictions of access to Purley Park Trust Estate, with each home having its own individual security arrangements according to what was most suitable.

Each service of the eight had their own separate staffing team and facilities, which helped to promote individualised care tailored to people’s needs. People could socialise with other people on site if they wished, but their care was developed around their own interests, goals and preferences. The home was in walking distance of the local town and there were bus routes available for people who wished to use public transport. People were connected to their local community, utilising services for their vocation, leisure and social activities.

People's experience of using this service:

The provider had a proven track record of successfully supporting people with complex health and behavioural needs, where previous care placements had broken down.

Many people required close monitoring by staff and ongoing input from healthcare professionals. Their historical anxieties around accessing healthcare services had proved to be a barrier to receiving the healthcare they required, resulting in a reduced quality of life. These barriers included past negative experiences and sensitivity to new people and surroundings. Staff provided highly personalised and focussed support to help people effectively overcome these barriers, ensuring they received the healthcare input they needed. This resulted in good outcomes for people, enabling them to live full lives, which were not limited by their healthcare conditions.

The provider had an innate understanding of delivering empathetic and responsive end of life care, fully considering the protected equality characteristic of people’s learning disability. Staff worked to ensure people’s needs and preferences were at the forefront of how decisions were made and how care was arranged. This resulted in a and person-centred service wide approach to caring for people at the end of their lives.

Relatives and professionals were universal in their praise for the skill and dedication of the provider in ensuring people's needs were met. The provider had consistently delivered high quality care which was intuitive, responsive and individualised.

The provider met people's communication needs and helped them contribute towards making decisions about their care. Staff understood people's preferences and they encouraged people to build meaningful relationships, follow their interests and build upon their skills and abilities. The environment at the home had been adapted to maximise the opportunities for people to be as independent as possible.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager was a role model to their staff. They were dedicated, professional and provided effective leadership to staff. There were effective systems in place to monitor the quality and safety of the service. There were appropriate policies in place to handle people's complaints and act on feedback.

There were safe systems in place in relation to the management of people's medicines. The provider had supported people and medical professionals to minimise the use of some medicines, where possible.

People were supported appropriately with their nutrition and hydration.

There was an open and transparent culture at the service, which was embodied through all branches of the staff team. The service was clean and had a homely atmosphere. People were comfortable in staff's presence. There were enough staff in place, many of whom had established extremely positive working relationships with people.

Rating at last inspection:

The service was rated good at our last inspection (17 February 2017))

Why we inspected

This was a planned inspection based on the previous rating.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk