Watford House Residential Home

Updated 8 March 2024

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 two inspectors, a specialist advisor and an Expert by Experience.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Watford House Residential Home 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.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. 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

We spoke with two people who used the service and one relative about their experience of the care provided. We spoke with 11 members of staff including the regional support manager, registered manager, deputy manager, senior care workers, care workers, activities co-ordinator, housekeeping staff, the chef, kitchen assistant and maintenance person. We also spoke with two health care professionals who were visiting the service.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with 14 relatives about their experience of the care provided.

Updated 8 March 2024

About the service

Watford House Residential Home is a residential care home providing accommodation for persons who require nursing or personal care to 35 people aged 65 and over at the time of the inspection. The service can support up to 40 people.

Watford House Residential Home accommodates people in one adapted building. People have their own bedrooms with ensuite facilities. There are communal lounges, a dining room and a garden that people can access.

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

People were not always safe. People did not always have their care needs and associated risks thoroughly assessed and medicines may not always have been safely administered. There were not always enough staff to provide the care and support people required.

The service was not always well-led. Governance systems and processes were not always effective in identifying areas of concern, or ensuring measures were taken to drive improvement at the service.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

People did not always have their changing health needs reviewed and responded to in a timely manner.

People were supported by caring and passionate staff. People’s relatives felt welcome visiting the service.

Staff knew people well and worked to take in to account their wishes and preferences when delivering care. People and their families were supported well during the end stages of their life.

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 29 March 2019). The service remains rated requires improvement.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and culture at the service. A decision was made for us to inspect and examine those risks.

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 have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Watford 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to how risks were assessed and managed; medicine management; staffing levels; recruitment of staff; safeguarding; and how the service was managed at this inspection.

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.