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Inspection Summary

Overall summary & rating


Updated 10 December 2019

About the service

Waterfall House is a residential care home providing accommodation and personal care to up to 18 people with mental health needs. At the time of the inspection there were 11 people living at the home.

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

People told us that they were happy living at Waterfall House and felt safe. Many people had been living at Waterfall House for several years and considered it their home.

Staffing levels during the day were observed to be appropriate and met people’s needs safely. However, only one member of staff was allocated to work at night. We highlighted specific concerns regarding this to the registered manager and provider, especially in relation to fire safety and evacuation of people.

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. However, we found that where people lacked capacity, a mental capacity assessment and best interest decisions that had been made, had not always been clearly documented within the person’s care plan.

Risks identified with people’s health and care needs had been assessed and appropriate guidance had been provided to staff which enabled them to support people to remain safe and free from harm.

Medicines management and administration systems in place ensured people received their medicines on time and as prescribed.

Recruitment records confirmed that the provider only employed staff members who had been assessed as safe to work with vulnerable adults.

People were supported with their nutrition and hydration needs. People had access to drinks and snacks throughout the day. Where specialist support was required this was provided.

The service supported people to access the services of a range of health and social care professionals where required.

Support staff received the relevant training and support to carry out their role.

We observed positive and respectful interactions between people and staff. People were supported and encouraged to maintain their independence as far as practicably possible.

Care plans were person centred and detailed and focused on people’s needs and wishes.

People knew the provider and the registered manager well. We observed people approaching them with confidence.

A variety of systems and processes were in place to oversee and monitor the quality of care that people received. This enabled the service to learn, develop and improve care provision.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (published 9 May 2018).

Why we inspected

The inspection was prompted in part due to concerns we received about the provider, staffing allocations especially at night, the level of care people received and food and drink provisions. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the full report for further detail.

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.

Inspection areas



Updated 10 December 2019

The service was safe.

Details are in our safe findings below.



Updated 10 December 2019

The service was effective.

Details are in our effective findings below.



Updated 10 December 2019

The service was caring.

Details are in our caring findings below.



Updated 10 December 2019

The service was responsive.

Details are in our responsive findings below.



Updated 10 December 2019

The service was well-led.

Details are in our well-Led findings below.