Archived: Waterside Care Home

Waterside Care Home is registered to provide accommodation and personal care to a maximum of 60 older people. At the time of the inspection there were 59 people living at the home.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood how to identify and report abuse and had a good understanding of how to manage risks to keep people safe. People were given their medication by staff who had been trained in how to do this.

People told us there were sufficient staff available to meet their needs. Staff had undergone appropriate recruitment checks prior to starting work and had access to ongoing training and supervision to support them in their role.

People had been supported to make their own decisions and had their rights upheld in line with the Mental Capacity Act 2005. Where people had been deprived of their liberty, this was done in line with Mental Capacity Act 2005 and staff were aware of why these safeguards were required.

People were supported to have enough to eat and drink and had meals that met their dietary requirements. Where people required support to access healthcare services, staff had provided appropriate support to meet people’s health needs.

Staff had a kind and caring approach and treated people with dignity. People were supported to regain independence where possible and had access to advocacy services if required.

People and their relatives were involved in the assessment and review of their care. People were supported by staff that had a good knowledge of people’s needs and people had access to activities that interested them.

People knew how to make complaints and complaints made had been investigated fully by the registered manager. People were supported to provide feedback on the service via resident meetings and suggestions made had been acted upon by the registered manager.

People spoke positively about the leadership at the home. The registered manager completed audits to monitor the quality of the service.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, and the records we looked at. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

Risk assessments were in place for things such as moving and handling, skin integrity and falls. Control measures had been put in place. This meant that people's needs were met and people were kept safe. People and their relatives confirmed they felt the service was safe. A relative we spoke with said, 'I feel safe here, I am happy with my room, I can personalise it and I can have lunch in my room.' Another person said, 'Yes, staff complete my records.' A relative said, 'I am involved in any changes to X's care or medicines. If there is a problem they always notify a relative.'

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Documented procedures were in place for the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made. Staff had also had training in the Mental Capacity Act 2005. This meant that systems were in place to safeguard people as required.

The service was safe, clean and hygienic. People we spoke with were able to confirm their rooms were cleaned daily. We found the home to be clean and odour free. We saw evidence that flooring in the kitchen was due to be repaired or replaced. We saw that cleaning schedules and checklists had been completed. Vacant rooms were deep cleaned. This meant that the provider took action to maintain a clean hygienic environment and reduce the risk of spread of infection.

On a previous inspection we found that people were not always fully protected against the risks associated with medicines because arrangements in place to manage medicines were not always followed. During this inspection we found that arrangements in place were being followed. Medication records were accurately maintained. Only staff that had been trained administered medication.

Is the service effective?

People experienced care and support that met their needs. People told us how they were supported. The registered manager told us they worked with other agencies to ensure people's health and social care needs were met. One person said, 'The Doctor comes to see me whenever I need him.' A visiting professional said, 'The services attention to detail is very good.' People confirmed that they were involved in decisions about their care. This meant that people received care in the way they wanted.

Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.

Is the service caring?

People were supported by kind and considerate staff. Staff we spoke with told us how they supported people. People and relatives confirmed staff were caring, respectful and polite. One person said, 'Yes staff are caring, I see the manager every day.'

People's preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People were involved in their day to day care and were supported to maintain their independence. One person said, 'Some staff are very good, The food is excellent, we are given choices.' This meant people's diversity and individuality were promoted and respected.

Is the service responsive?

People were treated with respect and dignity by the staff. Care plans had been developed that took into account people's changing needs and wishes. They identified people's needs and were reviewed regularly or when there was a change in need. Staff demonstrated a good understanding of people's needs. People were given choices and supported to make decisions themselves. A relative said, 'We have no complaints, X is very happy here.'

We observed the service responded as quickly as it could to meet people's needs and ensured people's safety and dignity was maintained. However, when staff were busy taking people to the bathroom a few people had to wait until a member of staff was free to attend to them. A relative said, 'They could do with more staff.' People told us that staff responded to call bells as soon as they could. People and their relatives confirmed that they were given choices and encouraged to express their views.

People told us they would speak to the manager if they were unhappy about anything. We saw a copy of the complaints procedure was available in people's rooms. The registered manager told us there had been no complaints since the last inspection.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. This was confirmed by a visiting professional. Staff told us they felt supported and that the training opportunities were good. However, most staff said that they could do with more staff. Staff were aware of their roles and responsibilities and had opportunities to raise any issues or concerns. People we spoke with were positive about the service and care they received. One person said, 'Yes I think it is well led.'

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. People had access to a copy of the complaints procedure. This reduced the risks to people and helped the service to continually improve.

The service had a quality assurance system in place. Audits were undertaken regularly. The registered manager showed us monitoring reports that they supplied to the provider. Analysis was undertaken and action taken where necessary. This meant the quality of the service was able to continually improve.

At the time of our inspection 59 people lived at Waterside Nursing Home. (This number included 11 people who were receiving care for a short period of time before returning back to their homes within the community or moving on to an alternative care provision). Accommodation was in a two storey building that was divided into three separate units.

During our inspection days we spoke with twelve people who lived there, nine relatives, ten staff and the registered manager. Everyone we spoke with was complimentary about the overall service provided, their care and the staff. One person who lived there said, 'I had to go into hospital. Although they were good there I was really glad to get back here. It is good here'. Another person told us, 'I did not want to come in here. I have been here for some time now and would not want to go anywhere else. It is a good place'. A relative said, 'The care that they have been given has been excellent'. Another relative told us, 'They are the first person in our family that have gone into a home. We heard horror stories on the news about care homes and we were worried. However, they have been so well cared for here. It is a wonderful place. We do not worry at all'. All staff we spoke with confirmed that in their view the people who lived there were cared for and safe.

We saw that people's needs had been assessed by a range of health professionals including specialist doctors, specialist nurses, the dietician, and the speech and language therapist. This meant that staff had taken action so that people's health and care needs would be monitored and met.

People had been provided with varied food and drink options to prevent malnutrition and dehydration.

Arrangements that were in place did not give full assurance that people were protected from the risks associated with the unsafe management of medicines.

We saw that the premises were adequately maintained and were reasonably safe.

Satisfactory recruitment procedures ensured that people were protected from the risk of unsuitable staff being employed.

We determined that staffing levels were adequate to ensure that people's needs were met and that they were safe.

We saw that complaints processes were in place for people or their relatives to use if they were not happy with the service provided.

We inspected the home in October 2012 and found that staffing levels were not adequate which meant that staff only had minimal time to spend with people to meet their needs.

At this inspection we looked at the improvements that had been made in relation to this. We saw that staffing levels had been increased so that people needs were being met.

People we spoke with told us positive things about the home. One person told us "It is a good home and I like it here. We are well looked after". Another person said 'They are very good to us here'. The majority of relatives complimented the home. One relative said 'It is excellent. I can not praise this place enough. If I needed to go into a home I would come here". Another relative said "The home is brilliant, they are very well looked after".

People's needs had been assessed by a range of health professionals including specialist doctors and the optician. This meant that staff had taken action so that people's health and care needs had been met.

Medication systems were in place so that medication would be given to people as it had been prescribed by their doctor.

Staffing levels were not adequate which meant that staff only had minimal time to spend with people to meet their needs.

We saw that the home was adequately maintained and bright. This meant that people had a pleasant environment to live in.

We found that recruitment checks prevented unsuitable staff working at the home and the risk of harm to people.

Records that we looked at confirmed that systems had been used to monitor how the home had been run.