You are here

Options Watermill House Outstanding

Reports


Inspection carried out on 16 July 2018

During a routine inspection

Options Watermill House was inspected on 16 and 17 July 2018 and was unannounced.

Options Watermill House is a care home providing accommodation and personal care for up to ten younger adults with a learning disability, autistic spectrum disorder and associated complex needs.

Options Watermill House consists of two separate buildings, the house and the bungalow. Those living in the house have their own en-suites and quiet spaces. People are encouraged to personalise these areas. They share access to kitchen, lounges, and dining facilities. There is also a fully equipped single occupancy flat within the house.

The bungalow has four independent, high quality single occupancy flats. This means those who use the service have the opportunity to practice independence skills and develop these with a view to moving to more independent living at a future date, should they wish to do so. Every flat has access to a patio or garden area. People who use the service have access to the other facilities on site which include; a sports hall, an activity barn, a woodland area, sensory room, computer room, external gardening, hydrotherapy pool and specialist outdoor activity equipment.

Options Watermill House 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. At the time of our inspection there were 9 people living at the service.

At our last inspection in November 2015 we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that showed serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place at the time of our inspection. 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.

Options Watermill House have maintained and further developed the outstanding model of care and support provided to those who live in the service, which underpins the values of Registering the Right Support. The service is extremely committed to person-centred planning making every effort to assist people to be involved in and understand decisions about their care and support to enhance their self-esteem, quality of life and confidence.

Staff were compassionate and kind and went ‘above and beyond’ to ensure people received positive outcomes. Recruitment processes were robust to ensure prospective staff had the right skills and were suitable to work with vulnerable people. Staff had regular supervision and their personal performance was evaluated at an annual appraisal. Staff were very well qualified, competent and had extensive training based on best practice and guidance, to equip them with the skills and knowledge needed to support people extremely effectively.

The service continued to support an extremely person-centred approach, care plans were comprehensive and showed people whose behaviour had previously isolated them, had been supported by the service to develop new skills and successfully become involved in their local community and achieve extremely positive outcomes. For example, one person had particularly high needs regarding their behaviour, when they first arrived at Options Watermill House other providers had stated they could not meet their complex needs. Staff had worked tirelessly with the person to improve their quality of life. Relatives and professionals told us they were amazed

Inspection carried out on 5 and 10 November 2015

During a routine inspection

This inspection took place on 5 and 10 November 2015 and the inspection was unannounced, which meant the registered provider did not know we would be visiting the service. The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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. There was a manager registered with the Care Quality Commission (CQC); they had been registered since December 2010. At the last inspection on 28 October 2013, the registered provider was compliant with all the regulations we assessed.

Watermill House is a care service providing accommodation and personal care for up to ten younger adults with a learning disability, autistic spectrum disorder and associated complex needs. Many people the service supports had previously challenged traditional services and require bespoke and flexible support packages. There were nine people living at the service on the day of our inspection. Watermill House consists of two separate units, the house and the bungalow.

Within the main house, people who used the service had their own en-suite bedrooms and quiet spaces, which they were encouraged and supported to personalise. They also had shared access to a kitchen, lounges and dining facilities. A fully equipped single occupancy flat was also available within the main house, with bedroom, en-suite bathroom and kitchen diner. The bungalow was divided into four independent high-quality single occupancy flats; each had a bedroom, en-suite bathroom and kitchen. This meant that people who used the service had the opportunity to practice their independence skills and develop these with a view to moving to more independent living at a future date, should they wish to do so.

Every unit has access to a patio or garden area. People who used the service had access to the other facilities on site which included; a sports hall, an activity barn, a woodland area, sensory room, computer room, external gardening, hydrotherapy pool and specialist outdoor activity equipment.

Positive risk taking was driven throughout the organisation, balancing the potential benefits and risks of choosing particular actions over others, in order to support people to live lives in as ordinary a way as possible. In delivering this consistent approach people were supported to try new things and make changes in their lives. The registered provider, the registered manager and staff had an excellent understanding of managing risks and supported people that had previously challenged services to reach their full potential.

An outstanding feature of Watermill House was the time spent developing the service to accommodate the changing needs of the people who used the service, using innovative and flexible ways to support people to move forward. The registered provider was seen to constantly adapt and strive to ensure people who used the service were able to achieve their full potential. Over a period of time we have seen people be supported to progress and their environments adapted and developed to promote more independent living.

We found personalised programmes and flexible staffing enabled people to learn to live fulfilled and meaningful lives. Staff were skilled at ensuring people were safe whilst encouraging them to stretch their potential and achieve as much independence as possible. This was based on the philosophy of the organisation ‘fitting a service around you, not fitting you within a service’. The registered manager and team demonstrated passion and commitment to providing the best care possible for people, celebrating individual’s personal achievements with them.

There was a strong person-centred culture apparent within the service. Person centred means care is tailored to meet the needs and aspirations of each individual. Care records showed people’s individual needs were continually reviewed and both they and their families were consulted and involved in these. Relatives confirmed their family members were also included in decisions and discussions about their care and treatment.

Staff described working together as a team, how they were dedicated to providing person-centred care and helping people to achieve their potential. Staff told us the registered manager had strong leadership qualities, led by example, promoted an ‘open door policy’ and was visible within the service, making themselves accessible to all. They told us the registered manager had strong values in promoting the delivery of best practice.

We observed staff treated people with respect and dignity and it was clear they knew people’s needs well.

We found staff were recruited in a safe way; all checks were in place before they started work and they received an in-depth comprehensive induction. There were sufficient staff on duty to meet people’s health and welfare needs.

The registered manager ensured staff had a clear understanding of people’s support needs whilst recognising their individual qualities and attributes. Staff had the skills and knowledge to meet people’s needs. They received training and support to equip them with the skills and knowledge required to support the people who used the service. Training was based on best practice and guidance, so staff were provided with the most current information to support them in their work.

Thorough systems were in place to protect people from the risk of harm or abuse. People lived in a safe environment that had been designed and adapted to meet their specific needs. Staff made sure risk assessments were carried out and took steps to minimise risks without taking away people’s right to make decisions.

Staff had received training in dealing with concerns and complaints and knew how to report any concerns. There was a clear complaints procedure in place which was also available in pictorial format.

Medicines were ordered, stored, administered or disposed of safely. Personalised support plans had been developed to ensure people received their medicines in line with their preferences.

We saw people had assessments of their needs and care was planned and delivered in a person-centred way. Throughout our inspection we saw the service had creative ways of ensuring people led fulfilling lives and they were supported to make choices and have control of their lives.

People participated in a range of personal development programmes. Individual programmes were designed to provide both familiar and new experiences for people and the opportunity to develop new skills. People who used the service accessed a range of community facilities and completed activities within the service. A vocational life skills supporter had been appointed to promote further structured activities based on individual need and preferences. People were encouraged to follow and develop social interests and be active and healthy.

People’s nutritional needs were well met and they had access to a range of professionals in the community for advice, treatment and support. Staff monitored people’s health and wellbeing and responded quickly to any concerns. We observed staff treated people with dignity and respect and it was clear they knew people well and their preferences for how they wished to be supported.

Care plans had been developed to provide guidance for staff to support in the positive management of behaviours that may challenge the service and others. This was based on least restrictive best practice guidance to support people’s safety. The guidance supported staff to provide a consistent approach to situations that may be presented, which protected people’s dignity and rights.

The registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service. Staff were very highly motivated and proud of the service. The service had developed and sustained effective links with organisations that helped them develop best practice in the service.

The registered manager used effective systems to continually monitor the quality of the service and had ongoing plans for improving the service people received.


Inspection carried out on 28 October 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people who used the service, because the people who used the service had complex needs which meant they were not able to tell us their experiences.

We were told that choice was offered to people using a variety of different methods including symbol and picture documentation and, individualised activity planning programmes.

We observed positive interactions between staff and people living in the home. We saw that staff offered people choices in how care was to be delivered and that they took their time to explain care tasks to people.

Discussions with staff showed they were knowledgeable about peoples care needs and the care required in meeting needs. We found that professional advice had been sought by care workers where any health needs were identified.

We saw that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. The people we spoke with told us they decided things and staff respected their decisions. Where people did not have the capacity to make an informed decision a system was in place for appropriate people to be involved in making decisions in their best interest.

The manager confirmed that they would complete an assessment if capacity to make decisions was in doubt and a best interest meeting would be held.

Relatives of people who used the service told us that they were always involved in decision making and had copies of all records for areas where consent had been given.

Comments included �We were bowled over when we visited the service, the space, the site and the staff. It made us feel that we had made the right decision, after having looked at a number of places.� �There is so much for him to do. We visit regularly and we have got to know the staff.� �We are always kept up to date and his best interests are always paramount.�and �The staff understand him and know him well.�

We found that the numbers of staff provided was based on individual need and regularly reviewed to ensure that there was adequate support available to meet the needs of the people who used the service.

We found that staff helped to make sure health and social care was well coordinated and provided by a range of professionals.

Inspection carried out on 6 February 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people who used the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We observed four people who use the service using the Short Observational Framework for Inspection (SOFI).

The SOFI observation showed that staff interactions were good and that people who used the service engaged positively with a staff member or visitor on a particular activity or task.

We were told that choice was offered to people using a variety of different methods including symbol and picture documentation, individualised activity planning programmes and person centred planning.

We observed that people were able to convey their views to staff and had developed their own ways of communicating.

Inspection carried out on 2 November 2011

During a routine inspection

Many of the people currently using the service have a variety of complex needs and communication difficulties and were not able to tell us directly about their care. Throughout the visit we observed that staff treated people using the service with kindness and respect.

We found that care staff were very aware of the individual personal and healthcare needs of the people that use the service and supported them to make choices about their care and daily life.

We saw that staff involved people in meaningful activities throughout the day and there was a positive, happy atmosphere within the home. We observed people participating in a range of activities such as singing, watching TV, art therapy and walking in the grounds.

Reports under our old system of regulation (including those from before CQC was created)