Waterhouse Manor Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this newly dual registered service. This key question has been rated Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People told us they were happy living at the service and felt safe and well cared for. One person said, “Got nothing to complain about, I do feel safe, I like sitting here, everyone is pleasant”

Accidents and incidents were audited each month. Findings and any issues identified were shared with the staff for learning and to improve practice.

The manager understood their responsibilities under the Duty of Candour. They told us, “It is about being open and honest when things go wrong.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Staff worked with external professionals including District nurses and GPs to support the move and have ongoing monitoring. Observations confirmed staff understood people’s assessed needs and supported them appropriately. Healthcare professionals told us they had a good working relationship with the service and communication was good.

Staff told us they were happy working at the service and felt supported and listened to.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People said they felt safe from harm and abuse and relatives agreed. One person told us, “Yes, I feel very safe there is always staff around.” A relative told us, “I do not feel that [name] is vulnerable now they are in this home.”

Staff received training in safeguarding and were aware of their responsibility to safeguard people and knew who to contact in the event of any safeguarding concerns. One staff member told us, “Any concerns about a resident I would report to the senior in charge.” Another member of staff told us, “I would report to safeguarding and contact CQC.”

The provider was proactive in raising safeguarding concerns with the local authority and CQC. They worked with the relevant professionals to investigate concerns when incidents occurred.

The provider understood their responsibilities under the Mental Capacity Act 2005 in ensuring Deprivation of Liberty safeguards (DoLS) applications were submitted as required.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People said staff knew their needs and met these safely. There were processes in place to ensure risks to people were assessed and mitigated. Risk assessments provided staff with information to mitigate the risk and were regularly reviewed or when changes occurred.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff had undertaken training in health safety and fire safety. Cleaning chemicals and medicines were securely stored.

The providers carried out and organised safety checks, which included, gas safety, portable electrical appliances and water safety to ensure the risk of legionella disease was well managed.

Equipment used to support people was suitable, well maintained and stored securely. The providers had an up-to-date plan in place to help ensure people were supported in the event of an emergency. Staff told us they made checks on items such as slings as part of their daily checks.

All these checks helped to ensure that people lived in a safe environment.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Policies and procedures were in place for the recruitment of staff, which included checks on staff’s identity, eligibility to work in the United Kingdom, Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

Staff generally told us they were happy working at the service and felt supported and listened to. They said they received training that equipped them with the skills and knowledge needed to carry out their roles effectively and provide good care to people using the service. Some staff told us there had been occasions when staffing levels were low, which meant people may have experienced delays in having their care needs met.

The manager used a dependency tool to help ensure staffing levels were sufficient to meet people's needs. People's needs were regularly assessed and reviewed to inform staffing requirements. We received mixed feedback regarding staffing levels. Comments included, "I think there are just about enough staff on duty during the day," "Care staff can be stretched in the mornings, and you do wait longer," and "There are not enough staff. Some days there are only a few staff on, and activity staff have to support with care and kitchen duties."

We discussed staffing arrangements with the manager, who acknowledged that the service had experienced some staffing challenges. However, there was no evidence that these had resulted in unsafe care. The provider had undertaken a recruitment campaign, with new staff recently joining the service, and the reliance on agency staff was reducing.

New staff completed a thorough induction, including mandatory and training specific to the needs of people using the service, such as diabetes and dementia, shadowing experienced staff, and competency assessments before working independently.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was free of odours and housekeeping staff made sure areas were sanitised, clean, hygienic and fresh. One person said, “Staff come and clean my room every day.” Another person said, “My room is lovely and clean.”

Staff had sufficient supplies of PPE. They received training to help them maintain good standards of infection control. Staff told us they followed procedures for the use and disposal of their PPE. People and relatives also confirmed staff followed safe infection control practices. The provider has introduced a champion responsible for infection prevention control (IPC). They have started holding short sessions with new starters, covering IPC.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People received their medicines safely and as prescribed. People’s care plans reflected their preferences about how they wanted to take their medicines and this was respected.

Senior care staff were trained in medicines administration, and their competencies were checked regularly. Medicines audits were undertaken weekly.

We observed the administering medicines. Staff followed safe procedures and displayed a confident and calm manner. They communicated with people respectfully and kindly, explaining what they were doing and providing support. Consent was obtained from each person before administration.

Where people were prescribed ‘as required’ (PRN) medicines, we saw PRN protocols were in place. These were clear and contained all the necessary details about the person, the prescribed medicines and how to administer these.

Medicines were stored appropriately in a locked cabinet and kept in a cool room. Temperatures were taken and recorded regularly and were within safe range.

The provider used an electronic recording system. The system highlighted if a medicine was not given within the safe time of administration, or if someone had not received their medicine safely. The manager undertook regular audits to ensure people were receiving their medicines as prescribed. Where errors were identified, we saw appropriate actions were taken.