Watford House Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.
 

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider had systems in place to assess people's needs and maintain care records. This included a "resident of the day" process, which was used to review care plans and ensure information remained current and reflective of people's needs. As part of this process, the provider told us relatives and those important to people were contacted, where appropriate, to contribute to reviews and provide feedback on the care being delivered.

Relatives spoke positively about the service's responsiveness when people's needs changed and told us staff generally acted appropriately when additional support was required. However, relatives consistently told us that formal care plan reviews typically took place only once a year.
 

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff used recognised assessment tools to monitor people's health and wellbeing. For example, the Malnutrition Universal Screening Tool (MUST) was used to identify people at risk of malnutrition and support appropriate nutritional interventions, while Waterlow assessments were used to identify people's risk of developing pressure ulcers so preventative measures could be put in place.

Care plans relating to eating and drinking were detailed and reflected people's assessed needs, including any identified risks and specialist dietary requirements. People and their relatives generally spoke positively about the quality of meals provided.

The registered manager completed regular nutrition and hydration audits to maintain oversight of people's nutritional needs and ensure care records remained accurate and up to date. A recent dining experience audit had also been undertaken to evaluate the quality of mealtime experiences. This identified areas for improvement and demonstrated how people had been actively involved in developing a new menu to better reflect their preferences and choices.
 

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider had developed positive working relationships with a range of external health and social care professionals to support people's care and treatment needs. Staff worked with services including district nurses, GPs, dementia liaison teams and the community mental health team. Regular multi-disciplinary working was evident, with weekly ward rounds taking place and support from the community mental health team being available every two months, or more frequently when required.

Internal communication systems were also in place to support information sharing between staff. Leaders and staff completed daily 'flash' meetings where key information about people, risks and changing needs was communicated to the staff team.

The service was working to address a number of concerns identified by local stakeholders and was progressing an improvement action plan at the time of our assessment. The provider had made progress against the action plan and demonstrated a willingness to work openly with external partners to drive improvement.
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Care plans outlined people's individual healthcare needs and provided staff with guidance on how to support people to manage long-term health conditions. For example, where people were living with diabetes, care plans contained specific information about their needs and the support required to help them maintain their health. Care records demonstrated that plans were reviewed and updated when people's health needs changed, including following involvement from healthcare professionals, helping to ensure care remained current and responsive to people's needs. Staff worked with relevant health professionals to support positive health outcomes for people.

However, although staff received additional training to meet people's specific needs, we identified that staff had not received diabetes awareness training.
 

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Where people experienced changes in their health, staff worked with healthcare professionals to monitor progress and implement recommended interventions. For example, people with pressure ulcers received regular visits from district nurses, and care plans were updated to reflect professional guidance, treatment plans and any actions required. This information was communicated to staff through daily handovers, helping to ensure care was delivered consistently and in line with current needs.

Staff used the provider's electronic care recording system to record and monitor people's health and wellbeing, enabling changes in needs or concerns to be identified and responded to in a timely way. The registered manager reviewed these records daily, providing oversight of people's outcomes and ensuring appropriate action was taken where required.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood the importance of gaining consent and people’s agreement was sought before support was provided. Relatives told us staff consistently explained what support they were going to provide and sought consent before carrying out any care tasks. Where people were unable to communicate verbally, staff sought and responded to non-verbal forms of communication and consent, recognising individual preferences and cues to ensure people remained involved in decisions about their care.

The provider acted in accordance with the principles of the Mental Capacity Act 2005 (MCA). Where people’s capacity to make specific decisions was in doubt, appropriate mental capacity assessments had been completed. These assessments were decision-specific and considered people's ability to understand, retain, weigh up and communicate information relevant to the decision being made. Where people lacked capacity to make certain decisions, best interest decision-making processes had been followed.