Watford House Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.
At our last assessment we rated this key question good. At this assessment the rating has remained as good. This meant people’s needs were met through good organisation and delivery.
 

This service scored 68 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff demonstrated a strong understanding of the importance of delivering person-centred care and spoke passionately about ensuring people remained at the centre of decisions about their care and support. Staff described taking time to understand people's preferences and adapting their approach to meet individual needs. One staff member told us, "I always try to work at the resident's pace and make sure their dignity and choices are respected, because that's really important to me in my role." Another said, "People are well looked after, respected and cared for, and the staff genuinely care." These comments reflected a caring culture where staff were committed to providing personalised support and promoting positive outcomes for people.

People's relatives were positive about the care provided and told us they felt support was personalised to their loved one's needs. Relatives described being involved in care planning, particularly when people first moved into the service, helping staff to understand people's histories, preferences and routines. continuity of care. Relatives reported good involvement during the initial care planning process, However, this involvement was not always maintained consistently through ongoing reviews. The provider had recently implemented the ‘resident of the day’ which meant people and their relatives would be consulted with each month to drive this improvement.
 

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The registered manager described a range of measures to help ensure staff had a consistent understanding of people's needs and preferences. This included asking staff to review care plans and complete knowledge checks to confirm their understanding of how people wished to be supported. Leaders emphasised the importance of staff referring back to care plans where required and ensuring a consistent approach to care delivery. Additional tools, including summary information sheets, were being introduced to support staff knowledge and reduce the risk of important information being overlooked.

Relatives spoke positively about the care and support provided and told us they were happy with the service their loved ones received. They described their family members as being happy living at the home and told us staff provided consistent care and support which met their needs.
 

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People consistently told us they were unaware of their care plans and, as a result, were also unaware that they could access and review information relating to their care and support. This limited opportunities for people to understand, contribute to, and take ownership of the planning of their care.

The provider had systems and processes in place to support accessible communication, including the use of electronic systems to develop communication aids tailored to individuals' needs.
 

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Whilst most people told us they felt comfortable raising concerns with staff or management, people and their relatives consistently told us they were unaware of the provider's complaints procedure and were not clear about how to make a formal complaint.

Opportunities for people and those important to them to provide feedback and influence the development of the service were not always effective. Relatives told us they had not been routinely asked for feedback about the care and support their family members received and felt relatives' meetings could take place more frequently. This meant we could not be fully assured that people and those close to them were consistently involved in shaping and improving the service.
 

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

During the assessment, we observed occasions where people experienced prolonged delays in having their needs met. This included people waiting significant periods of time for support to access the bathroom or to be assisted to their bedrooms when they wished to rest. Delays in responding to people's requests reduced their comfort and dignity and meant people were not always supported in a timely manner when they required assistance.

We also received feedback from relatives that people were not consistently supported by staff when attending hospital for urgent medical treatment. Relatives described occasions where people were left unaccompanied in unfamiliar and potentially distressing environments whilst awaiting treatment or assessment.

Whilst people could move around the home and was accessible, there were opportunities to further enhance the environment for people living with dementia. For example, the use of contrasting colours and clear signage could support people's orientation and independence. In addition, more specialist dementia-friendly approaches, such as the use of coloured crockery and adapted dining experiences, could further improve accessibility for people with cognitive impairments.
 

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People experienced care and support that promoted equality, dignity and respect. People and their relatives told us they were treated fairly and did not experience discrimination. Feedback indicated staff treated people as individuals and respected their diverse backgrounds, needs and preferences.

The provider had an Equality and Diversity Policy in place to guide staff in delivering inclusive care. Staff also received equality and diversity training, helping them to understand their responsibilities in promoting people's rights and ensuring care was provided in a non-discriminatory way.
 

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider recognised the importance of having sensitive and person-centred conversations with people and those important to them to ensure future care reflected their values, choices and beliefs.

Care records demonstrated that people's future wishes were considered as part of the care planning process. People and, where appropriate, their relatives were involved in discussions about future care needs, including end-of-life care preferences. This helped to ensure important decisions were documented and understood by those responsible for providing care.

Where a do not attempt cardiopulmonary resuscitation (DNACPR) decision was in place, records showed this had been made following appropriate clinical assessment and discussion with the person and/or those legally involved in decisions about their care. DNACPR decisions were individualised, regularly reviewed, clearly documented, and made in accordance with the Mental Capacity Act 2005 and national guidance.