Waterside Care Home

Waterside Care Home is a care home providing personal care for up to 19 people who live with dementia and mental health conditions. At the time of our inspection there were 19 people using the service. Waterside Care Home will be referred to as Waterside within this report.

People’s experience of using this service and what we found

People’s care records included risk assessments guiding staff to reduce the risk of unsafe or inappropriate care. The registered manager demonstrated they sustained improvements in service oversight following findings at our last inspection. Control measures, such as environmental risk assessments and audits, enabled people to live in a safe, comfortable home.

People told us there were sufficient staff to meet their needs. One person said, “Whenever I need something there is always someone on hand straight away.” Staff had adequate training levels to underpin their knowledge. For instance, they had training on the safe administration of people’s medicines, which the registered manager underpinned with competency checks of their skills.

The management team had good oversight of quality assurance to ensure everyone lived and worked in a safe environment. Without exception, people said they were happy living at Waterside and were consulted about various aspects of their care. There was a desire to continuously develop and improve the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 11 October 2017).

Why we inspected

We undertook this inspection as part of a random selection of services rated good and outstanding.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

The provider had dedicated staff to ensure people were admitted safely and continued to be supported in the service in accordance with national guidance. They supported people and their relatives to understand the policies and procedures surrounding protection against COVID 19, the isolation processes and how the management team and staff could help keep people safe.

Social media systems such as mobile phones and computer systems were used to facilitate contact between people and their relatives. One person said, “I come and go as I please around the home, visitors come to the pod.” The registered manager was facilitating safe visiting in line with government guidance.

During our visit we observed the staff using Personal Protective Equipment, (PPE) safely. The registered manager told us sufficient stocks of PPE were available and we confirmed this on the visit. A staff member said, “Always provided with PPE.”

People living in the home and staff were tested regularly for COVID-19. There were no staff employed who had not been vaccinated as now required.

The home was clean and hygienic. Cleaning schedules were in place and PPE stations placed around the home in individual rooms. Additional PPE stations were being fitted in communal areas on the wall to accommodate staff when entering people’s rooms. There were designated domestic staff and cleaning schedules were followed. The registered manager carried out regular checks of the environment and cleanliness and any shortfalls were being acted on.

At the last inspection on 07 March 2017 we asked the provider to take action to make improvements because we found breaches of legal requirements. This was in relation to care planning, staff training and good governance. The provider sent us an action plan saying they would meet the legal requirements. During our inspection visit on 12 September 2017 we found these actions had been completed.

Waterside Care Home is registered to provide personal care for a maximum of 19 older people. The home is an adapted property, which is situated on the promenade at Bispham. The accommodation comprises of 19 single bedrooms, of which 14 have en-suite facilities. A stair lift enables people to gain access between the ground and first floor. At the time of our inspection visit there were 19 people who lived at the home.

There was a registered manager in place. 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.

We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and treated people with dignity and respect.

People who lived at the home and one person visiting their relative told us they were happy with the care provided. Comments received included, “I am very happy here the staff couldn’t do any more for me.” And, “I have been very happy with the care provided for [relative].”

The service hadn’t recruited any new staff since our last inspection. Recruitment procedures were found to be safe during that inspection.

Staff had received training to enable them to support people who presented behaviour which challenged the service safely.

Staff spoken with had received safeguarding training and understood their responsibility to report unsafe care or abusive practices.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required. The registered provider had an ongoing refurbishment programme in place making improvements to the environment. This included new carpets and flooring being fitted throughout the home and improvements to people’s bedrooms.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

The service demonstrated appropriate systems to assess risk for people living at the home. Information about how staff supported people who presented behaviour which challenged the service was in place to inform staff how to support people safely.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff knew people they supported and provided a personalised service in a caring and professional manner.

People told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

We saw people had access to healthcare professionals and their healthcare needs had been met. The service had responded promptly when people had experienced health problems.

People who lived at the home told us they enjoyed a variety of activities which were organised for their entertainment.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were happy with their care.

The service used a variety of methods to assess and monitor the quality of the service. These included resident meetings and care reviews.

Although the service had improved since the last inspection we still need to ensure the improvements will be sustained. This is because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.

Since that inspection we have been informed about a specific incident which raised concerns in relation to safeguarding procedures, care planning arrangements, medicines management and management of behaviour that challenged. As a result we undertook a focused inspection to ensure fundamental standards were in place to keep people safe. This report only covers our findings in relation to the raised concerns. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Waterside Care Home on our website at www.cqc.org.uk”

Waterside Care Home is registered to provide personal care for a maximum of 19 older people. The home is situated on the promenade at Bispham. The accommodation comprises of 19 single bedrooms, of which 14 have en-suite facilities. A stair lift enables people to gain access between the ground and first floor. When we completed this focussed inspection there were 19 people who lived at the home.

The service did not have a registered manager in place. 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.

Prior to this inspection the manager had submitted an application to be registered with the Care Quality Commission (CQC). This was being dealt with by CQC’s registration team when the inspection visit took place.

We asked the regional manager and the home’s manager if there had been any safeguarding incidents involving people who lived at the home since we last inspected the service. They told us there had been one which had been investigated by the local authority safeguarding team. The manager said there hadn’t been any incidents which she had needed to report.

Staff spoken with told us they had received safeguarding training and understood their responsibility to report concerns to the manager.

We noted within the daily notes there had been incidents where people had been aggressive towards members of staff. There had been no incident reports completed identifying the results of challenging behaviour by people who lived at the home towards staff. The manager acknowledged documentation was poor and confirmed these would be reviewed.

We found care records did not always provide staff with clear guidance to meet people's needs.

Care plans did not provide clear strategies for staff supporting people who became agitated and distressed.

This was breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Safe care and treatment).

The staff members we spoke with told us there were people who could be challenging but they hadn’t received any training to manage their behaviour.

This was breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Staffing).

We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and showed affection towards the people in their care. The atmosphere in the home was relaxed and calm and we saw no evidence of behaviour that challenged the service during our inspection visit.

We spoke with a visiting healthcare professional during our inspection visit. They told us they were happy with the care provided at the home and had no concerns about the staff who worked there. They told us they had never seen anything that would need to be reported the local authority safeguarding team.

We found medication procedures at the home were safe. Medicines were safely kept with appropriate arrangements for storing in place. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required.

The service had not maintained accurate, complete and contemporaneous records in respect of each person who lived at the home. We found care records did not provide staff with clear guidance to meet people's needs. There had been no incident reports completed following incidents where people who lived at the home had presented behaviour which challenged staff. We found incomplete records including consent forms, care needs and dependency forms which hadn’t been signed or dated.

The provider did not have effective quality assurance systems in place to identify where quality and safety was compromised. Systems were not in place to safeguard all people against risk and ensure appropriate care was delivered to meet individual needs.

These were breaches of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Good Governance).

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

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At the last inspection on 01 September 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Waterside Care Home is registered to accommodate 19 older people. The home is an adapted property, which is situated on the promenade at Bispham. The accommodation comprises of 19 single bedrooms, of which 14 have en-suite facilities. A stair lift enables people to gain access between the ground and first floor. At the time of our inspection visit there were 17 people who lived there.

There was a registered manager in place. 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.

We found the registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report any unsafe care or abusive practices. People we spoke with told us they felt safe and their rights and dignity were respected.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

We found recruitment procedures were safe with appropriate checks undertaken before new staff members commenced their employment. Staff spoken with and records seen confirmed they had received induction training when they commenced working at the home. One staff member said, “I found my recruitment very thorough.”

Staff had received training and were knowledgeable about their roles and responsibilities. They had skills, knowledge and experience required to support people with their care and social needs.

We found sufficient staffing levels were in place to provide the support people required. We saw the deployment of staff throughout the day was organised. We saw staff were available to support people when needed and call bells were answered quickly. People told us when they requested assistance this was responded to in a timely manner. One person said, “I haven’t been here very long but I feel happy and safe. I have no concerns about the carers and I think there are sufficient staff on duty both day and night.”

We undertook a tour of the environment and found it was maintained, clean and hygienic. No offensive odours were observed by any members of the inspection team, The registered provider had a refurbishment programme in place to make improvements to the environment. The registered manager informed us some bedrooms were scheduled for new carpets and vanity units to be fitted in the new year.

Equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.

We found care plans were organised and had identified the care and support people required. We saw people or a family member had been involved in the assessment and had consented to the support being provided. We found the care plans were informative about the care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs. People we spoke with said they were happy with their care and they liked living at the home.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care being provided.

People told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. We observed the lunch time meal which was well organised. People who required support to eat their meals were supported by staff who were caring and patient. The cook had information about people’s dietary needs and these were being met.

We found people had access to healthcare professionals and their healthcare needs were met. A visiting healthcare professional told us staff were organised and communicated effectively with them when they visited the home.

People told us they were happy with the activities arranged to keep them entertained. Activities organised on the day of our inspection visit were well attended.

We found medication procedures in place at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept and appropriate arrangements for storing were in place.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they knew how to make a complaint if they had any concerns.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included staff and resident meetings and care reviews. We found people were satisfied with the service they were receiving.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records. We also spoke with Blackpool council's contracts monitoring team and Healthwatch Blackpool who are an independent consumer champion for health and social care.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe and their rights and dignity were respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard people they supported.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff understood when an application should be made and in how to submit one. We saw best interest meetings had been held when necessary and these were clearly recorded. The records confirmed safeguarding procedures had been followed and the people had received appropriate support and representation during the meetings. This meant people's rights were safely protected.

The service was safe, clean and hygienic. One person we spoke with said, 'The cleaner is very good. My room is spotless.' Equipment had been maintained and serviced regularly ensuring people were not put at unnecessary risk.

Is the service effective?

People's health and care needs had been assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. People said their care plans were up to date and reflected their current needs. The premises had been sensitively adapted to meet the needs of people with physical impairments.

Care plans had risk assessments completed to identify the potential risk of accidents and harm. Staff members we spoke with confirmed guidance was provided to ensure they provided safe and appropriate care. We found care plans were flexible, regularly reviewed for their effectiveness and changed in recognition of the changing needs of the person.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. The people we spoke with were very happy with the care being provided. One person said, 'I am very happy here. I prefer to stay in my room in the morning and will go downstairs for lunch. The meals are very good. I will stay downstairs after lunch and join in whatever activities are being organised.' Another person said, 'The staff are lovely with me. I wasn't very well when I moved in to the home but thanks to their care I am feeling much better.'

Care plans had been maintained recording the care and support people were receiving. Good care practices were observed and people told us they were happy with the support they were receiving.

Is the service responsive?

People spoken with said they were happy with their care and had no complaints. Records showed admissions to the home were well planned. Information about people's care and dietary needs had been recorded. We also saw potential risks to people's health and welfare had been identified. Guidance had been provided for staff to ensure they provided safe and appropriate care.

We saw people received regular health checks with their General Practitioner and the outcome of these visits were recorded on their care records. We found a range of activities were organised to keep people entertained. People told us they enjoyed the activities organised by the staff. One person said, 'We have a good variety of activities organised for us. We have entertainers, trips out, we go for walks and play bingo and dominoes.'

Is the service well-led?

The service had quality assurance systems in place. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff had a good understanding of their roles and responsibilities. People we spoke with said they received a good quality service at all times.

The people we spoke with said they were receiving safe and appropriate care which was meeting their needs. One person said, 'This is a lovely place. The staff and management are very kind. The staff are always around if you need them. I haven't a bad word to say about any of them'. Another person said, 'The food is marvellous. I have been really surprised by the quality of meals. We are provided with so many choices and we are always being offered drinks and snacks'.

We observed the staff team providing sensitive and flexible personal care support. The staff were kind and patient and showed a good understanding of the needs of the people in their care. We saw meal times were served in a relaxed and unhurried manner. Staff members were observed being attentive to the needs of people who required assistance.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

We spent time in the dining room/lounge area observing care practices. We saw examples of good practice with staff being responsive and attentive. These confirmed people who required support with their personal care were being treated with respect and dignity. We saw routines were relaxed and the standard of food was very good. The people we spoke with said activities were organised and kept them entertained.

During a tour of the home we observed the building was well maintained, clean and hygienic.

People told us they could express their views and were involved in decision making about their care. They told us they felt listened to when discussing their care needs.

"Very happy with my care. The staff are very kind".

"The food is very good and we have lots of activities".

"I get on very well with the staff. They are always fussing over me".

"No complaints about anything".