We carried out a review of the data available to us about Waterbury House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Waterbury House, you can give feedback on this service.
Waterbury House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Waterbury House accommodates nine people in a flat, a cottage and an adapted building. The flat and cottage are single-person accommodation. At the time of our inspection there were eight people living at the service.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager at the service. ‘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 warm and friendly interactions between people living at the service and staff. People were supported to maximise their independence in an environment which encouraged positive risk-taking. The staff team were passionate about promoting people’s choice and independence. Staff were encouraged to think creatively about how to improve people’s access to activities and the community. Staff discussed people’s achievements with pride.
The staff team were thoughtful and creative about increasing opportunities for people. They were supported in this by the management team who had an ethos of empowering staff. Staff were trained and supervised and where needed received additional training to improve their understanding of people’s care needs.
People felt safe and at home in the service. We observed good communication between people and staff, with staff quick to intervene when needed. The environment was safe, with any potential risks identified and managed.
People were able to maintain family contact and visitors were welcome at the service at any time.
People received their medicines safely; where possible people administered their own medicines with help. Staff were proactive about people’s health needs and worked with health professionals to enable people to access health care.
People received individualised care which respected their preferences. The service had increased the range and frequency of people’s activities and this had reduced the number of incidents of behaviour which challenged.
There was strong and effective leadership at the service. Staff were very positive about their job, the managers of the service and the quality of care they delivered.
There was a registered manager in post. 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.
People told us they felt safe with staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.
Potential risks to people had been identified and assessed appropriately. There were sufficient numbers of staff to support people and safe recruitment practices were followed. Medicines were managed safely.
Staff had received all essential training and there were opportunities for them to study for additional qualifications. All staff training was up-to-date. Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found the registered manager understood when an application should be made and how to submit one. We found the provider to be meeting the requirements of DoLS. The registered manager and staff were guided by the principles of the Mental Capacity Act 2005 (MCA) regarding best interests decisions should anyone be deemed to lack capacity.
People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated in line with their personal preferences.
Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and these were communicated to staff in a variety of ways – verbally, through physical gestures or body language. People were involved in decisions about their care as much as they were able. Their privacy and dignity were respected and promoted. Staff understood how to care for people in a sensitive way.
Care plans provided information about people in a person-centred way. People’s personal histories had been recorded and their preferences, likes and dislikes were documented so that staff knew how people wished to be supported. There was a variety of activities and outings on offer which people could choose to do. Complaints were dealt with in line with the provider’s complaints procedure.
Weekly and monthly checks were carried out to monitor the quality of the service provided. There were regular staff meetings and feedback was sought on the quality of the service provided. People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular one to one meetings with staff and people took place. These meetings enabled the registered manager and provider to monitor if people’s needs were being met.
Is the service safe?
People told us that they felt safe. Safeguarding and whistleblowing procedures were robust and staff understood how to safeguard the people they supported.
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the provider to maintain safe care. The provider had robust policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
Is the service effective?
People's health and care needs were assessed with them and they or their representatives were involved in the compilation of their care plans. People said that they had been involved in the process and that care plans reflected their current needs.
Is the service caring?
We spoke with two people who live at the home. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example one person said, "I love it". Another told us, "I like my keyworker".
People who live at the home and their families were asked to complete a satisfaction survey. These were used to help improve the service in the future.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
The home worked well with other agencies and services to make sure people received care in a coherent way.
People knew how to make a complaint if they were unhappy. Complaints were managed in a timely and satisfactory manner, in line with the provider's policy.
People engaged in a range of activities both in the home and in the wider community. The home had its own adapted minibus to facilitate this.
Is the service well-led?
The service operated a quality assurance system which identified and addressed shortcomings. As a result, a good quality of the service was maintained.
The staff we spoke with were clear about their roles and responsibilities. They had a good understanding of the needs of the people they were looking after and were properly trained and supported to carry out their duties.
As most people living at the service were unable to share their experience with us, we spoke with the relatives of four people. In general, they were pleased with the service. One said, 'The staff there are great'. Another told us, 'We are happy, they are very thoughtful and caring'.
We spoke with five members of staff and the manager. Staff told us that it was a good place to work and that they felt people received good support. One told us, 'I think it is fantastic here'. A new member of staff said, 'There is so much going on all the time, I feel like part of the team already. They are very supportive'.
We found that people looked well cared for and observed that they had a good rapport with the staff. Staff understood how people's capacity should be considered. They had a good understanding of individual needs and we saw that they supported people with kindness and respect.
We found that people were involved in making decisions about their care and support and their privacy and dignity were respected. Support plans were based on thorough assessments and support was delivered according to the plans. People using the service were protected against the risks of abuse, and the service responded appropriately if abuse was witnessed or suspected. The provider had recruitment processes in place to ensure that people's care was delivered by staff who were of good character and had the right skills. The quality of the service provided was monitored and assessed regularly.
In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.