Watermoor House

Updated 11 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Watermoor House is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Watermoor House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection, there was no registered manager in post. The service had recruited a new manager who had started their role the week prior to our inspection and was planning to become registered with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We observed staff interacting with people and looked at the premises. We spoke with 18 members of staff, including the nominated individual, the home manager, the deputy manager, the recruitment manager, the training coordinator, the chef, the activities lead, the dementia link, a team leader, a senior carer, the housekeeping lead, 2 housekeepers, the maintenance person and 4 care staff. We also spoke with 16 people using the service, a healthcare professional who visits the service on a regular basis and 10 people's relatives.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 5 people's care records and records related to medicines. We looked at 4 staff files in relation to recruitment. A variety of records relating to the management of the service, including audits and safety checks were reviewed.

Updated 11 May 2023

About the service

Watermoor House is a residential care home providing accommodation and personal care for up to 39 older people and people living with dementia in one adapted building which has a range of communal areas, an external courtyard and outdoor areas people can use. At the time of the inspection, 25 people were living in the home.

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

We found some improvements were still needed to ensure safe recruitment practices were followed and to the provider’s quality monitoring systems and processes . Not all staff understood people's risks and how to keep them safe. People's care records were not always reflective and up to date with this information.

The provider's audits were not always effective in identifying and addressing quality and safety concerns in staff recruitment and care records.

We did not find that these shortfalls had impacted people's care. The new manager had recently started, and prior to our inspection, identified the action required to ensure improvements were made.

People told us they felt content living at Watermoor House. People's relatives were complimentary about the care their loved ones received. Staff spoke positively about the leadership of the home and the new home manager.

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

People were supported to receive their prescribed medicines safely.

People were supported by staff trained to meet their needs.

The service had infection control processes and systems to reduce the risk of people contracting COVID-19.

Managers promoted a culture that enabled people, their representatives and staff to feel comfortable giving feedback, raising a concern or, where needed, making a complaint.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 01 November 2022), and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found that not enough improvements had been made, and the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to verify if the provider made enough improvement in relation to previous breaches of regulations.

The inspection was also prompted in part by notification of an incident following which a person using the service died. This incident was subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of the risk of falls. This inspection examined those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections, even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We used the ratings awarded at the last inspection for those key questions not inspected to calculate the overall rating. This is based on the findings of this inspection.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Watermoor House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising from the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches of regulations in relation to people’s risk management, safe recruitment, and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.