22 March 2023
During an inspection looking at part of 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.