Waterloo House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Following assessment, care plans were completed so staff could provide the care people wanted from the point they moved into the home. Any changes to people’s health and welfare were communicated at daily meetings and staff received electronic alerts to make sure they were aware of any changes. Speaking with staff, showed they had key information about people’s mobility, how people required their food and fluids and how they supported people with cognitive impairment. Ongoing reviews and working alongside health professionals helped ensure people received the right levels of care and interventions.

Although care plans were reviewed at regular intervals, we found some people’s reviews had not always identified gaps in risk management strategies or if people’s care had changed. The registered manager told us they would address this and make sure any reviews identified changes. The registered manager was confident through their communication systems, staff knew how to support each person.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Some of the providers processes to deliver evidence-based care utilised recognised assessment tools to assess and identify risks. Some of those risks included managing malnutrition, falls and skin integrity. Regular checks of risk assessment tools made sure people continued to receive their care in an effective way.

For people on modified food and fluids, the provider followed the International Dysphagia Diet Standardisation Initiative (IDDSI). IDDSI is a standard for describing food textures and drink thicknesses for people with swallowing difficulties. The provider used an externally recognised food company who produced food that catered to taste, dietary and cultural preference. People received pre prepared meals to the recommended consistency to help people who were at risk of choking. Staff recorded people’s food and fluid intake but there needed to be better oversight to show, exactly what people had consumed, especially those at risk.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People’s plans were personalised to them including people’s ability to communicate, understand decisions, their sensory needs and what people’s individual preferences were. Staff said they knew people’s routines and when people wanted to be known by a preferred name other than their first name.

Staff described good communication to ensure people’s needs were met safely and effectively. Internal communications kept staff updated on people’s needs as well as any other changes at the home. If people needed specific medicines before breakfast, night staff administered the medicine so people could continue to stay in their own rooms and have their breakfast when they wanted.

The registered manager said they had positive and effective links with health professionals which helped them maintain people’s overall health and wellbeing. We received positive feedback from health professionals. One health professional said, “One clear example of improved health and well-being resulting from effective joint working within our organisation involved a person approaching end of life. Through coordinated joint working between our clinical team, the person’s family, and the deputy manager, we were able to complete a respectful and sensitive conversation about the person’s preferences for care.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People and their relatives said if needed, people received support from other health professionals.Health care professional spoke positively of the home, saying staff followed any advice they gave and their support was requested at the right time. One health professional told us, “Every week we review acutely unwell residents, with urinary infections and chest infections. The care homes are advised that if the person deteriorates, they can get advice from the Urgent Response Team which we work closely with.”

People were weighed regularly and referred to other healthcare professionals such as the dietician and SALT team if they were not eating or drinking well. People were encouraged to make healthy meal choices based on their individual needs and those at risk of losing weight were given a diet with extra calories added. A health professional commented, “I feel that Waterloo House takes preventative action with people’s weight. They weigh people at least monthly but it can be weekly if weight is an issue. They will liaise with us if a person is consistently losing weight, we can then initiate dietary supplements and/or referral to dietician.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The registered manager had regular oversight through health-related audits and checks. The registered manager said they used those audits to identify any trends and patterns, as well as quickly identifying if a person’s condition had remained stable, improved or further interventions were needed. In addition, daily handover meetings and weekly heads of department meetings helped share feedback and information to ensure information was effectively communicated with everyone involved in people’s care. The provider used internal communication to update staff.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People felt respected. One person said, “Of course, staff are very respectful, they treat us with courtesy and care.” We heard staff telling people what support they were going to provide, before they undertook the task. Staff respected people’s privacy by knocking on people’s doors and seeking consent before entering. Staff were seen asking for people’s consent, whether they wanted extra items of clothing to wear or if they wanted to go to their bedroom. Staff knew consent was important to people. A staff member said they would not force anyone to do anything they hadn’t asked them to do first. It was clear from our conversations staff understood they should follow people’s wishes.