The inspection took place on 30 July 2018 and was announced. At the last inspection we rated the home overall as ‘Good’ at this inspection we found that some improvements were required in the ‘Well led’ domain.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

There are 38 rented flats within the extra care building. At the time of our inspection, 21 people were receiving personal care as part of their care package.

Waltham House has a registered manager. 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 who used the service and staff had not always communicated well to ensure they understood how they could give and receive the support they needed. We found there were sufficient staff to meet people’s needs and people told us they were supported when needed. However there was some mixed views about staffing levels. People were asked for their feedback about the care they received and improvements were made following these requests.

Audits were completed to review all aspects of care to consider reducing risk or driving improvements. The registered manager understood their role and provided us with notifications as required in association with events or incidents.

People felt safe in their environment and protected from harm. Risk assessments were completed to consider all elements of risk and guidance was provided. Medicines were handled safely and staff used equipment appropriately to reduce the risk of infection. Staff had received training for their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. When people required medical assistance or referrals linked to their health care this was supported by staff who looked to develop people’s independence.

Some people received assistance with their meals which included their diets and shopping, People liked the opportunity to enjoy the onsite café.

Staff were caring and had developed relationships with people. Privacy and dignity was valued and promoted. We saw that information was kept securely. Partnerships had been developed with health care professionals and the housing provider to reflect a seamless package of housing and care.

Care was provided on a commissioned basis; however additional care was available when people felt unwell or required additional support. Activities were provided on site along with social groups. There was a complaints policy which was followed and people felt able to raise concerns individually or at the regular meetings held at the home.