About the service:

Waters Edge is a care home that accommodates 63 people in a purpose built residential home for the elderly. Support is provided on two floors. There are various communal areas, including lounges and dining rooms that people can access. The home also has an adapted garden.

People’s experience of using this service:

At the last inspection in June 2018, the service was rated as Good overall.

The care people received was not always safe. Measures put in place to keep people safe were not always effectively implemented in the home. Records were not always up to date to reflect people’s current needs. Individual risks to people were considered and reviewed when incidents had occurred. Staff raised concerns about staffing levels and these had not been reviewed to reflect changes made in the home. Safeguarding procedures were in place and these were followed. Medicines were managed in a safe way. Infection control procedures were implemented. Lessons were learnt when things went wrong in the home.

The provider had introduced a more robust system as a safeguarding concern had not previously been shared across the home. The action the provider had told us they had taken to keep people safe had not always been fully completed. There were audits in place which were effective in continually developing the quality of the care that was provided to them. Feedback was sought from people and relatives who used the service and this was used to make changes. Staff felt supported and listened to.

More information is in the full report.

Rating at last inspection:

Good (Last report published 14 June 2018)

Why we inspected:

We carried out this focused inspection as we received information of concern about the management of unwitnessed falls within the home.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The comprehensive inspection visit took place on 15 May 2018 and was unannounced.

Waters Edge 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.

Waters Edge is registered to provide accommodation for up to 63 people. There are two floors which both have various communal areas for people to access including, communal lounges and dining areas. There is also a large garden area for people to access. At the time of our inspection 50 people were using the service.

There was a registered manager in place. 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.

As some capacity assessment were not in place, people were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice. Relatives consented on behalf of people when they did not have the legal power to do so.

There were enough staff to support people. People felt safe and were supported by staff who knew them well. The provider had suitable recruitment processes in place to ensure staffs suitability to work within the home. Staff understood how to recognise and report potential abuse. They felt listened to and were assured action would be taken if concerns were raised. Individual risks had been identified for people and staff had the information needed to keep people safe. Medicines were administered, stored and recorded to ensure people were protected from the risks associated to them

People were supported in a caring way by staff they liked. They were encouraged to remain independent and make everyday choices. People’s privacy and dignity was maintained. When people needed support to access health professionals this was available for them. Visitors were welcomed in the home. People enjoyed the food that was available to them and were offered a choice. People were also offered the opportunity to participate in activities they enjoyed.

Staff received an induction and training that helped them offer support to people. Staff knew people well including their likes and dislikes. And care plans were written and reviewed in line with current legislation. There were infection control procedures within the home that were effectively implemented. People knew how to complain and there were procedures in place in relation to this.

Staff felt listened to and had the opportunity to raise concerns. The registered manager understood their responsibilities around registration with us and notified us of significant events that occurred within the home. There were systems in place to drive improvements within the service. People and relatives had the opportunity to raise concerns and suggest improvements and we saw these were considered. When needed lessons had been considered and learnt so that improvements could be made.

We inspected this service on 11 April 2017. This was an unannounced inspection.

Our last inspection took place in March 2016 and we found when people lacked capacity to make certain decisions capacity assessments had not been completed and best interest decisions were not in place. We also found the provider did not have systems and reviews in place that were effective in identifying areas of improvement. We found that not all the information which was recorded was accurate.

The service was registered to provide accommodation for up to 63 people. At the time of our inspection 55 people were using the service.

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.

When people were not able to consent, mental capacity assessments and best interest decisions were not completed. The systems in place did not always identify areas of improvements and the provider was not displaying their rating in the home in line with our requirements.

People were happy with the staff that supported them and they felt safe living in the home. Staff understood safeguarding and how to report concerns if needed. The provider had procedures in place for reporting safeguarding concerns. Risks to people were managed in a safe way and equipment used within the home was maintained to ensure it was safe to use. There were enough staff available to offer support to people and they did not have to wait. Medicines were managed in a safe way to ensure people were protected from the risks associated with them.

People’s privacy and dignity was promoted and they were treated in a kind and caring way. People were encouraged to be independent and make choices about their day. Families told us they were free to visit throughout the day. People enjoyed the food and were offered a choice. We found people had the opportunity to participate in activities they enjoyed. When needed people had access to health care professionals.

Staff received training and induction that helped them support people. The provider ensured staffs suitability to work within the home. Staff felt listened to and were able to raise concerns. The provider used feedback from people and relatives to bring about changes.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We inspected this service on 8 March 2016. This was an unannounced inspection. Our last inspection took place in November 2013 and we found no concerns with the areas we looked at.

The service was registered to provide accommodation for up to 63 people. At the time of our inspection 54 people were using the service.

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.

When people were not able to consent mental capacity assessments and best interest decisions were not completed. The provider had not considered that some people were being restricted and that deprivations of liberty safeguards were needed.

The systems in place to review and monitor care were not always effective. We found that not all the information which was recorded was accurate.

People told us they felt safe and staff knew how to recognise and report potential abuse. Risks to people were managed in a way to keep people safe. We found there were enough staff to support people and they had received an induction and training that helped then to do this. Medicines were managed in a way to keep people safe from the risks associated to them.

People told us the food was sufficient and we saw choices were available for people. People and relatives told us they were involved with reviewing their care and were happy with the care they received. We found people had access to health professionals when needed.

We found people’s privacy and dignity was promoted and they were treated in a kind and caring way. People were encouraged to be independent and make choices about their day. There were activities available that people enjoyed that they could participate in. Families told us they were free to visit and people were encouraged to maintain relationships that were important to them.

Staff felt listened to and were confident concerns they had would be dealt with. The provider used feedback from people and relatives to bring about improvements to the service.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We inspected WatersEdge Care Home as part of our scheduled inspection programme. The inspection was unannounced which meant that the provider and staff did not know we were visiting.

During the inspection we spoke with the registered manager, the deputy manager, two team leaders, two care staff and two domestics. We met and spoke with nine people that used the service and two relatives. We looked at five people’s care plans. We saw how people gave consent to receive care and support. We looked at how care was planned, delivered and documented in the care plans. The care records we looked at were up to date and personalised.

We reviewed the medication administration procedures in the home and found them to be in good order. We looked at how staff were recruited and saw that the provider followed a good standard of recruitment procedures to ensure suitable staff were employed in the home. During the inspection we looked at the home’s complaints procedures and complaint records. People we spoke with told us they knew how to make a complaint if necessary.

We visited the service on a planned unannounced inspection, which meant the service did not know we were coming.

People who used the service told us they liked it at Watersedge and the staff were good to them. We saw that people were offered choices throughout the day.

Relatives of people who used the service told us that they were happy with the care that their relative received.

On the day of the inspection the service was busy with activities being offered to people in the communal lounge area and visitors coming and going visiting their relatives. Everyone appeared happy and relaxed.

We saw social care and health professionals within the home. This included a GP and a social worker, who were visiting people who used the service.

The service had made several improvements to the facilities since our last inspection, including a cafe area and a bar, the cafe was in use during the day as a place for relatives and visitors to meet with people who used the service.

Systems were in place to monitor the quality of the service and the manager told us they worked alongside the staff to ensure high standards were met.