Waterside Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified 1 breach of regulation in relation to the governance systems within the home. Governance systems were not always effective and had not identified the shortfalls we had found. Some care records required more detail to ensure they were person-centred. Records were also not always accurate and updated in a timely manner. Further time was needed to embed working practices in the use of the new electronic care planning system that had recently been introduced. Action was taken to address all of the issues we had raised and action plans were in place or had been developed.

Staff understood their role and responsibilities and felt supported by the management team. The registered manager had oversight of the service and was aware of their legal responsibilities.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff we spoke with shared a passion for the service and care for the people living there. Staff told us they were happy in their role and felt supported. The registered manager demonstrated a caring attitude and knowledge of the people using the service. Everyone spoke about teamwork and were supportive of everyone’s roles within the home.

There was evidence of a culture where feedback was sought from people, relatives, staff and visiting professionals. However, we could not see how some of this feedback had been used to develop and improve the service. We saw the values of the home were displayed for all to access.

Staff spoke positively about the management team. They felt well supported and confident in their job roles. Staff told us the management team was approachable and knowledgeable. The management team was supported by the provider. Senior managers visited the home to support the management team on a regular basis.

Our assessment identified some areas for development, including improved oversight of risk. The management team responded positively and told us they would be taking steps to make the required improvements.

The home was managed by a registered manager with experience in this care setting. The registered manager was clear about their role and responsibilities.

Some staff told us concerns raised about the staffing levels were not always listened to and acted upon. However, staff told us the management team were approachable, and they felt confident to raise any concerns.

The registered manager told us they had an open-door policy, and staff could approach them or the deputy manager at any time.

The registered manager told us they had an open-door policy, and staff could approach them or the deputy manager at any time.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us time was needed to fully embed the system and to ensure records were completed accurately and in a timely manner. Staff told us they were now getting used to the new electronic care planning system and confirmed training had been provided on how to use this. However, staff confirmed they were clear about their and other staff members’ roles and responsibilities within the home.

Discussions with the management team demonstrated their knowledge in relation to their regulatory responsibilities. The management team told us and records supported they completed daily- walk arounds to monitor care practices and maintain oversight. This was in addition to the daily meetings that were held.

We found some audits were not always effective as they had not identified the areas for improvements we had found. However, various audits were conducted to monitor the quality of the service provided and to maintain oversight. These were completed by both the management team and the provider.

The home had recently moved to electronic records. We found some records were not completed accurately or there were discrepancies with the information provided. For example, information about a person’s wound was recorded on the incorrect part of their body. Records did not clearly demonstrate actions taken in response to body markings or the rationale for these.

We also found records about people were task focused and contained limited information about their well-being. The registered manager told us action would be taken to address this and a new ‘interaction form’ would be introduced.

Audits were completed on a sample of care records each month. Action plans were in place where gaps were identified.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us about the challenges of moving to electronic records, but they saw the benefits of this long term. Staff confirmed they felt able to share ideas with the management team during meetings.

The management team told us they wanted to develop the service and action plans were in place for various areas to drive improvements. For example, to improve the dementia unit to make it more accessible and comfortable for people.

Although various systems were in place to drive improvements, and to seek feedback and ideas for improvement from others, it was not clear to see how this feedback was incorporated into the provider’s developmental plans. For example, in relation to staffing and the feedback the provider has already received about this and the impact on people and their experiences. Technology had recently been introduced for the care planning system and time was needed to embed this so that staff in all roles were confident in its use and for staff to have the time to complete accurate records that reflected people’s wellbeing. The registered manager told us about the various award schemes in place for staff to reward them for continued service with the provider and to celebrate achievements.