Watson House

Watson House is one of eight separate residential care homes within Purley Park Trust Estate. Watson House provides personal care and support for up to seven people who have learning disabilities and associated conditions, such as autistic spectrum disorders.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service had been registered with CQC prior to the publication of Registering the Right Support, in 2017. The provider recognised that the need to ensure the service did not reflect the characteristics of a ‘campus style development or congregate setting model’, which would not be in line with the principles of this best practice guidance.

The eight homes were situated on a residential street, surrounded by public residential areas. There were no restrictions of access to Purley Park Trust Estate, with each home having its own individual security arrangements according to what was most suitable.

Each service of the eight had their own separate staffing team and facilities, which helped to promote individualised care tailored to people’s needs. People could socialise with other people on site if they wished, but their care was developed around their own interests, goals and preferences. The home was in walking distance of the local town and there were bus routes available for people who wished to use public transport. People were connected to their local community, utilising services for their vocation, leisure and social activities.

People's experience of using this service:

The provider had a proven track record of successfully supporting people with complex health and behavioural needs, where previous care placements had broken down.

Many people required close monitoring by staff and ongoing input from healthcare professionals. Their historical anxieties around accessing healthcare services had proved to be a barrier to receiving the healthcare they required, resulting in a reduced quality of life. These barriers included past negative experiences and sensitivity to new people and surroundings. Staff provided highly personalised and focussed support to help people effectively overcome these barriers, ensuring they received the healthcare input they needed. This resulted in good outcomes for people, enabling them to live full lives, which were not limited by their healthcare conditions.

The provider had an innate understanding of delivering empathetic and responsive end of life care, fully considering the protected equality characteristic of people’s learning disability. Staff worked to ensure people’s needs and preferences were at the forefront of how decisions were made and how care was arranged. This resulted in a and person-centred service wide approach to caring for people at the end of their lives.

Relatives and professionals were universal in their praise for the skill and dedication of the provider in ensuring people's needs were met. The provider had consistently delivered high quality care which was intuitive, responsive and individualised.

The provider met people's communication needs and helped them contribute towards making decisions about their care. Staff understood people's preferences and they encouraged people to build meaningful relationships, follow their interests and build upon their skills and abilities. The environment at the home had been adapted to maximise the opportunities for people to be as independent as possible.

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.

The registered manager was a role model to their staff. They were dedicated, professional and provided effective leadership to staff. There were effective systems in place to monitor the quality and safety of the service. There were appropriate policies in place to handle people's complaints and act on feedback.

There were safe systems in place in relation to the management of people's medicines. The provider had supported people and medical professionals to minimise the use of some medicines, where possible.

People were supported appropriately with their nutrition and hydration.

There was an open and transparent culture at the service, which was embodied through all branches of the staff team. The service was clean and had a homely atmosphere. People were comfortable in staff's presence. There were enough staff in place, many of whom had established extremely positive working relationships with people.

Rating at last inspection:

The service was rated good at our last inspection (17 February 2017))

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Watson House is a residential care home which is registered to provide a service for up to seven people with learning disabilities and other associated difficulties. Some people had developed needs relating to the ageing process. There were seven people living there on the day of the visit. The service offers accommodation in a purpose built house which offers ground floor accommodation.

There is a registered manager running the service. 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.

Staff had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Their knowledge and understanding contributed to keeping people, themselves and others as safe as possible.

People were kept safe because general risks and risks to individuals were identified and action was taken to reduce them as much as possible. There were enough staff on duty to ensure people were supported safely. The recruitment procedures were robust and made sure, that as far as possible, staff were safe and suitable to work with the people who live in the home. Medicines were given safely, in the right amounts and at the right times by trained and competent staff.

People’s health and well-being needs were well met by staff who responded very effectively to people’s changing needs. The service sought advice from and worked very closely with health and other professionals to ensure they met people’s health and well-being needs to a very high standard.

Peoples’ human and civil rights were understood, and upheld by the staff and registered manager of the service. The service understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who may not have capacity to do so. People were supported to make as many decisions and have as much control over their lives as they were able to.

People’s care was provided by extraordinarily kind, caring and committed staff who were exceptionally attentive and knowledgeable. Individualised care planning ensured the staff team used a highly person centred approach and people’s equality and diversity was always respected. People were provided with a lifestyle they thoroughly enjoyed because it was individually designed according to their needs, abilities and preferences.

The service was exceptionally responsive to people and met their needs in a totally person centred way. People were given the opportunity to enhance their lifestyle by participating in a wide variety of activities that they really enjoyed.

People received outstanding person centred care which was overseen by a highly thought of and exceptionally committed registered manager. She listened and responded to people, staff and others and upheld extremely high standards and values. The registered manager was described as totally approachable and always supportive. The high quality of care the service provided was assessed, reviewed, improved and developed to enhance people’s lifestyle.

We observed people being given choices. They were encouraged and supported to make decisions. There was evidence in people's care and support plans of their involvement in care and treatment.

People were offered suitable food and drink which was available to them throughout the day. Adapted cutlery and crockery was used to enable people to maintain their independence.

There were sufficient qualified and experienced staff on duty. Staff told us they thought the staffing levels were correct. They also said if they needed more help in an emergency then there were always other staff available.

Records were accurate and fit for purpose. They were stored securely and destroyed in line with the provider's policy.

The house was clean and homely. The people living in Watson House appeared well dressed, happy and content. They got on well with the staff who clearly knew each of them well. People were called by their preferred name and staff treated them with dignity and respect. We observed people being involved in activities and given choices.

We spoke with three staff members and the manager. They all told us they felt supported. One told us 'I love my job; this is by far the best place I have worked'. Another said 'there is lots of support, and communication is excellent'. They told us that the training was 'excellent and constantly available'

The provider had an effective assessing and monitoring system and issues that needed addressing were identified and rectified in a timely manner.