Background to this inspection
Updated
1 March 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 18 January 2019 and was unannounced. The inspection team consisted of one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
As part of the inspection we reviewed the information we held about the service. We looked to see if statutory notifications had been sent by the provider. A statutory notification contains information about important events which the provider is required to send to us by law. We looked at information contained in the provider’s Provider Information Return (PIR). A PIR is a document the provider completes in advance of an inspection to share information about the service. They can advise us of areas of good practice and outline improvements needed within their service. We sought information and views from the local authority. We also reviewed information that had been sent to us by the public. We used this information to help us plan our inspection.
During the inspection we spoke with five people who used the service and eleven relatives. We spoke with the registered manager and seven members of staff including the day centre manager, the cook, the reminiscence coordinator and care staff. As part of the inspection we also obtained feedback from members of the community, partner organisations and health and social care professionals. To help us understand the experiences of people we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people living at the service. We also carried out observations across the service regarding the quality of care people received. We reviewed records relating to people’s medicines, three people’s care records and records relating to the management of the service; including recruitment records, complaints and quality assurance records.
Updated
1 March 2019
This inspection took place on 18 January 2019 and was unannounced. At the last inspection completed 02 March 2016 we found the service to be ‘good’ and meeting all the legal requirements. At this inspection we found the service was now ‘outstanding’.
The Watermill 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. The care home accommodates up to 40 people in one adapted building. The service is split into four ‘houses’ each accommodating up to 10 people. At the time of the inspection there were 37 people using the service, all of whom were living with dementia.
A registered manager was 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.
People were supported by a passionate and committed staff and management team. People were made to feel valued, important and respected as individuals. The staff and managers went the extra mile to ensure that people felt cared for and that their lives were enhanced wherever possible. People’s independence was fully promoted and their dignity was upheld.
Care staff knew people well and fully understood their needs. Where people’s needs had changed they were reassessed and care staff understood how the support they provided needed to change. People’s equality, diversity and human rights were fully respected and the service took proactive steps to ensure that people felt comfortable to express who they were and to live how they chose.
People were given access to a wide range of leisure opportunities. The reminiscence coordinator considered people’s individual preferences and developed a unique range of activities that people could participate in. The registered manager and staff team placed a high level of importance on ensuring people’s quality of life was good and they were able to live as full a life as they wished.
People, relatives and care staff gave excellent feedback about the registered manager and the service as a whole. They were encouraged to be fully involved in the development of the service and making decisions. People felt they had a voice and that they were heard.
The registered manager was committed to driving improvements and ensuring people were able to live in a service providing excellent service to them. They were proactive in securing community links and volunteered to be involved in new initiatives and opportunities for learning. Professionals, partner organisations and people from the community all spoke highly of the management, staff and service as a whole.
People felt safe living at the service. They were supported by a staff team who understood how to protect them from the risk of abuse, accident and injury. Where incidents had arisen, lessons were learned to enable steps to be taken to reduce the risk of harm to people in the future.
People received their medicines as prescribed. People were protected by effective infection prevention and control. People were supported by sufficient numbers of staff who had been recruited safely.
People’s needs were assessed holistically and the service worked to meet their emotional, physical and health needs. People’s consent was sought before staff provided support. Where people lacked the mental capacity to make decisions or provide consent, decisions were made in their best interests in line with the law.