Membership review for Options Watermill
By – Date of visit:
The membership review is intended to reflect the experiences of the visitor who might be looking for a placement.
The review is subjective, consistent and impartial, representing the impressions of our team member on the day of the visit. It is a snapshot view only. The contents of this review are intended to cover some of the subjects and issues which an individual, their relatives or their placement officer might ask.
This review has been published with the written agreement of the home owner, or an authorised representative of the company.
‘Although the management structure had slightly changed, the senior staff were all still in place from my previous visit 2 years ago and this gave a really solid foundation for the staff group as a whole.’
Summary of findings
I found Watermill House to be a spacious, friendly, well-organised and therapeutic home for individuals with autism and severe learning difficulties, set in a quiet, rural environment. The Watermill House staff team are dedicated and knowledgeable. Although the management structure had slightly changed, the senior staff were all still in place from my previous visit 2 years ago and this gave a really solid foundation for the staff group as a whole. Add to that the access to support from a clinical team based at the nearby Options Group Roxby House service and this gives a service with real depth.
Introduction
Watermill House is a ten-bedded residential home for adults with autism and additional complex needs, most particularly, pronounced learning difficulties and epilepsy.
Watermill is situated in the quiet North Lincolnshire village of Wressle. Watermill House was visited by a Care Quality Commission officer in October 2013 and was seen to be compliant in the following areas with no requirements -
- Standards of treating people with respect and involving them in their care
- Standards of providing care, treatment & support which meets people's needs
- Standards of caring for people safely & protecting them from harm
- Standards of staffing
- Standards of management
- The statements and information recorded in the Watermill House profile were seen to be correct.
First impressions
Watermill House is situated down a long driveway accessed from Common Road on the outskirts of Wressle village. It is clearly signposted from Common Road. You drive past the house and the newly-tarmacked car park is straight in front of you. The entrance to the site is to the front of the main house. I was met shortly upon arrival and shown through to the Registered Manager, Helen Horsewood’s, office.
The Environment (Internal)
The living accommodation at Watermill House is effectively divided into two separate residential areas. Five people live in the main house, four in the adjacent bungalow.
There is a purpose-built log building on the site which now, in the main, functions as a venue for meetings or comfortable accommodation for visiting parents. In the main house there is a large light and airy conservatory which is used for a variety of activities by both the individuals residing at Watermill House and the staff team.
As well as a bedroom, each person has their own lounge/quiet room and en-suite bathroom. These areas have all been furnished and decorated with the individual in mind. Some spaces are very minimal due to particular sensory intolerances.
As well as individual spaces there are several communal lounge areas and, as previously mentioned, a large conservatory. All areas visited internally were clean and warm. Overall one would describe the living areas as comfortable and spacious.
Various adaptations have been made internally since I visited two years ago; one of the most notable ones was the modifications to one individual’s bathroom which included the installation of a Parker bath.
The Environment (External)
As well as the accommodation, there are other buildings on site which house a variety of areas for individuals to access and use for differing activities throughout the day and evening. There is a really large ‘play barn’ which contains lots of soft play equipment and now features murals around the side, each mural associated with an individual living at Watermill House, each individual assisting in the painting process. There is also a computer room and Snoezelen; usage of these areas is usually incorporated into an individual’s daily programme.
The site itself has grassed areas throughout as well as several patio areas. There is also a safe (with a rubberised flooring material) outdoor play area with a swing and there are lots of open spaces for individuals to move around the site.
Watermill House sits next door to the newly-built Watermill Lodge which is a separate building and registered service within the Options Group.
The Environment (Wider Environment)
The area surrounding Watermill House is very quiet and peaceful. Several individuals are supported to walk to the local shops and one young man regularly goes with staff to a local pub to play pool.
There is a local bus service which runs through the village and several people from Watermill House are supported to use this service. Staff travel free when supporting an individual thanks to a local travel scheme.
Several individuals have access to their own motability vehicles. There was also another general pool vehicle.
Staff often take people residing at Watermill House to undertake activities at another Options Group facility at Roxby House, approximately 7 miles away. To summarise, there are a lot of resources and activities to tap into.
Understanding Autism
Watermill is an autism-specific placement facility and as such the level of focus on autism is particularly strong.
Autism training forms the core of staff induction, although training is clearly very much seen as an ongoing process. On occasion, anxiety levels of individuals can lead to outbursts which may require staff to physically intervene for the person’s own safety. The Options Group have developed along with PRICE (Protecting Rights In a Caring Environment), a bespoke autism intervention package which all staff are trained to use safely.
In terms of communication, profiles are developed for each individual to suit their strengths. Some individuals can use symbol-based communication and there was considerable evidence of this throughout the site, but for others this is too complex and simple objects of reference are used. There is significant input from Options Group’s own Speech and Language Therapist in developing systems and individual communication profiles. Each individual also has a sensory profile which, again, is developed with Options Group's own ‘in-house’ psychology team based at Roxby House.
Preparation for both admission and transition is very thorough. Staff always visit the individual at their current placement or home setting. There had been increasing involvement of Options Groups clinical team at Roxby in this process.
Each individual has a daily activity programme which takes into account their needs, potential and need for structure.
Health and Wellbeing
Individuals at Watermill House receive the benefit of having the Options Group clinical team just a few miles away at Roxby House. This has enabled both detailed sensory and communication profiles to be established for each person.
One of the things that really stood out to me was the organisation, particularly around individual healthcare needs. Watermill staff had previously worked to establish an excellent relationship with the local General Practitioner’s surgery and local hospitals and this has been maintained. Helen told me about one individual who sadly eventually had to leave Watermill due to increased health complications and, despite it being sad to see the individual leave, it was good to hear how well Watermill staff worked so well in tandem with the staff at the hospital.
At the time of my visit, more than half the individuals at Watermill House had epilepsy and staff receive thorough training in this particular area. Staff have developed good relationships with individuals and have become expert in monitoring and supporting when an individual has an episode of anxiety.
Several individuals require regular medication and the procedure for ensuring appropriate administration of medication is very thorough. Only key staff can deliver certain medication, although all staff receive training in the administration of medication and records are audited on a regular basis as part of the ongoing quality monitoring of the service. This is overseen by Geoff Evans, the Head of Quality Improvement. No one living at Watermill House when I visited was self-medicating.
Individuals living in the home
At the time of my visit nine people were living at Watermill House. All had an autism diagnosis and all individuals had profound learning disabilities; five young men also had epilepsy. The complexity of needs are considerable and varied. On occasion, it is necessary to restrict an individual’s movement on site for their own and others' safety. This is carefully planned and all relevant authorities are informed and in agreement with any measures taken. All in all, this is very well managed. No person has the capability to cope off site without close supervision.
Each person’s daily programme reflects their abilities, interests and capabilities. Every effort is made to ensure that whatever the individual is engaged in is meaningful and that they enjoy the activity. Specialist workers in horticulture, sport and music come onto site every week to work with individuals on specific programmes.
Watermill House was also offering a variety of activities including day trips out and holidays.
Individuals were also making good use of the play barn sensory room, computer room and safe enclosed areas with a swing and cycles.
Staffing
No staff members are allowed to work until they have completed a Disclosure and Barring Service check. The induction period for staff members is thorough and autism-focused and, again, until this has been completed no staff member would be allowed to work with any individual living at Watermill House.
All staff members work to ascertain the Health and Social Care Diploma Level 2 Award as a minimum.
All staff members are issued with a handbook (hard copy received) at the beginning of their time at Watermill House which includes information around standards of conduct and appropriate clothing, amongst other standards expected.
Staff members have regular supervisions with a staff member senior to them to assess their work and set targets for the future. Supervisions are undertaken every two months as a minimum. Incorporated into this process are staff members’ appraisals which cover the time period January to March.
Management of the home
There have been changes to the managerial structure since my last visit with the establishment of a Deputy to the Registered Manager and House Managers for the House and Bungalow areas.
Policies and procedures relating to the running of the home are located in the main office and are easily accessible for staff when required. Staff are also able to access policies via the Options Group online portal. This is also the place where good practice is shared between services, with downloadable resources available. The ‘Statement of Purpose’ has been updated and I received a hard copy to read.
There is a system in place for debriefing staff after stressful incidents. Individual debriefs are also available and these are carried out by senior members of staff who were not involved in the incident or issue.
Watermill House staff have continued to foster good relationships with parents. Support to parents and family is given in different ways according to Helen, because of each family's differing situation; however, staff will go out to bring individuals back to Watermill if the individual is having difficulties when on a home visit.
Individual Care Plans are reviewed on a monthly basis and Person Centred Plans which cover issues relating to the individual as a whole incorporating their wishes and aspirations are reviewed on a quarterly basis. A sophisticated software tool called ‘Reveal’ helps to monitor an individual’s behaviour to help with behaviour management and to ultimately provide positive outcomes for that person.
Risk Assessments are reviewed as a whole on an annual basis; however, they can be updated regularly depending on any emerging behavioural issues.
When asked what makes Watermill unique and special, Helen felt that the size, space and structure of the site lent itself to the support and care of individuals on the autistic spectrum. For me, a really important example was that Helen felt staff appreciate the personality of each individual. In terms of the next two years Helen wants Watermill to be at full capacity with a stable population and to enhance their already good reputation.
Conclusion
Watermill House is a spacious, warm and friendly well-organised home for individuals with autism and severe leaning difficulties, set in a quiet rural environment. There are lots of onsite activities available and lots of space to move around on site both internally and externally. The staff team are dedicated and knowledgeable and have easy access to support from a nearby clinical team. All in all, Watermill presented as a really excellent placement for a person with autism and additional complex needs.
Visiting Officer - Craig Godding
Director of Compliance and Client Liaison, Living Autism