Waterbury House

This service supports people living with a learning disability and autistic people.

The service uses a household model of care. People had their own bedrooms and bathrooms and shared the kitchen, lounge and dining area’s. One person had a studio flat within the main house. This helped to create a familiar home environment where staff could support people in a more personal and flexible way.

We carried out this assessment on 7 October 2026. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.

We assessed the service in line with CQC’s ‘Right Support, Right Care, Right Culture’ best practice guidance to judge whether people received respectful, dignified, and person-centred care that promoted their independence, choices, and inclusion in the community. The provider was working in line with national best practice guidance for supporting people with a learning disability and autistic people.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions. They had choice, control and freedom over their lives. Records showed people, their relatives and those important to them were involved in MCA assessments and best interest decisions. Where people had conditions on their DoLS such as medicine reviews, these were managed in line with requirements.

People were supported by enough suitably skilled staff, with safe recruitment processes in place. Staff received appropriate training to support people’s needs well, including training required to support people with a learning disability. Staff understood their safeguarding responsibilities. They knew how to recognise signs of abuse and how to report concerns appropriately to protect people from harm. Risks were managed in a person-centred way, balancing people’s safety with their independence, choice and control. Risk assessments considered people’s daily living skills, health, behaviour, the environment and access to transport. This supported people to maintain their independence, manage risks safely and continue accessing community facilities and activities. Effective systems were in place to manage medicines safely and maintain a safe environment. Environmental checks were completed, and fire safety systems were regularly serviced. Following 2 recent safety incidents, learning was identified to reduce the risk of recurrence. Staff had applied their fire safety training to evacuate everyone safely during a recent fire at an adjoining property and provided lifesaving first aid to a person during a choking incident. The registered manager praised staff for their actions and calm and professional response to both incidents. They highlighted the “amazing and supportive wrap around support” they had received from the wider organisation following both incidents.

People received safe, effective and well-planned support that reflected best practice guidance for people with a learning disability and autistic people. Systems were in place to assess, monitor and review people’s care and changing needs. A relative told us, “I can say I am happy with everything there at present”. People had timely access to healthcare professionals and routine health screening to support their health and wellbeing. This included women’s health and mental health support. Referrals were made when people’s needs changed. For example, following a choking incident, a person was referred to speech and language therapy (SaLT) to support safe eating and drinking. Another person was referred to occupational therapy for a sensory assessment to identify environmental adjustments to meet their needs. This demonstrated staff recognised changes in people’s needs and took timely action to support their health, wellbeing and safety.

Throughout the inspection, we observed people being treated with dignity and respect. Communication was good and the atmosphere was relaxed, chatty and cheerful. Staff supported people to make choices and decisions about their care and daily lives, while promoting and encouraging their independence. We observed a person preparing their own drink. Staff told us the person also prepares their own breakfast, usually toast. Staff knew people well and understood what was important to them. For example, 1 person likes staff to put the television on in their bedroom at 6.30am. The person’s care plan described them as a ‘Morning person’ and outlined their preference to do outside activities in the mornings. A relative told us their loved one, “Seems to be well supported by the staff”. And “They all seem to be quite caring towards [name] when I have been there. If any problems arise, I am advised of them”.

People received person-centred care and support that reflected their individual needs, preferences, strengths and aspirations. Health and social care professionals provided positive feedback about the support people received and their outcomes. Staff adapted their approach to enable people to make choices, maintain relationships, pursue personal interests and take part in activities that were meaningful to them. For example, a social story was used to support a person to visit their family home. The story included photographs and details about the journey and who would be supporting them. This enabled the person to enjoy quality time with their family. Staff adapted communication to meet people’s individual needs, using objects of reference, pictorial prompts and Makaton sign language. Information was available in accessible formats to support people’s understanding and involvement in decisions.

Governance systems supported quality monitoring and improvement. Audits identified issues, with leaders setting actions and monitoring progress. Records were accurate and up to date, and effective information sharing supported coordinated care across teams and services. The registered manager promoted openness, continuous improvement and staff involvement. Staff described an inclusive culture where they felt valued and supported, commenting, “It is a wonderful place to work, we are like one big family.” Staff were encouraged to share ideas through team meetings, and confidential support was available through an employee assistance programme, wellbeing coaches and mental health first aiders. The registered manager engaged with local provider forums and national conferences, sharing learning to drive improvements and enhance people’s experiences of care. People and their families had opportunities to provide feedback and influence service development.