Background to this inspection
Updated
30 March 2017
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.
The inspection took place on 13 December 2016 and was unannounced.
The inspection team consisted of two inspectors 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.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with other information we held about the service. This included safeguarding alerts and statutory notifications which related to the service. Statutory notifications include information about important events which the provider is required to send us by law.
We focused on speaking with people who lived at the service and observing how people were cared for. Where people at the service had complex needs and were not able verbally to talk with us, or chose not to, we used observation as our main tool to gather evidence of people’s experiences of the service. As part of our observations we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
We met with the regional manager, the registered manager and the deputy manager. We spoke with 14 members of care and domestic staff, 10 people who used the service and five family members. We also spoke with two health and social care professional to find out their views on the service.
We reviewed a range of documents and records including the care records for people who used the service. We also looked at four staff files and documents relating to the employment of staff, complaints, accidents and incidents and the management of the service.
Updated
30 March 2017
The inspection took place on 13 December 2016 and was unannounced.
Willowmead provides care and accommodation to people who may need assistance with personal care and may have care needs associated with living with dementia. The service does not provide nursing care. The service is provided in two separate houses, called Wickham and Hatfield. The houses share communal gardens and other facilities. At the time of our visit there were 59 people living in the service.
A registered manager was in post at 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.
When we last visited in 2015 we had concerns regarding the skills and attitude of some of the staff at the service. During this visit we found the manager had been pro-active about resolving the concerns and we saw improvements in the way staff supported and cared for people.
Whilst there were measures in place to support people to remain safe, we found that the risk of infection had not been minimised. This was because the accommodation people lived in had not been cleaned and maintained to an acceptable standard. Whilst there were significant plans in place to update the property in the near future, the manager had not ensured the current property met people’s needs and kept them safe.
The manager was supportive and approachable. They had a positive working relationship with the deputy manager and they were both committed to improving the service. However, although numerous checks took place which looked at the quality of the care provided, these did not always pick up the concerns around infection control which we had found during our visit. Staff observations were also not used effectively to improve staff performance and attitudes.
People were protected from the risk of abuse. Staff supported people to take their medicines safely, as prescribed. There were sufficient staff to meet people’s needs. Staff were well supported and were enabled to develop their skills in a variety of ways.
The service was meeting the requirements of The Mental Capacity Act 2005 (MCA). Assessments of capacity had been undertaken and applications for Deprivation of Liberty Safeguards (DoLS) had been made to the relevant local authority. People were supported to make choices about the care they received. Processes were in place to ensure decisions were made in people’s best interest, involving family and outside professionals as appropriate.
People had enough to eat and drink. People's food and liquid intake was recorded and monitored and any concerns addressed promptly. Staff worked well with health and social care professionals to support people to maintain good health and wellbeing.
Staff treated people with kindness, dignity and respect. They took the time to get to know people and to reassure them when they were distressed. Care plans had been developed to support staff to provide personalised support. Staff motivated people to engage in a range of meaningful activities and pastimes. The importance of family relationships was valued and communication with families was excellent. People knew how to complain and received a personalised response to their concerns.