Archived: Willowmead Care Home

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.

This is a summary of what we found:

Is the service safe?

When we arrived at the service the staff asked to see our identification and for us to sign the visitors book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

We saw records which showed that the health and safety in the service was regularly checked. This included regular checks on equipment as well as checks on the environment. This told us people were looked after safely.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

We saw the service regularly reviewed the required number of staff needed to provide care and took steps to provide these staff.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

Is the service caring?

We saw that people were relaxed in the company of each other and staff. We saw that staff were attentive to people's needs. Staff we spoke with were able to demonstrate they knew people well. We saw staff treated people with dignity and respect.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to. This was demonstrated in minutes we saw which related to meetings with people who used the service. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor, chiropodist and district nurse. This told us that the service worked well with other professionals and that people's needs were met.

Is the service well-led

The service had a number of quality assurance measures in place. The manager was very proactive in monitoring and looking for ways to improve the service. We saw the quality of the service had been maintained.

Recruitment practices were good. Staff received a good induction and they told us that they shadowed more experienced staff until they felt confident in working alone. Staff were well trained and supported to do their work.

There was a complaints procedure available and people told us that staff were responsive to their concerns. One person said: 'If anything is not quite right I tell the staff and they make sure it is dealt with quickly.

We observed that people were offered support at a level which encouraged independence and ensured that their individual needs were met. Where equipment was required to help people to mobilise and move, it was used confidently and safely. There was a relaxed atmosphere in the home, and the staff were friendly and courteous in their approach to people and interacted confidently with them.

There were systems in place to ensure the staff employed were suitable to work in the care environment. We found they were knowledgeable about the policies and procedures that were in place to protect peoples' health and welfare.

We noted that people were encouraged to express their views and were involved in planning their care and making decisions about their support and treatment, and how they spent their time. However within the care files we did not see that care documentation reviews had been signed by the individual or a representative to confirm their involvement and agreement with their particular care needs.