Green Willow Care Home

We found the following examples of good practice.

People had been supported to use technology to keep in touch with family and friends. Staff had encouraged people to learn to use video calling applications independently. A representative of the provider told us, “Many can answer calls themselves and can start the phone calls. Watching them progress with it and get more used to it has been really amazing”. Staff had helped one person celebrate their birthday by cutting the cake during a video call with family members from around the world. Each bedroom had a telephone point if people chose to have their own line.

To promote safe visiting for people and their relatives, the provider had converted a bedroom into a visiting ‘pod’. The pod had floor to ceiling screens and was accessed by visitors from outside. There was an intercom to aid hearing and communication.

When a person was admitted to the service, they were required to spend 14 days isolating in their room. The provider had made an ‘isolation pledge’ to try and make this a positive time. Staff used the time as an opportunity to get to know the person and to tailor their care according to their wishes and preferences. Bedrooms used for isolation had garden access and staff supported people to walk in the garden and enjoy fresh air.

During our visit, people were busily engaged and appeared to be enjoying their activities and each others’ company. The wellbeing lead had started individual scrapbooks as a record of what people had been doing. She told us, “I have used them to perk people up, it brings back lots of lovely memories”. Relatives had posted positive feedback online, one wrote, ‘I love the way the staff have been creative in thinking of great activities to do at this time.’ Another, ‘At this difficult time, they are all doing a brilliant job keeping everyone safe and going the extra mile to keep people entertained and cared for.’

Staff felt well supported. The manager and senior staff were completing courses in mental health to further their knowledge. All staff had completed ‘wellbeing assessments’ which looked at their triggers, how they might present when stressed and how they would like to be helped. Staff said this had really helped them to understand one another and had brought them closer as a team.

Staff monitored residents with the aim to detecting any early symptoms of Covid-19. These checks included twice daily temperature checks. Staff had been trained to use an Oximeter, this gives a reading of oxygen saturation levels in a person’s blood and is useful when discussing a person’s support needs with healthcare professionals.

The manager had clear procedures for infection prevention and control in place, which were understood and followed by staff. Staff were required to change on-site and uniforms were laundered at the home. All staff had received additional training in infection prevention and control and had completed a competency check for the donning and doffing of PPE.

People’s experience of using this service:

People told us they were happy at the service. They felt safe and well-cared for by kind and caring staff. People’s relatives confirmed they were confident their loved ones received safe and kind care.

People were complimentary about the food. They had a choice of meals and were always able to have an alternative. Staff made sure people had enough to drink and received any support necessary to eat their meals. The kitchen staff were aware of any special dietary needs.

The environment was bright, well-maintained and clean throughout. People had access to different communal spaces, one of which was TV free. There was a range of activities including exercises, games and puzzles, trips out and visits from entertainers. People told us they could participate or just watch. There were ample pictures around the service to remind people of activities they had enjoyed.

Care was provided by staff who were suitably trained and supervised. Staff had undergone recruitment checks before being employed by the service. Staff morale was good and we observed staff interacting with people in a way they preferred.

People’s care needs were assessed and their care provided in the way they preferred. Any risks to people were assessed and plans put in place to reduce risks. People’s emotional and social needs were included in their plans of care. Relatives were involved in planning and reviews of people’s care and were able to discuss any change in needs. They were informed of any incidents, such as falls.

However, people’s capacity to consent to their care and treatment had not always been recorded in line with legislation. We have made a recommendation about this.

The provider sought feedback about the service from people and their families. A satisfaction survey had recently been carried out which scored highly. There was a complaints procedure and any complaints were received openly and responded to with transparency. The provider apologised for any shortfalls and took action to address the complaint. The service had received a high number of compliments; many relatives expressed how satisfied they were with the care their loved ones received.

The registered manager demonstrated good leadership and staff morale was high. Staff told us they were well-supported and confident they would be listened to if they raised any concerns or had ideas for improving the service. The provider operated a clear governance system to identify and rectify any shortfalls.

Rating at last inspection: Good (September 2016)

Why we inspected: This was a planned inspection based on the previous rating. The service’s rating remained Good.

Follow up: We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

There was a registered manager 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 and relatives said they felt safe and secure and had no concerns about safety at the home. Staff understood local safeguarding procedures. They knew what action to take if they were concerned that someone was at risk of abuse. Risks to people’s safety were assessed and reviewed. People received their medicines safely.

Thorough recruitment processes were in place for newly appointed staff to check they were suitable to work with people. Staffing numbers were maintained at a level to meet people’s needs safely.

Staff received regular training and there were opportunities for them to study for additional qualifications. Staff were supported by the management through supervision and appraisal.

Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). We found the registered manager understood when an application should be made and how to submit one.

People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated in line with their personal preferences.

People were supported by kind and caring staff who understood their job role. Staff took time to engage with people, providing reassurance and support. People had developed very good relationships with staff and told us that staff were kind, caring and that they treated them respectfully. Staff understood how to care for people in a sensitive way. People were supported at the end of their life to have a private, comfortable, dignified and pain-free death.

Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.

People were involved as much as possible in planning their care. Care plans provided information about people in a person-centred way and identified the support people needed and how support should be given. The registered manager and staff were flexible and responsive to people's individual preferences and ensured people were supported to live the life they wanted, in accordance with their needs and abilities.

Care plans were regularly reviewed. We saw that when a person’s needs had changed the care plan was updated to reflect this. People were encouraged to maintain their independence and to participate in activities that interested them. People were supported to express their religious beliefs and to maintain their cultural or religious needs. There was a clear complaints policy and people knew how to make a complaint if necessary.

The service was well led. The registered manager operated an open door policy and welcomed feedback on any aspect of the service. There was strong leadership within the home and the registered manager, deputy managers and senior staff monitored the delivery of care. The Service had a clear vision and values which were enforced by an open and positive culture. A system of audits were in place to measure and monitor the quality of the service provided and this helped to ensure care was delivered consistently. Suggestions on improvements to the service were welcomed and people’s feedback encouraged.

There were elements in the well-led section of the report which could be developed further to achieve an “outstanding” rating. We made a recommendation to the provider about this in the main body of the report.

One inspector carried out this inspection and spoke with the registered manager and three members of staff. We toured the home and reviewed the cleanliness of the premises. We also looked at policies and procedures in place to support the management of infection control.

At this inspection we found that the provider had completed the works necessary to ensure people were protected from the risk of infection and appropriate action had been taken to ensure people were cared for in a clean, hygienic environment.

During our visit we spoke with eight people who lived at the home. We also spoke with one visitor, the registered manager, the deputy manager, a senior carer and four members of staff.

The inspection was conducted by one inspector who was assisted by an expert by experience. We used this inspection to answer our five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.

Is the service safe?

None of the people we spoke with had any concerns about the support they received. All the people we spoke with told us they felt safe at Green Willow Care Home

We saw care and treatment was planned and delivered in a way that ensured people's safety and welfare. All of the care plans we looked at had risk assessments in place to help minimise any risk that had been identified.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Although we found the home was clean the systems in place with regard to the control of infections needed improvement.

Is the service effective?

Each person had a plan of care and support. We saw support plans explained what the person could do themselves and what support they needed from staff. Staff told us the care and support plans gave them the information they needed to provide the level of support people required.

We observed staff supporting people and care staff we spoke with were aware of people's needs and how people wanted care to be delivered. We saw staff offered advice and support and people were enabled to make their own choices and decisions.

Is the service caring?

Without exception, people said they were very happy with the way the staff interacted with them and felt they were both skilful and knowledgeable, but most importantly that they were kind and caring.

We observed staff speaking to people appropriately and they used people's preferred form of address; We saw people and staff got on well together.

Is the service responsive?

We saw people had regular reviews of the care and support they received. People were able to participate in a range of activities both in the home and in the local community. Staff told us that they encouraged and supported people to participate in activities to promote and maintain their well-being.

People who used the service and their relatives were asked for their views about how the home was meeting people's needs and any concerns or ways to improve the service were acted on.

Is the service well led?

Green Willow Care Home had a policy and procedure for quality assurance and one of the providers visited the service on a regular basis.

The manager told us they carried out a range of weekly and monthly audits to ensure that the home was maintaining a good standard of care and support. The provider checked that these audits were undertaken. The provider compiled a report after each visit and a copy of these reports were kept on file at the home.

Staff meetings took place every four to six weeks and minutes of these meetings were kept. The home also had regular meetings with people who used the service to obtain their views on how the home was performing.

The manager told us systems were in place for all staff to received regular one to one supervision where staff performance issues were discussed and additional staff training was identified.

We spoke with eight people who have been accommodated at Green Willow Care Home. We also spoke with two relatives who were visiting. They told us about the care and support they had received and confirmed they were very satisfied with the way it had been delivered.

They told us they had discussed their needs with the manager of the home and had given consent to the care they received. They also confirmed that the food provided was of a good standard and their nutrition needs had been met.

One person told us, "I get very good care. If I want anything I can get someone to help me." Another person said, "The staff are very good." A relative told us, 'I know the staff are unable to improve my relative's health, but they can make my relative comfortable and happy.'

We noted the atmosphere throughout the visit was good. It was calm, friendly and homely. We observed staff on duty had a good relationship with the people living at Green Willow Care Home. When talking with people, staff were friendly and professional. They spoke clearly to ensure they were understood and listened carefully to make sure they knew what was expected of them.

We spoke with four people who have been accommodated at Green Willow Care Home. We also spoke with two relatives who were visiting. They told us about the care and support they had received and confirmed they were very satisfied. They also confirmed that they found staff were competent and skilled when providing for their needs.

One person told us, "The staff are pretty good. I am very comfortable. I always get the care provided when I need it." Another person said, "The staff are very loving towards us all!"

We spoke with three members of staff who were on duty. They informed us that they had received training that provided them with the necessary skills to deliver the care and support to people that was required. They also said they felt well supported by the manager in their work.

The atmosphere throughout the visit was good. It was calm, friendly and homely. We observed staff on duty had a good relationship with the people living there. When talking to people, staff were friendly and professional. They spoke clearly to ensure they were understood and listened carefully to make sure they knew what was expected of them.