Willow Brook House

Willow Brook House is a nursing home providing accommodation and personal care to up to 43 adults. The service is comprised of one building over two levels. At the time of inspection there were 17 people living at the service with dementia, mental health and physical needs.

People’s experience of using this service and what we found

Risks to people’s care had been identified but the measures in place to mitigate those risks were not always consistently applied. Any deterioration in people’s health was not easily identifiable, the provider was in the process of developing a handover document to ensure all nursing staff were easily and fully appraised of people’s current health condition.

People’s care plans were basic and improvements were needed to ensure staff had all the information they needed to fully support people in the way they wished and provide them with more person centred activities.

The systems in place to monitor the quality and safety of the service needed to be improved, embedded and sustained to be able to fully assessed.

There were sufficient staff who had been recruited safely and had the training and skills to meet people’s needs. People were protected from harm and received their medicines safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were kind and caring and treated people with respect. People’s dignity was protected and they were involved in decisions about their care. Staff knew them well and responded well to people.

People, their relatives and staff felt listened to. Any complaints raised had been investigated and responded to. Staff felt able to speak up and had confidence in the new management team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 11 August 2023) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 10 August 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Willow Brook House is a nursing home providing accommodation and personal care to up to 43 adults. The service is comprised of one building over two levels. At the time of inspection there were 36 people living at the service with severe, enduring mental illness with complex needs.

People’s experience of using this service and what we found

People were not always safe as the provider had admitted people to the home without ensuring they could meet their needs and were compatible with people already living at the home. People were exposed to incidents of verbal and physical aggression.

There were not enough staff with the skills, competencies and experience to meet people’s clinical and care needs.

People did not have all their risks assessed and staff did not have the information they needed to provide for their needs. Staff did not have all the information they needed to ensure people had the right texture of food and drink to prevent them from choking or aspirating.

People were at risk of undetected deterioration in their health, as staff did not always follow the provider’s systems to monitor people’s clinical observations. The provider failed to have a system to manage people’s healthcare appointments or include outcomes of health appointments in people’s care plans.

People did not always receive their prescribed medicines as they were out of stock. People who required time critical medicines were not receiving these on time to prevent unmanaged symptoms of their conditions.

People were not involved in their care planning or asked for their feedback about the service. The provider failed to ensure people’s communication needs were met. People’s and relatives’ verbal complaints were not recorded or always responded to.

The provider failed to employ enough staff to manage, monitor and improve quality and safety of the service. The provider identified areas for improvement but did not have the resources or systems to implement and embed these into practice.

The provider’s systems were ineffective in identifying and mitigating environmental or health and safety concerns.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This is the first inspection since registering on 21 July 2022.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and safeguarding concerns. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified 7 breaches in relation to staffing, safe care and treatment, person-centred care, nutrition, consent to care, complaints, governance and leadership at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures:

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.