The Willow

We found the following examples of good practice.

The provider had measures in place to ensure safe visiting and these included presenting a proof of a negative lateral flow device test’s result and a proof of vaccination against COVID-19. Infection control procedures were explained to visitors on arrival and they were provided with the appropriate personal protective equipment (PPE), if required.

People were supported to see their relatives, either at the service or by using a dedicated ‘pod’ situated outside the service’s main entrance. Staff ensured people were able to stay in touch with their families via video calls or phone calls if preferred.

Staff received training in infection prevention and control and in correct use of PPE as well as handwashing techniques. The provider ensured there was a stock of appropriate PPE available and there was a regular COVID-19 testing regime for both, the people and the staff.

The management team praised their team and the commitment of the staff and told us, “We’ve got the best team.” Risk assessments had been carried out with staff around their personal circumstances or health conditions and where needed additional support had been put in place.

There was a safe system of ensuring any new admissions were only possible after a confirmed negative result of the COVID-19 test was received.

People were supported to continue with their chosen activities that involved leaving the service and the provider gave us examples how they worked with partners to ensure people’s safety when doing so.

The registered manager reported good support from the local health professionals.

The Willow is a residential care home providing personal care for up to 11 people aged 65 and over. At the time of the inspection 11 people were living at the home.

The care home is located in a large detached house, within a residential area of the small town of Chesham, Buckinghamshire. People had access to three seated areas on the ground floor and extensive well-maintained garden.

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

People benefited from a service which was exceptionally person-centred, individualised and responsive. People were valued as individuals and encouraged to maintain a role in society and take part in local community events. The registered manager had forged many links with local services and had developed a local club called ‘The Willow Club’. There was an emphasis on reducing social isolation and increasing integration.

People and their relatives told us the service was well-led. The provider had policies and procedures in place. However, they did not always reflect best practice guidelines. We have made a recommendation about this in the report.

People were supported by staff who routinely promoted privacy and dignity. Staff had a good understanding of people, their likes and dislikes.

People were supported by staff who had a good knowledge of how to protect them from abuse and harm. People were encouraged to live as they wanted to. Staff encouraged independence in people.

People who required end life care were supported by staff who demonstrated kindness, compassion and supported the person’s family.

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.

Rating at last inspection

The last rating for this service was Good (published 21 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The Willow is a family run care home registered to provide care and accommodation for up to eleven people who are elderly and physically frail. At the time of the inspection The Willow had no vacancies. The home is located in Chesham.

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 l Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 11 August 2015 the provider was in breach of one regulation. We asked the provider to take action and make improvements in relation to the Mental Capacity Act 2005 as they were not adhering to the principles of the act. The provider sent us an action plan outlining the actions they were going to take. At this inspection we found improvements had been made and the provider had completed these actions.

People and their families told us they felt safe at The Willow. Staff understood their responsibilities in relation to safeguarding people. Staff received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the authorities where concerns were identified. People received their medicine as prescribed.

People benefitted from caring relationships with the staff. People and their relatives were involved in their care and people’s independence was actively promoted. Relatives and staff told us people’s dignity was promoted.

Where risks to people had been identified, risk assessments were in place and action had been taken to manage these risks. Staff sought people’s consent and involved them in their care where possible.

There were sufficient staff to meet people’s needs. Staff rotas confirmed planned staffing levels were maintained. The service had safe recruitment procedures and conducted background checks to ensure staff were suitable to undertake their care role.

People and their families told us people had enough to eat and drink. People were given a choice of meals and their preferences were respected. Where people had specific nutritional needs, staff were aware of, and ensured these needs were met.

Relatives and people told us they were confident they would be listened to and action would be taken if they raised a concern. The service had systems to assess the quality of the service provided. Learning needs of staff were identified and training was in place which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the Registered Manager and all of the team at the home. Staff supervision and other meetings were scheduled as were annual appraisals. People, their relatives and staff told us all of the management team were approachable and there was a good level of communication within the service.

People and their relatives told us the service was very friendly, responsive and very well managed. Comments received included “I would not want to be anywhere else”; “We are like a family” and “Amazing boss and support is very good”. The service sought people’s views and opinions and acted on them.

The management teams’ ethos was echoed by staff and embedded within the culture of the service.

A relative and some people who lived there said the care staff were thoughtful, kind and considerate. One person told us they wished there were more "active" activities, but most people said they were happy socialising and going out with family and friends. We heard that the local church held services in the home from time to time, and that people liked this.

We looked at the complaints folder for the year since our last inspection; no complaints had been made.

A relative told us that the food was excellent, and that "the cook went to great trouble to ensure people had what they wanted, even if it meant more work for her". People who used the service told us they had many choices in their activities, their food, when they rise and go to bed.

There was evidence that people who use the service's opinions were listened to and acted upon, in the Resident meeting minutes. One person told us "The staff are always helpful, and so kind; they really care about us". We found that the people who lived in the Home were keen to tell us how good it was to live there. One healthcare professional told us that "The staff are always available and helpful; there is a calm atmosphere here".

The provider had systems in place to assess and monitor the quality of the service offered, and had identified and managed risks relating to the care and welfare of their service users.