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Willow Health Limited Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 27 July 2018

This inspection took place on the 22 May 2018 and was unannounced.

Willow Health is a bungalow which has been adapted and provides accommodation in single bedrooms. It is a ‘care home’ and is located in a residential area within the town of Colchester. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Willow Health is registered to support up to seven people who have a learning disability, an autistic spectrum disorder and /or a physical disability. There were six people living in the service on the day of our inspection.

Willow Health was last inspected in April 2017and was rated Requires Improvement as they were not meeting the legal requirements. For example, we found that medicines were not being managed in a safe way and incidents between individuals identified as safeguarding issues. Following the last inspection, we met with the registered provider and discussed with them what they would do to improve the quality of care at the service.

At this inspection we found that some progress had been made but further work was needed to fully imbed the changes and ensure that people consistently received a good service.

The service is required to have a registered manager. 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. The previous registered manager was no longer working at the service and a new manager had been appointed. We saw that they had made an application to the CQC to be registered as manager.

Risks to individuals were identified and guidance provided to staff on the steps that they should take to mitigate the risks. Records however were not always well maintained and meant that oversight of the environment and safety was not fully effective.

The systems in place to safeguard people from abuse had improved. There was greater openness and staff were clearer about what was a safeguarding incident and the steps that they needed to take to protect individuals. Incidents were reviewed to identify learning and this meant that staff were able to see how effective their actions had been.

The processes in place for the oversight and management of medicines had improved since the last inspection. Medicines were securely stored and regular checks were undertaken, to ensure that staff were following procedures and any errors quickly identified.

There were some staffing vacancies and the service was dependent on agency staff. Recruitment was underway. Staffing levels did not always promote individualised care and the manager told us that they were working with the local authority on reviewing people’s needs to ensure that people had the support they needed.

Recruitment procedures for new staff had been strengthened and staff only commenced employment when the pre-employment checks were complete. We have recommended that when staff transfer between the providers different services there is a clear audit trail of decision making.

Newly appointed staff received an induction to ensure that they had the knowledge required to meet people’s needs. Ongoing training was provided for existing staff to ensure that their skills were kept up to date.

Staff had a better understanding of the Mental Capacity Act 2005 (MCA) and their responsibilities. Routines were more flexible and staff were working with people on improving communication and choice. However, we have recommended that the use of new technology is expanded to support people’s communication needs. Care records demonstrated that people had good access to health care support when neede

Inspection areas

Safe

Requires improvement

Updated 27 July 2018

The service was not consistently safe.

Risks to people were assessed and reviewed as necessary to keep people safe. The organisation of records did not always support effective oversight of safety and this meant that there were gaps which placed people at risk.

Staff knew people well and were effectively deployed. However, people’s access to the community continued to be limited. The manager was organising reviews with the local authority to ensure that people’s one to one funded hours for staffing allocation met their needs.

Recruitment procedures were in place and offered protection to people

People’s medicines were managed in a safer way.

Safeguarding procedures had been strengthened and staff clearer about the steps needed to protect people.

Incidents were reviewed and learning identified

The service was clean and staff trained in infection control systems.

Effective

Good

Updated 27 July 2018

The service was effective.

Staff had received training in the Mental Capacity Act 2005 and were clearer as to their responsibilities

People were supported to maintain their health and wellbeing with good access to health professionals.

People were supported to maintain a balanced diet.

Staff received ongoing training and support.

Caring

Good

Updated 27 July 2018

The service was caring.

People were treated with respect and their dignity promoted.

Staff were knowledgeable about people’s care and support needs.

People’s independence was promoted.

Responsive

Requires improvement

Updated 27 July 2018

The service was not always responsive.

People had a care plan but information was not always up to date or reflective of people’s needs.

People’s access to the community had improved and they were provided with a greater variety of opportunities.

There were systems in place to respond to complaints.

Well-led

Requires improvement

Updated 27 July 2018

The service was not consistently well led.

Quality assurance systems were in place but were not well developed.

The new manager had introduced changes to the service and there was greater focus on the needs of individuals. Some changes still had to be imbedded into life at the service.

Incidents recorded and there was oversight by the provider.