Archived: The Willows

This inspection was carried out on 28 November 2017 and 07 March 2018 and was unannounced. When we previously inspected the service on 07 January 2016 we found that care records were not always regularly updated to provide a comprehensive account of people’s changing needs and staff were not provided with sufficient training to develop their skills to meet people`s needs effectively. At this inspection we found that these areas had improved.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us they felt safe living at The Willows and their needs were met. Health care professionals were complimentary about staff and the registered manager and they felt that staff provided effective care and support to people. Staff were knowledgeable about how keep people safe and how to manage risks to people’s safety and well-being. People told us there were sufficient numbers of staff to meet their needs in a timely manner. Staff were recruited through robust procedures.

People were involved in planning their care and support and their views were listened to by staff. Staff worked in accordance with the principles of the Mental Capacity Act 2005 (MCA) and promoted choice and involvement. Staff knew people well, were caring and respected people’s preferences. People were asked for their permission before staff assisted them with care or support.

Staff attended regular training sessions and the registered manager created opportunities for continuous development. Staff received regular support from management which helped them to feel supported and valued and they told us they felt able to seek assistance when they needed to. People were supported to eat and drink and had regular access to health and social care professionals.

People’s privacy and dignity was promoted and they told us staff were caring and kind. People received care that met their needs in a way they liked and care plans contained up to date, clear information. People told us they planned their days and the activities they wanted to do on a daily basis. There were no recent complaints and feedback we received from people, their relatives, staff and professionals was positive.

Everyone we spoke to in the home and health professionals were positive about the management of the home. There were effective quality assurance systems in the home and there was visible leadership for staff. The ethos of the home was person centred and the environment was homely.

The inspection took place on 07 January 2016 and was unannounced following concerning information we received. This suggested that there were insufficient staff available to support people, staff had not received appropriate training and unqualified staff were administering people’s medicines.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection we found that applications had not been made as they were not required at that time.

People told us they felt safe living at The Willows. Staff were able to describe to us how to keep people safe and how they positively managed risks to people’s safety and well-being. There were sufficient numbers of staff deployed to support people, and the home was calm and relaxed throughout our inspection. Staff were recruited following a robust vetting process that ensured they were suitable to work with vulnerable adults. There were suitable arrangements for the safe storage, and administration of people’s medicines.

People were asked for their permission before staff assisted them with care or support. Staff were not always provided with the required skills and knowledge to provide care effectively to people. Staff received regular support from management which helped them to feel supported and valued and they told us they felt able to seek assistance when they needed to. People received appropriate support and encouragement to eat and drink sufficient quantities and their nutritional needs were assessed and monitored effectively. People had access to a range of healthcare professionals when they needed them.

People’s privacy and dignity was promoted and they told us they were treated with kindness and compassion by staff that listened to them. Staff knew people’s individual needs and were able to describe to us how to provide care in a way that met them.

People and staff told us the culture in the home was open and supportive. Care records were not always regularly updated to provide a comprehensive account of a person’s changing needs and care. However, staff were aware of people’s care needs and how to provide support.

Arrangements were in place to obtain feedback from people who used the service, their relatives, and staff members about the services provided. People told us they felt confident to raise anything that concerned them with staff or management.

The provider did not always have arrangements in place to regularly monitor and review the quality of the care and support provided for people who lived at The Willows.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, and the staff supporting them. We also spent time looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

The home environment was safe and generally well maintained. We noted there was damage to the flooring in the hall and downstairs communal toilet; however the manager told us they would repair this promptly.

There were systems in place to ensure regular checks of the environment we carried out. Staff we spoke with were familiar with health and safety requirements and had received regular support and training.

The manager ensured when they recruited new members of staff that the appropriate checks were carried out before people started employment. This included a criminal records check which demonstrated that the provider had assessed the staff were fit to work with vulnerable adults.

Is the service effective?

We saw that where changes to a person's needs were identified the appropriate updates were made to their care plan and the relevant professionals were contacted if needed.

When issues were found through assessing and monitoring the service, an action plan was created and there was a record of this action being carried out.

Staff told us they felt supported by the manager to perform their role. We saw that staff received regular support from the manager and their knowledge was updated frequently throughout the year by annual training and development. People we spoke with told us they thought the staff were suitably skilled to perform their role.

Is the service caring?

We observed staff with people who used the service. We saw staff acted in a dignified and respectful manner toward people.

People who used the service told us they felt cared for by the staff. One person told us, "My health was really plummeting and this home has helped me to stabilise my health along with my family and friends, so yes I am very happy here."

Is the service responsive?

We saw from care plans that when people arrived at the service their needs were assessed and recorded. There was evidence of people's involvement in the planning of their care and their individual personal requests were carried out.

Is the service well-led?

There were regular audits completed and where issues were identified the manager acted swiftly to remedy these. We saw evidence which demonstrated these actions being completed.

The views of people were sought and acted upon, and the manager also sought the views of relatives and stakeholders.

Five people were able to give us their views. They said that they were, "Fine" and there was, "Nothing they would change'. People said that the staff were, "Very good".

We observed that the house was fresh and clean. People had been able to personalise their rooms with furnishings and belongings that reflected their interests and life history. This told us that people were respected as individuals and staff recognised the importance of peoples past experiences.

We noted that there were appropriate arrangements in place for people to receive their prescribed medicines.

We identified that further action was needed regarding the contractual arrangements in place for the disposal of clinical waste and monitoring the hot water supplies, to reduce the possible transfer of infection within the service and wider community.