The Willows Care Home

At the last inspection carried out on 22 March 2016 the service was rated Outstanding. At this inspection we found the evidence continued to support the rating of Outstanding. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place. 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 who lived at the home continued to receive personalised care which was very responsive to their individual needs. Staff had an excellent understanding of the care and support people required and provided this with great care and patience.

The Willows had achieved the highest award possible for end of life care. A healthcare professional we spoke with told us this was explementary as standards required to achieve this were extremely high. We saw relatives had praised end of life care provision for their loved ones at the home.

The owner and registered manager continued to support staff to provide extremely high standards of care for the benefit of people who lived at The Willows Care Home. This was demonstrated by the outstanding awards in caring for people the service had achieved.

Without exception everyone we spoke with including people who lived at the home, their visitors and healthcare professionals couldn’t praise the home high enough. People who lived at the home told us how happy and well cared for they were.

People’s care and support had been planned proactively and in partnership with them. People felt consulted and listened to about how their care would be delivered.

Links with health and social care professionals were excellent. Health professionals we spoke with repeatedly praised the high standards of care provided and described the service as exceptional. Health care professionals told us staff were very responsive and acted quickly if people had healthcare issues.

The home had a vibrant and welcoming atmosphere where visitors were welcomed and encouraged. People we spoke with told us it was a pleasure to visit their relatives at the home.

People who lived at the home, their visitors, staff and healthcare professionals told us without exception the registered manager 'led by example'. This was underpinned by a clear set of values which included promoting each person's individuality, privacy, dignity, choice and rights. During our visit we observed staff acted according to these values when providing support to people in their care.

People who lived at the home and relatives repeatedly praised the quality and choices of food provided. Healthy eating was promoted. Meal times were relaxed and organised around people’s individual daily routines. We saw the dining experience was enjoyed by people who were supported by caring, attentive and patient staff. Healthcare professionals told us nutritional support provided at the home was excellent.

The service continued to provide interesting and stimulating activities for people to participate in. People who lived at the home told us they felt engaged and spoke with great enthusiasm about the activities organised for them.

Systems, processes and practices were embedded to safeguard people from abuse and risk of harm. Good practice guidance had been followed to keep people safe. Staffing levels were continuously reviewed to ensure there were enough staff on duty to provide flexible care.

Recruitment procedures were safe with appropriate checks undertaken. Careful consideration had been given to ensure staff offered employment shared the same care values of the registered provider to deliver high quality care alongside the existing staff team.

Staff and their mix of skills were used innovatively to give them the time to develop positive and meaningful relationships with people to keep them safe and meet their needs. There was a strong emphasis on promoting independence and empowering people wherever possible.

Staff retention was good and people told us they were supported by staff who knew and consistently met their needs.

The service used innovative and creative ways to train and develop their staff and ensured they put their learning into practice to provide an outstanding service.

People who lived at the home, their relatives and healthcare professionals praised the way in which safety and risk was managed. We were repeatedly told that people remained safe whilst living at the home.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People received their medicines as prescribed and when needed and appropriate records had been completed.

The service had safe infection control procedures in place and staff had received infection control training.

People who lived at the home and relatives repeatedly praised the quality and choices of food provided. Healthy eating was promoted. Meal times were relaxed and organised around people’s individual daily routines. We saw the dining experience was enjoyed by people who were supported by caring, attentive and patient staff. A healthcare professional told us nutritional support provided at the home was excellent.

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

The service used a variety of methods to assess and monitor the quality of the service. These included regular audits and satisfaction surveys to seek people’s views about the service provided.

Further information is in the detailed findings below

The Willows Care Home is situated on the outskirts of Blackpool in a rural setting. It is a detached single storey property, providing accommodation for 16 people who require nursing or personal care. Many of the rooms overlook the large garden and orchard and have direct access to the grounds. All rooms have en-suite facilities including a shower. There is a communal lounge and dining area as well as a conservatory. At the time of the inspection visit there were 14 people who lived at the home.

A registered manager was in place. 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.

At the last inspection on 10 June 2014 we found the provider was meeting the requirements of the regulations inspected.

Without exception, people and their representatives could not praise The Willows Care Home enough. One relative said, “It’s an amazing place. Nothing is too much trouble. I can’t recommend it highly enough.”

A relative we spoke with said, “The staff are exceptional, the residents always matter as most important no matter what is going on. That is fed down by the management. A first class home.”

Comments we received from people who lived at the home told us all staff were exceptionally caring, respectful and sensitive towards them. We also observed staff and the management team engaged with individuals in an affectionate, respectful and loving manner. One person who lived at the home said, “Excellent staff always willing to help wherever they can.”

The owner and registered manager had supported staff to provide high standards of care for the benefit of people who lived at The Willows Care Home. This was demonstrated by the outstanding awards in caring for people the service had achieved.

Staff told us the registered manager ‘led by example’. This was underpinned by a clear set of values which included promoting each person’s individuality, privacy, dignity, choice and rights. During our visit we observed staff acted according to these values when providing support to people in their care.

The management team used a variety of methods to assess and monitor the quality of the service. We looked at a number of audits that had taken place. This ensured the service continued to be monitored and improvements made when they were identified. People who lived at the home and relatives had opportunities to feed back to the management team. This was about the quality of their care through surveys and meetings. This ensured outstanding levels of personalised care were monitored and sustained.

We found the registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Staff had received safeguarding training and understood their responsibilities to report any unsafe care. One staff member said, “We have had training and I would be confident in what to do should I see somebody not treated right.”

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

The owner and registered manager had completed an assessment of people’s support needs. This was before they moved into the home. A person who lived at the home told us they had been consulted and involved in the assessment and care planning. We found evidence of this in records we looked at.

We found recruitment checks were carried out to ensure suitable people were employed to work at the home and there were sufficient staff to meet people’s needs. This was confirmed by talking with staff members and looking at records of staff recruitment.

We found sufficient staffing levels were in place to provide support people required. We observed staff could undertake tasks supporting people on a one to one basis in a timely manner. A person who lived at the home said, “I feel there are enough staff around. I know at times they are busy but they don’t seem short to me.”

Medicines were dispensed in a safe manner and people received their medicines on time. Staff had received related training to ensure medicines were administered correctly by knowledgeable staff. Controlled drugs were being administered at the time of the inspection visit. We found correct documentation was recorded to ensure accurate administration of controlled drugs.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

Staff had received training and were knowledgeable about their roles and responsibilities. Staff told us access to training courses and opportunities to develop their skills were encouraged by the management team.

People who lived at the home were happy with the variety and choice of meals available to them. Meal provision was provided by an outside agency and comments about meal provision included, “You do get plenty and they are nice.”

Comments we received from people who lived at the home told us all staff were exceptionally caring, respectful and sensitive towards them. We also observed staff and the management team engaged with individuals in an affectionate, respectful and loving manner. One person who lived at the home said, “Excellent staff always willing to help wherever they can.”

The owner and registered manager had supported staff to provide high standards of care for the benefit of people who lived at The Willows Care Home. This was demonstrated by the outstanding awards in caring for people the service had achieved. In addition various audits were completed regularly in order to monitor and sustain outstanding levels of personalised care approaches.

There was a complaints policy in place, which was understood by staff. Information on the complaints procedure was available in the reception of the home.

The management team used a variety of methods to assess and monitor the quality of the service. We looked at a number of audits that had taken place. This ensured the service continued to be monitored and improvements made when they were identified. People who lived at the home and relatives had opportunities to feed back to the management team. This was about the quality of their care through surveys and meetings.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records. We also spoke with Blackpool council's contracts monitoring team and Healthwatch Blackpool who are an independent consumer champion for health and social care.

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

Is the service safe?

People told us they felt safe and their rights and dignity was respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard people they supported. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required.

The service was safe, clean and hygienic. Equipment had been maintained and serviced regularly ensuring people were not put at unnecessary risk. People living at the home told us they were happy and well looked after. We found staff had received appropriate training and good supervisory and peer support arrangements were in place. This confirmed people were having their health and welfare needs met by competent staff. Systems were in place to make sure the manager and her staff learnt from events such as accidents and incidents, complaints and concerns raised about the service.

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access additional support. People's health and care needs had been assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. Care plans had risk assessments completed to identify the potential risk of accidents and harm. Staff members we spoke with confirmed guidance was provided to ensure they provided safe and appropriate care. We found the care plans were flexible, regularly reviewed for their effectiveness and changed in recognition of the changing needs of the person. People spoken with said their care plans were up to date and reflected their current needs.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. The people we spoke with were very happy with the care being provided. One person said, 'I haven't been here very long but I have to say how impressed I am. The staff have been very welcoming and I find them all polite and friendly. The place is absolutely spotless and the food is excellent. I am being very well looked after'. Another person said, 'It's lovely here I couldn't be happier. The place is absolutely beautiful. We have great staff who look after us really well. The food is excellent and we have lots of activities to keep us entertained'. A visiting relative said, 'Mum is receiving the best possible care. I visit at least twice a week and she is always spotless. She is very happy and gets on well with all the staff. She enjoys the food and they have excellent activities. I am going on holiday soon and know I don't have to worry about her'. Care plans had been maintained recording the care and support people were receiving. Good care practices were observed and people told us they were happy with the support they were receiving.

Is the service responsive?

Records showed admissions to the home were well planned. Information about people's care and dietary needs had been recorded. We also saw potential risks to people's health and welfare had been identified. Guidance had been provided for staff to ensure they provided safe and appropriate care. We found people completed a range of activities in and outside the service regularly. These included various games, access to the computer, going out for walks and entertainers. People we spoke with said they were kept busy and entertained and they were happy. We found people had access to healthcare professionals. People received regular health checks with their General Practitioner and the outcome of these visits were recorded on their care records.

Is the service well-led?

The service had quality assurance systems in place. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff had a good understanding of their roles and responsibilities. People we spoke with said they received a good quality service at all times.

The people we spoke with said they were receiving safe and appropriate care which was meeting their needs. One person said, 'I am really well looked after. We are well fed and have access to drinks throughout the day. This is a lovely home, I love it here'. Another person said, 'I couldn't have found a better home to live. The staff are lovely, we are well fed and have plenty of activities to keep us entertained. I am very happy'.

We observed the staff team providing sensitive and flexible personal care support. The staff were kind and patient and showed a good understanding of the needs of the people in their care. We saw meal times were served in a relaxed and unhurried manner. Staff members were observed being attentive to the needs of people who required assistance.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

We also spoke with Lancashire Fire & Rescue Service. They told us they had no issues with the building when they last undertook an inspection.

The people we spoke with said they were receiving safe and appropriate care which was meeting their needs. They told us the staff were polite, caring and professional when undertaking their work. Comments received included:

'This is a most pleasant home. I have a lovely room with views of the grounds. The staff are a very caring and friendly group of people. We have good food with healthy options and plenty of activities organised. I never get bored'.

'I have settled in really well and have found the care and meals are excellent. They provide entertainment for us and I have found the staff very attentive and available when I need them. I have no complaints about anything'.

'The care is excellent, the food is good and we have regular entertainment. I am very happy. The staff really look after me'.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.