Willett Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The care home provides accommodation and nursing care for up to 20 people in one adapted building. The home provides support for people living with a range of healthcare, mobility and sensory needs, including people living with dementia. There were 18 people living at the home at the time of our inspection.
People’s experience of using this service and what we found
People were not always protected from avoidable harm because risks to people's health and wellbeing were not consistently managed. Processes were not in place to ensure care plans and risk assessments were reviewed and updated following specific risk incidents or events. Care plans did not contain detailed and person-centred information to accurately reflect the needs of people and mitigate identified and potential risks.
There was no adequate process for ensuring that care recommended by specialist healthcare professionals was implemented. People's risk management plans lacked important detail to guide staff on how to keep people safe or manage specific health conditions.
Staff were recruited in accordance with the providers policy, although recruitment processes for agency staff were not always robust enough ensure that agency staff employed at short notice were inducted sufficiently, or had the skills, training and competence to provide safe care.
We observed a task focussed culture of the service which meant that care was not consistently person centred and did not always promote good outcomes for people. Staffing levels were not always sufficient in meeting people's emotional or psychological needs in a person-centred way, and staff did not always have time to provide structured, meaningful activities for people to engage in.
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.
People were cared for by staff who were kind and compassionate. People received support from a consistent team of staff who knew them well. Relatives told us they thought their loved ones were safe and there were enough staff to support them and meet their needs.
Staff had received training in infection prevention and control (IPC) and IPC practice within the home was aligned with current government guidance.
Rating at last inspection
The last rating for this service was Good (published 27 March 2018).
Why we inspected
The inspection was prompted in part by notification of a specific incident, where concerns had been raised regarding the security of the home. This incident is subject to a police investigation. The information CQC received about the incident identified concerns about the assessment and management of risks, people’s safety and neglect. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. This inspection examined those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from ‘Good’ to ‘Requires Improvement’. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Willett Lodge on our website at www.cqc.org.uk.
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to providing safe care and treatment, recruitment and the overall governance of the service at this inspection.
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.
After the inspection we contacted the provider about some of the urgent concerns found during inspection. The provider sent us assurances and evidence that informed us of the immediate actions they had taken to address these concerns.
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.