Willett House

We found the following examples of good practice.

The provider screened all visitors for symptoms of acute respiratory infection before they were allowed to enter the home. Visiting professional and contractors were also required to show proof of vaccination before they entered the home in line with guidance. We were assured the provider was facilitating visits for people living in the home in accordance with the current guidance during this outbreak. People had nominated essential care givers who were visiting and provided with access to testing and PPE.

Visitors were supported with testing and to follow the government's guidance on hand washing, sanitising and wearing personal protective equipment (PPE) before entering the home and social distancing whilst on the premises.

There were enough staff to meet people's needs. Where required dedicated agency staff could be block booked to ensure they only worked at Willett House. The provider carried out checks on agency staff to make sure they had received training on infection control and they had been fully vaccinated. Agency staff were required to take part in the staff testing regime which was enhanced in line with outbreak guidance. Staff worked only on specific units to minimise the risk of infection spreading.

All staff had received training on COVID-19, infection control and the use of PPE. We observed staff wearing appropriate PPE throughout our visit. The provider told us they had access ample supplies of PPE and cleaning equipment.

During our visit we saw that the home was very clean throughout. The home had a dedicated housekeeping team and care staff also carried out extra cleaning of higher infection risk points such as handrails.

When people or staff showed symptoms of COVID-19 they were supported to self-isolate. No one had been admitted to the home recently due to the outbreak but the provider followed guidance on isolation on readmission from hospital.

The provider was working closely with the GP, health care professionals, the Clinical Commissioning Group (CCG), the Local Authority Commissioning Team and Public Health England throughout the pandemic.

The provider had a COVID-19 specific policy, risk assessments and contingency plans in place to support staff as government guidance changed; which they had followed throughout the COVID-19 pandemic.

We found the following examples of good practice.

The provider had modified a lounge by adding a visiting pod with intercom, and a designated area where visitors were tested for COVID-19. There were hand washing facilities at the entrance of the home and visitors were required to wash their hands before entering. They were supported to follow national guidance on wearing personal protective equipment (PPE) and social distancing. People were supported to speak to their families on the phone or via video call. The provider had introduced virtual consultations to reduce the need for external visitors to the home.

People were supported to maintain social distancing whilst in communal areas. There was adequate stock of PPE and hand sanitiser at strategic locations around the home. Staff were provided with a clean uniform and a place to change when they came on duty. We observed staff wearing appropriate PPE throughout our visit.

The provider had arrangements in place to test both people and staff for COVID-19, in line with the current guidelines on testing.

The provider had clear protocols for people who were infected with COVID-19, and for people who had been admitted to the home from hospital or the community.

Staff who were more vulnerable to COVID-19 were supported and risk assessed to ensure staff they and the people they supported remained safe.

Willett House is a residential care home providing personal and nursing care to 36 adults and older people at the time of the inspection. The service can support up to 37 people in one adapted building and specialises in providing care to people living with dementia.

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

People told us they were happy living at the home. They were protected from the risk of abuse because staff received safeguarding training and knew the action to take if they suspected abuse had occurred. Risks to people had been assessed and staff followed the risk management guidelines to maintain people’s safety. There were enough staff working on each shift to meet people’s needs. The provider followed safe recruitment practices.

Staff worked in ways that reduced the risk of the spread of infection. People’s medicines were safely managed. Staff were supported in their roles through an induction, training and regular supervision. People’s needs were assessed before they moved into the home to ensure the service was suitable for them. They had been involved in developing their care plans, which included information about their preferences in the way they wished to be supported.

Staff sought people’s consent when offering to assist them. 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 supported to maintain a balanced diet. They had access to a range of healthcare services when needed and staff worked to ensure they received consistent support when moving between different services. The home had been built and adapted to meet people’s needs.

Staff treated people with kindness and care. They respected people’s privacy and treated them with dignity. People received responsive support at the end of their lives. They were involved in decisions about the support they received. They also knew how to complain and expressed confidence that any issues they raised would be dealt with appropriately. The provider had systems in place to monitor the quality and safety of the service. Staff acted to address any issues identified as a result of the provider’s quality assurance processes.

People, relatives and staff commented positively about the management of the service. Staff worked well together and were focused on providing high quality care. The registered manager and staff demonstrated a good understanding of the responsibilities of their roles. They shared information about the running of the home through regular meetings and staff handovers between shifts. The provider sought the views of relatives and people through regular meetings and the use of surveys. They were in the process of implementing innovations to help broaden the ways in which feedback could be provided and to improve the monitoring of the support people received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 6 July 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.

There was no registered manager at the service at the time of our inspection. The previous registered manager had deregistered in January 2017 although they maintained a senior clinical role at the service. 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 provider’s nominated individual had taken on responsibility of manager of the home on a day to day basis, whilst recruiting for a new registered manager which we confirmed was in progress at the time of our inspection.

At this inspection we found improvement was required relating to the safe management of environmental risks and to ensure people consistently received their medicines as prescribed. The provider took prompt action to address the issues we identified in these areas to ensure people were protected.

People were protected from the risk of abuse because staff had received training in safeguarding adults. They were aware of the different potential types of abuse and the action to take if they suspected abuse had occurred. Risks to people had been assessed and measures put in place to manage identified areas of risk safely. There were sufficient staff deployed within the service to meet people’s needs and the provider followed safe recruitment practice when employing new staff.

Staff were supported in their roles through regular training, supervision and an annual appraisal of their performance. They were aware of the importance of seeking consent from people when offering them support and followed the requirements of the Mental Capacity Act 2005 (MCA) where people lacked capacity to make decisions for themselves to ensure decisions were made in their best interests. The provider worked within the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure any restrictions on people’s freedoms were minimised and lawful.

People were supported to maintain a balanced diet and told us they enjoyed the meals on offer at the service. Staff supported people to maintain good health and access a range of healthcare services when they needed them. People and relatives told us staff were caring and considerate and treated them with dignity and respect. Staff were aware of the steps to take to ensure people’s privacy was maintained.

People were involved in day to day decisions about their care and treatment and they, or their relatives where appropriate, had been involved in the planning and reviewing of their care. The provider offered a range of activities to people in order to promote social stimulation, and visitors were welcome at the service whenever they wished. The service had a complaints policy and procedure in place which was on display within the service for people to refer to. Records showed that any complaints received had been investigated and addressed.

Whilst people did not comment directly on the management of the service, relatives told us the service was well run, and this view was shared by staff, and health and social care professionals who visited the service. The service maintained a positive working culture and relatives spoke positively about the attitude of the staff. The provider undertook a range of checks and audits to monitor and improve the quality and safety of the service. They also sought feedback from people and relatives to help drive improvements at the service.

We found that relatives and professionals were involved in best interest decisions, where people lacked the mental capacity to make specific decisions about their care. Although staff had not received training of the Mental Capacity Act (2005), plans had been made by the provider to provide this training. We found that people's needs were assessed, and care was regularly reviewed and delivered in line with an individual's care needs. The provider had suitable arrangements in place to protect people against the risks associated with infections, and to ensure that suitable staffing levels were in place to meet the needs of the people. We found records were fit for purpose, securely stored and archived for an appropriate period of time.

We found that people were treated respectfully, their needs were assessed and their care was planned and delivered in a way to meet people's individual needs.

Staff members we spoke with told that they were well-supported by their senior workers and the manager and they liked working at Willett House.