We carried out a review of the data available to us about Willow Homecare & Support Services Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Willow Homecare & Support Services Limited, you can give feedback on this service.
Willow Homecare & Support services is a domiciliary care agency providing care and support to people who live in their own homes in Grimsby and surrounding areas. The service provides support to older people, people living with dementia, learning disabilities or autism spectrum disorder, and mental health needs. It also supports people who misuse drugs or alcohol, have an eating disorder, a physical disability or sensory impairment. At the time of our inspection there were 218 people who were receiving a service from this provider.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
The provider has a robust ongoing recruitment campaign to recruit more staff. The service considered travel time for staff to ensure people received the amount of care agreed in their care plan.
The service has effective safeguarding procedures in place and manages safeguarding's promptly. Staff knew the safeguarding policy and had a good understanding of their responsibility to protect people from harm. Lessons are learned and communicated to support service improvement
People are involved in managing risks and risk assessments were person centred. Staff were aware of people’s risks and how to manage them. Staff told us “I would always read the risk assessment first if I was going to see someone new,” and “They provide the right information and we have time to read them.”
Staff managed medicines consistently and safely. Staff are trained and follow clear policies and procedures on infection control that meet relevant national guidance.
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.
The provider had clear and effective governance systems in place that identify and manage risks through audits and action plans. This information is used to drive improvements in the service. All relevant legal requirements were understood and met, including notifying the CQC of significant incidents that had occurred.
The service involves people, their relatives and friends in a meaningful way. All staff understand the need to provide a good quality service. One person told us, “I enjoy making sure people are cared for and they can stay in their home for as long as possible.”
Quality assurance arrangements were applied consistently and identified current and potential concerns and areas for improvements. Concerns were investigated and lessons were shared and acted on.
The service worked in a transparent and collaborative way with relevant stakeholders and agencies to support service development and joined up care.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 15 July 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced inspection of this service on 13 April 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve well led.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. 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 Willow Homecare & Support services on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Willow Home Care & Support Services is a domiciliary care agency providing care and support to people in their own home. At the time of the inspection, the provider was providing care and support to 387 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
The service failed to notify the Care Quality Commission of incidents in line with legal requirements. This meant the Care Quality Commission (CQC) had no overview of incidents to check if appropriate actions had been taken.
Governance systems were not utilised for the last 12 months to monitor the quality of the service and drive improvements.
Staffing arrangements meant people did not always receive their calls at the correct times, times between calls varied and some overlapped. Family members said, "My relative is safely supported, but sometimes staff can arrive late which means they don't always get the care they need at the time they need it." The provider was aware of some of these issues as similar information had been captured through surveys. We have made a recommendation about this.
Issues relating to medicines were not identified by the provider prior to our inspection.
Ongoing risks relating to self neglect were not shared with health care professionals. We have made a recommendation about this.
Recruitment processes were safe, and people were mostly complimentary about staff’s approach. People told us they felt safe with staff and found staff were kind and attentive.
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.
The provider worked closely with local authorities who commissioned services to ensure people’s needs were met timely.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 21 February 2019)
Why we inspected
We received concerns in relation to the management of the service, staffing levels and the safety of people using the service, including concerns that people's care and support needs were not always met. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Willow Home Care and Support Services on our website at www.cqc.org.uk.
Enforcement
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 have identified two breaches at this inspection. One breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Regulation 17 Good Governance and a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 notification of other incidents.
Please see the action we have told the provider to take at the end of this report.
Follow up
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.
This inspection was carried out between 14 and 25 January 2019 and was announced.
At our last inspection we rated the service ‘good’. At this inspection we found the evidence continued to support the rating of ‘good’ and 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.
The provider had a registered manager in post. 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 were protected from harm and abuse by the provider’s safeguarding systems and staff knowing their responsibilities and being trained in this area. Any risks in people’s lives were reduced as necessary. The provider ensured staff that worked in the service were safely recruited. There were sufficient numbers of them to meet people’s needs. Staff practice around medication and infection control management was robust and safe.
Staff were trained and qualified to carry out their roles. They received supervision and an appraisal and demonstrated an understanding of people’s rights and treating them equally. People were supported with their nutrition and health. 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.
Staff were caring, compassionate and attentive in their support of people. Staff communicated well with people and respected their independence, choice, privacy and dignity.
People’s support plans were detailed and instructive. They enabled staff to provide the right support. Complaints were appropriately addressed and satisfied. Staff were responsive to the needs of people and their families at the end of their lives.
The service met its registration requirements. There was a registered manager and a general manager with day-to-day running of the service, with the registered manager being accountable for all management systems and practice. Staff understood their organisation’s visions and values and there was an organisational quality assurance system. Some people told us they had been asked about their views of the service and felt included in the organising of their support. Willow Home Care Support Services Limited continued to provide a good service.
Further information is in the detailed findings below.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered person’s’. 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.
In November 2015 the service secured a contract with North East Lincolnshire as one of their three preferred providers. This involved the transfer of high numbers of new clients and staff from other care agencies and has led to considerable expansion within the service. The development of the agency has also posed challenges for the management team and staff which they have worked hard to meet, including the on-going recruitment, training and deployment of staff.
We found staff were recruited in a safe way. All checks were in place before they started work and they received a comprehensive induction. Additional experienced staffing was available to support with assessments and offer support in emergency situations. People received a reliable service, with staff having time to provide the care people needed.
Staff received training in how to safeguard people from the risk of harm and abuse. They knew what to do if they had concerns and there were policies and procedures in place to guide them when reporting issues of potential abuse.
Safe systems were in place for the administration, storage and recording of people’s medicines.
The registered manager ensured staff had a clear understanding of people’s support needs whilst recognising their individual qualities and attributes. Staff were positive about the support they received from their manager.
Records showed people had assessments of their needs and support plans were produced. These showed people and their relatives had been consulted and involved in this process. We observed people received care that was person-centred and care plans provided staff with information about how to support people in line with their personal wishes and preferences.
Staff supported people in line with their nutritional and health needs. They encouraged and respected people’s independence and dignity. Staff liaised with healthcare professionals on people’s behalf if they needed support accessing their doctor or other professionals involved in their care.
Risk assessments were completed to guide staff in how to minimise risks and potential harm. Staff took steps to minimise risks to people’s wellbeing without taking away people’s rights to make decisions.
Staff had received training in legislation such as the Mental Capacity Act 2005, Deprivation of Liberty Safeguards and the Mental Health Act 1983. They were aware of the need to gain consent when delivering care and support, and what to do if people lacked capacity to agree to it.
There was a complaints procedure in place which was available in a suitable format, which enabled people who used the service to access this infomation if needed. The service had developed systems to review the quality of service provision and highlight areas which required further action. Action plans with identified timescales had been produced to address shortfalls.
People told us staff treated them with respect and were kind and caring. Staff demonstrated they understood how to promote peoples independence whilst protecting their privacy and dignity.
comments people who used the service told us:
"Willow Care are 100% reliable"
"The carers that come are very good and I find them to be very professional in what they do."
"I have the regular care workers who are very good, the problems arise when they are not on duty."
"Generally the carers have been very good, and the problems have been down to a few individuals who do not come regularly and are not fully familiar with my relative's needs."
We found before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.
People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We saw care plans were person centred and people's likes and dislikes were recorded in their care plan.
People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.
We found medicines were handled appropriately.
People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.
People were mainly positive about the staff that worked with them. One person told us, 'Staff are very good.' Another person said, 'I have always found them friendly and helpful.' Relatives comments included: 'Staff are consistent and regular,' and 'They are very good carers who come. There are no shortcomings.'
Questionnaires were used by the provider to gather the views of people who used the service during 2012. We saw that these were issued monthly and the action taken in response was recorded. One person told us, 'I do complete a survey. Sometimes I get feedback. They will ring or send me something in the post which deals with it.'
People we spoke with told us that they were satisfied with the care they received and that if they had any complaints they would raise these with the manager. We asked people if the carers visited them on the dates and times that had been planned and they told us that they did. We received comments such as 'The staff bend over backwards to help', 'I have no complaints, they are wonderful' and 'I am very happy with the care'.
We also spoke with some relatives of people who use the service and they told us that they were satisfied with the care provided for their relatives. They felt confident that any concerns or complaints they may have would be quickly addressed by the manager. The people that we spoke with had no concerns or complaints to raise about the service provided or staff.