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Archived: The Willows Residential and Nursing Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 18 October 2019

About the service

The Willows Residential and Nursing Home is a residential care home providing personal and nursing care. The service can accommodate up to 32 people in one adapted building. At the time of this inspection 30 people were using the service who had a range of needs including dementia and physical disabilities.

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

Some people, particularly those cared for in bed, felt lonely and isolated. Although staff told us activities were provided for people in their own rooms, this did not happen during the inspection. Staff carried out regular checks on people, but some of the interactions were task based and they assisted people with their care and support with little or no communication. In contrast, other people commented on how kind and caring some of the staff were.

People raised concerns about staff deployment in the home and we observed times when there were no staff in certain areas. Not everyone was able to use a call bell to summon assistance in these areas. The provider had recognised that the layout of the current building presented certain challenges, and they had a long-term plan to address this. In the interim the provider assured us that a senior staff member would make regular checks around the building to ensure staff were visible and people’s needs met.

The provider checked to make sure staff were safe to work at the service, but the checks being made did not always fully meet the legal requirements. This meant the provider’s recruitment checks were not robust enough to ensure people’s safety and wellbeing.

People’s privacy and dignity was not always upheld. Bedroom doors were routinely left open, meaning that people could be viewed easily by other people and visitors. Sometimes the people inside were asleep or not fully dressed. At times staff also failed to announce themselves when they entered people’s rooms and did not explain why they were there.

Some good attempts had been made to ensure some people’s communication needs were understood and met, but improvements were needed to explore everyone’s preferred communication methods.

The provider checked to make sure people received good quality, safe care and support. However, the auditing systems in place needed strengthening to ensure all legal requirements were met and to drive continuous improvement.

Staff ensured people received their medicines when they needed them. Risks to people were assessed too, to ensure their safety and protect them from harm, including the risk of infection. Staff understood how to report concerns and who to report to.

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. Staff asked people for their consent and involved them in planning their care and support. People were given the opportunity to make suggestions and provide feedback about the service provided to them. People’s concerns were listed to and acted on.

Staff supported people to stay healthy. Staff ensured people had a choice of food and had enough to eat and drink. They helped people to access healthcare services when they needed to and supported them at the end of their life to have a comfortable and dignified death.

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 25 May 2017).

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection. This is the fourth time since 2015 that the service has been rated requires improvement, although not all following consecutive inspections.

Why we inspected

The inspection was prompted in part due to allegations of poor care practice and abuse involving one person living at the servi

Inspection areas

Safe

Requires improvement

Updated 18 October 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 18 October 2019

The service was effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 18 October 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 18 October 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 18 October 2019

The service was not always well-led.

Details are in our well-Led findings below.