We carried out a review of the data available to us about The Willows 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 The Willows, you can give feedback on this service.
The Willows is a residential care home providing personal care to up to 10 people with a learning disability and associated physical disabilities. At the time of our inspection 10 people were living there. The home is a bungalow with a large garden. In addition to bedrooms the home had a communal lounge, dining room and an office for staff.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 10 people. Ten people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People and staff spoke positively about The Willows. We observed that there was a very homely atmosphere and that people and staff had good, caring relationships.
People took part in activities they enjoyed and were able to access the community. Visitors were welcomed. The home had good relationships with health and social care professionals. People had a healthy, varied diet and ate food they enjoyed.
People told us they felt safe and they were protected by staff who understood their responsibilities and how to keep people safe. People who did not express themselves verbally demonstrated through their behaviour that they were on friendly and trusting terms with staff. People were protected from risks by detailed, regularly updated risk assessments.
People had up-to-date care plans which detailed their strengths and promoted their independence. Their communication needs were assessed and recorded in detail and staff were observed appropriately interacting with people. Care plans and other information were regularly reviewed and involved people, their relatives and relevant external professionals such as therapists or social service professionals.
There were enough staff to meet people’s needs. Staff were well trained and understood the needs of the people they supported. The home was clean and tidy and good infection control practices were being followed.
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 procedures in the service supported good practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 11 November 2016).
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Willows on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The service had a registered manager. 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.
We met the gentlemen who lived at The Willows and spoke with two of these gentlemen during our inspection. Most people who resided at The Willows were not able to verbalise their views and used other methods of communication, for example gestures and sounds. Due to people’s complex needs we were unable to spend much time with people so we discussed their care with staff and reviewed family feedback.
People’s medicines were managed safely. Medicines were stored, given to people as prescribed and disposed of safely. Staff received appropriate training and understood the importance of safe administration and management of medicines. People were supported to maintain good health through regular access to health and social care professionals.
People’s care records were detailed and personalised to meet their individual needs. Staff understood people’s needs and responded when needed. People were not able to be fully involved with their care plans, therefore family members supported staff to complete and review the care plans. People’s preferences were sought and respected.
People’s risks were well documented, monitored and managed to ensure people remained safe. People lived full and active lives and were supported to access local areas and activities. Activities reflected people’s interests and individual hobbies. People were given the choice of meals, snacks and drinks they enjoyed to help support maintain a healthy diet. Some people had input in creating the menu and preparing some meals and drinks.
Staff understood their role with regards to ensuring people’s human and legal rights were respected. For example, the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were understood by the registered manager and staff. They knew how to make sure people, who did not have the mental capacity to make decisions for themselves, had their legal rights protected and worked with others in their best interest. People’s safety and liberty were promoted.
Staff had completed safeguarding training and had a good knowledge of what constituted abuse and how to report any concerns. Staff described what action they would take to protect people against harm. Staff were confident any incidents or allegations would be fully investigated.
Staff described the registered manager as being very approachable and supportive. Staff talked positively about their roles.
People, who required intensive support, had one to one staffing to meet their needs. Staff confirmed there were sufficient staff to meet these requirements and staffing levels were flexible dependant on people’s needs and activities during the week. Staff had completed appropriate training and had the right skills and knowledge to meet people’s needs. New staff received a comprehensive induction programme when they started work. People were protected by the company’s safe recruitment procedures.
All significant events and incidences were document and analysed. Evaluation of incidents was used to help make improvements and keep people safe. Improvements helped to ensure positive progress was made in the delivery of care and support provided by the staff. Feedback to assess the quality of the service provided was sought from people living in the home, relatives, professionals and staff.