Willowcroft Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Assessments of people’s needs were not always consistently completed or fully reflected in care planning. While care plans contained a range of information about people’s health and wellbeing, some key areas were inconsistent or contradictory. For example, one care plan stated a person required the use of a hoist and was not mobile, however it also stated the person was independently mobile. This meant staff did not always have up to date and detailed information about people’s assessed needs. This placed people at risk of receiving inappropriate care and treatment.

This was fed back to the provider who told us they would take action to review all care plans to ensure they were relevant and conflicting information had been corrected.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Best practice tools were used to monitor areas such as skin integrity and nutrition, however inconsistencies remained. For example, one care plan stated that a person could reposition themselves. However, shortly after this, it stated staff were to support with repositioning.

Although dietary requirements were known by staff, we found them to be incorrectly recorded in care plans. We found people’s preferences to not be acknowledged, and choice not to be offered.

We received mixed feedback on the food choices. One person told us the food could be better, with more choices, such as vegetarian options. They told us, “I tell them I am not eating, they offer me an alternative which is normally toast, tend to use too many carrots.”

We noted a ‘you said we did’ poster displayed in reception from a survey carried out a year ago. This highlighted meal choices as an issue. The provider responded they were consulting with the residents regarding preferred meals and would incorporate these into the menu. This remained an issue a year later.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Staff knew people well and were seen to be contacting professionals and requesting the support of external health professionals when required. They spoke positively about communication between themselves and external professionals.

People’s care plans were long, with needs not accurately detailed and documented. Therefore, the provider would be unable to share an accurate assessment with other services, for example the hospital if this was required.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

The provider employed an activities coordinator which people reported they enjoyed, however due to people’s differing interests and abilities and the home being over 3 floors, people were often left without social stimulation and meaningful activities. We observed people who preferred to stay in their room have access to colouring, however meaningful conversation or engagement was not provided round this.

People were well presented and personal hygiene appeared to be well supported. People had their own toiletries within their bathrooms to support with personal care needs.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s rooms were highly personalised. One person took great pride in showing us their room and spoke of their involvement in choosing the colours and decor. Staff were aware of people’s interests and used this to engage in conversations with people.

One staff member told us, “We have a [person] who asked for a church. I found one nearby and the opening times. Took him once and he enjoyed it. He is not religious, but he really liked it.”

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. While staff demonstrated an understanding of the need to involve people in decisions about their care and that people had the right to refuse care, records did not always clearly evidence consent. For example, some care plans did not include evidence where discussions had taken place with people regarding their consent.

Mental capacity assessment had not been completed in accordance with the principles of the Mental Capacity Act 2005. In addition, assessments were not decision-specific and therefore did not provide sufficient information to demonstrate how capacity had been assessed in relation to a particular decision. They did not clearly identify the matter requiring assessment, nor did they provide guidance regarding the interventions staff should use to support people appropriately. Where restrictive practice was in place, for example door sensors, we found people had not been consulted, nor had capacity assessments been completed.

We raised this with the provider at the time of the assessment who told us they would review mental capacity assessments to ensure they were in line with law and legislation.