Willows Care Southern Limited

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• 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. This is the first assessment for this service following a change of provider. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. People’s needs were regularly assessed and reviewed to provide appropriate support. Staff supported people to lead as healthy lives as possible, people had access to health professionals when their needs changed.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Relatives told us they had been involved in developing and reviewing people’s care and support. All the relatives confirmed staff understood people’s needs and these were reviewed regularly. Relatives described how staff made sure people were involved, “Yes, they explain things to them very well.” There were processes in place to assess people’s needs before they moved into the service. People met with the manager to make sure people’s needs could be met. The manager also reviewed if the person would fit in with others living at the service. The manager explained, there were times when a new person’s behaviour would cause others anxiety, this would be considered and may lead to the new person not being admitted. People’s care plans had been reviewed, clinical assessment tools had been used to assess people’s skin integrity and nutrition. Staff followed the guidance from the assessment tools including the use of specialist equipment and recording people’s diet and fluid intake.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Relatives told us, staff understood people’s needs and support, “They explained to them that they need pureed food, so they don’t choke.” Staff reviewed people’s care plans including clinical assessment tools. For example, when people’s needs changed this had been identified using the tools and people had been referred to the dietician or district nurse as needed. Staff knew and understood people’s dietary needs. The kitchen staff had this information on display in the kitchen including which people required a diabetic diet, modified texture food and thickened fluids. We observed people receiving the diet they had been assessed as needing. Staff were seen asking people what they would like to eat and drink, staff supported people to enjoy their meals safely.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Relatives told us, “I think they share information well between those who need to know. All services work well together. They have a very good relationship with the surgery.” Also, “I think they share information effectively. I think there is a cohesive team, and I think they do it well. The GP gets to know and share everything, they work well together.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff described how they supported people to access vaccinations and have access to the GP when they were unwell. Relatives confirmed people had access to healthcare professionals when they needed. The service arranged for people to access the chiropodist, eye and hearing tests when needed. The manager told us there were issues with access to a dentist, but they had put oral care plans in place, to support people with their oral care. People were supported to be as active as possible including mobilising around the service using mobility aids when needed. People were supported to eat a healthy diet.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. There were processes in place to monitor the clinical outcomes for people including the use of assessment tools which were reviewed monthly. The reviews identified if people’s needs had changed and adjusted people’s support accordingly. Staff understood the importance to monitor people including their diet and fluids and to report any concerns they may have. Care plans had identified when people were at risk of poor fluid intake and how this could affect their health, such as urine infections. Staff described how they encouraged people to drink more if their intake had been poor. Relatives told us, “They support her to eat and drink and they check on her every 15 minutes.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff worked within the principles of the Mental Capacity Act 2005 (MCA). People’s capacity to make decisions had been assessed, when people had been assessed as not having capacity to make decisions, these were made in people’s best interest. Records were maintained about how decisions had been made and who had been involved including relatives and health professionals who knew people well. Depravation of Liberty Safeguards (DoLS) had been applied for as necessary. There was a process in place to track and monitor applications and when authorisations needed to be renewed. When authorisations had been received these had been recorded in people’s care plans, there were currently no conditions on the authorisations in place. We observed people being asked about how they would like to spend their time or what they would like to eat or drink. Relatives told us, “They ask her about what she wants.” Another relative told us, “They talk to me about her care and ask me my views and tell me things. If I suggest things, then they listen.”