7 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection was unannounced and took place on 09 July 2018. The inspection was carried out by one inspector.
We used the information we held about the service to formulate our planning tool. This included information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service. This included notifications about events that had happened at the service, which the provider was required to send us by law. For example, safeguarding concerns, serious injuries and deaths that had occurred at the service. We received information from local authority commissioners to gain their experiences of the service provided.
We spoke with five people who used the service and three relatives. Some people were unable to communicate their experiences of the service so we observed care and support in communal areas to assess how people were supported by staff.
We spoke with three staff, the deputy manager, the support manager and the registered manager. We viewed three records about people’s care. We looked at how medicines were stored, administered and recorded for eight people. We also looked at documents that showed how the home was managed which included training and induction records for staff employed at the service and records that showed how the service was monitored by the registered manager and provider.
7 August 2018
We completed an unannounced inspection at The Willows on 09 July 2018. At our previous inspection on 08 December 2016 we found that improvements were needed to ensure medicines were managed safely, records were accurate and the systems in place to manage the service were effective. The service was rated as Requires Improvement overall. At this inspection we found that the provider had made the required improvements.
The Willows is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The Willows accommodates a maximum of 12 people. People are supported across two separate houses with each house accommodating up to six people. At the time of the inspection there were ten people using the service. The Willows follow the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager at the service. 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 received safe care and we found there were enough staff to provide support to people that met their needs. We found that people’s risks were assessed and managed to protect them from the risk of harm and people received their medicines safely. The provider had safe recruitment procedures in place to ensure that staff were of a good character and suitable to support people who used the service. People were protected from infection and cross contamination risks.
People were supported to make decisions about their care and staff sought people’s consent before they carried out support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People’s nutritional needs were met and people had positive mealtime experiences. People had access to health care services and advice sought was followed by staff to ensure people’s health and wellbeing was maintained. Staff received training to enable them to support people effectively. The environment was designed and adapted to meet people’s needs and promote independence.
People were treated with dignity and staff were caring and kind. People’s privacy was respected an upheld, people chose to have time to themselves in their private rooms and staff respected their wishes. Staff encouraged people’s independence and understood people’s individual communication needs. Staff supported people to maintain relationships with relatives/friends.
People were supported with interests and hobbies that were important to them. People and their relatives were involved in the planning and review of their care. Staff knew people well, which meant people were supported in line with their preferences. People understood how to complain if they needed to because complaints procedures were in a format that people understood. Plans were in place to gain people’s views of how they wanted to be supported at the end of their life.
Systems were in place to assess and monitor the quality of the service people received. People and staff were encouraged to provide feedback about the service. The registered manager was approachable and supportive to both people and staff and understood the requirements of their registration with us (CQC).