6 November 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 is 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 undertaken by two adult social care inspectors on 29 August 2018 and was unannounced. Prior to the inspection we looked the information we held about the service. This included any statutory notifications the provider is required to send to us by law, any investigation incidents or feedback about the service. We also looked at the Provider Information Return (PIR), which had sent to us. This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We used a planning tool to collate all this evidence and information prior to visiting the home.
During our inspection we spoke with four people who used the service. We also looked at a number of records. These included three care files, duty rotas, three staff files, training records and records relating to the operation and management of the service. This helped us to understand the experiences of people living in the home. We also spoke with seven staff members. These included care staff, housekeeping, the chef, the directors of the company and the registered manager. We undertook a tour of all of the communal areas included the lounges, dining room, kitchen, laundry, bathrooms and some people’s bedrooms.
6 November 2018
The inspection was undertaken on 29 August 2018 and was unannounced this meant that the service did not know we were coming. We previously undertook a comprehensive inspection on 10 April 2017 where it was rated as requires improvement in the areas of safe, effective and well led and good in the areas of caring and responsive. This meant that the service was requires improvement overall. At that inspection we found that the provider had not always safeguarded people who used the service from abuse and improper treatment, because they had failed to report a serious incident of alleged abuse on behalf of a person who used the service. This was in breach of regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had also not always obtained formal consent in relation to the provision of care and treatment. This was in breach of regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made recommendations in relation to nutritional risk assessments, personal emergency evacuation plans and submitting statutory notifications to the Care Quality Commission (CQC).
Following the last inspection, we asked the provider to complete an action plan to show us what they would do and by when to improve the key questions of safe, effective, caring and well led to at least good. During this inspection, we found the service was meeting the requirements of the current legislation.
Willowbank Rest Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Willowbank Rest Home accommodates up to 19 people in one building. It provides accommodation for persons who require personal care. All bedrooms were of single occupancy with separate bathing facilities, lounges, dining room and outside gardens areas and car parking. At the time of our inspection 17 people were living in the home.
The service had a registered manager in post at the time of our inspection. 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 was run.
All people we spoke with told us they felt safe in the home. Staff were able to discuss what actions they would take to deal with allegations of abuse. Records we looked at confirmed staff had received safeguarding training. Risk assessments had been completed for the environment and people’s individual needs.
Systems that ensured only suitable people were employed to work in the home was in place. Duty rotas were completed and staff we spoke with said there was generally enough staff to deliver people’s care. Staff received up to date and relevant training that supported them to deliver their role effectively.
Medicines were administered and stored safely, however we noted a controlled drug record did not match the quantity of medicine in the controlled drugs cupboard, the registered manager investigated this and confirmed this was a recording issue and stock levels were correct.
Improvements were noted in relation to the way the service recorded people’s formal consent. Best interest’s meetings had been held and capacity assessments had been completed where it was required. People were supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.
The food people were served looked appetising and nutritious. People told us they were happy with the meals in the home.
We saw positive, caring and meaningful interactions taking place between people who used the service and staff. People told us they were very happy with the care they received. Advocacy information was available for people to access if they needed support with important decisions.
Care records were detailed and contained good person-centred information about how to support people’s individual needs. An activities programme had been developed and we saw activities provided to people during our inspection.
Team meetings were undertaken regularly and surveys and feedback had been obtained recently that provided information about people’s views. A system to deal with complaints was in place. We saw positive feedback about the care people received in the home. We received positive feedback about the registered manager and nominated individual. People told us the directors of the company were regular visitors to the home.
A system to audit and monitor the service was seen that demonstrated the management team ensured the home was safe for people to live in.