The inspection took place on 24 and 25 July 2017 and was unannounced. Willow Gardens Care Home is registered to provide accommodation and support for up to 36 older people some of whom may experience dementia. At the time of the inspection there were 26 people living there. The service is located on the first floor of the main building in one of the provider’s retirement ‘Villages;’ which also provides independent flats and domiciliary care support packages for older people. The Village provides a range of amenities including: a wellness centre and spa, bistro, bar, library and delicatessen on the ground floor of the main building; which people living in the care home can also access.
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.
People told us they were safe within the service. Staff undertook both initial classroom based and annual on-line safeguarding training and understood their role in keeping people safe. Potential risks to people had been identified, assessed and measures put in place to manage the risks in a manner that did not restrict people’s rights. For example, people were supported to go away on holiday. The environment had been adapted to meet people’s needs. Processes were in place to ensure the equipment and premises were safe for people.
There were enough staff deployed to meet people‘s care needs. Robust recruitment policies and procedures were in place and relevant checks were made on staff’s suitability for their role.
People received their medicines safely from trained staff whose competency to administer medicines had been assessed. Processes were in place to store people’s medicines safely. When people were prescribed medicines that required special precautions staff ensured these were monitored by health professionals, for the person’s safety.
People were cared for by staff who had undergone an induction to their role. Records confirmed staff had received supervision and an annual appraisal of their work to enable them to reflect upon their work and development. People were supported by staff who were encouraged and supported to undertake professional development, to enable them to provide people with effective care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Feedback about the quality of the meals provided was mixed. However, processes were in place to ensure people had regular input into the types and quality of the meals provided and their comments about meals were acted upon. Risks to people associated with eating and drinking were effectively managed.
Staff supported people appropriately to access healthcare services as required and professional’s advice was acted upon to ensure people’s welfare.
People told us staff were caring. Staff were heard to speak with people in a warm and friendly manner as they provided their care. They had a good understanding of each person’s personal preferences about their care and how they liked to dress. Staff offered people choices about their care across the course of the inspection. They understood that people had the right to make their own decisions wherever possible. People’s privacy and dignity was upheld by staff in the provision of their care. People or their families where relevant; had been consulted about their end of life care.
People said they or their relatives had been involved in planning their care. People’s care plans were regularly reviewed with them. Staff had a good knowledge of each person and received updates about people’s care during the staff shift handover. Staff had undergone dementia care training and the needs of people living with dementia were understood and met by staff.
The activities co-ordinator provided people with a weekly schedule of activities based on their suggestions and feedback from the resident’s weekly meetings. People were provided with a range of activities, which ran in the morning, afternoon and evening, both in the service and in the community across seven days of the week to meet their needs for social activity and stimulation.
People told us that generally they had not needed to raise any complaints. However, if they had raised an issue verbally then it had been addressed at the time. Policies were in place for people to make formal complaints if required. Processes were in place to seek and act upon people’s feedback about the service provided.
There was open communication and people told us they were informed about what was happening. People’s care was based on clearly defined values and these were displayed by staff in their work with people. Inclusion was promoted both with relatives and with people living across the Village. Processes were in place to seek and act upon staff views and to recognise their work.
People and staff said the service was well managed. The registered manager had clear expectations of their staff and led by example. There was good communication between senior staff. The provider had a career development structure for care staff to enable them to develop their careers within the service. There were good links both within the service and externally to promote communication and the sharing of good practice.
Processes were in place to monitor the quality of the service provided and information about the service was analysed by the provider in order to identify any trends that required action for people.