Willow Home Care Ltd

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question inadequate. At this assessment the rating has remained inadequate.

This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls.
 

This service scored 30 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

People told us they felt rushed by staff and felt intimidated by some staff who provided care and support to them. They told us the office staff were often rude to them when they telephoned. One person told us they got shouted at for telephoning the service at the weekend and asking about their rota. However, despite this, most people told us staff were kind and respectful towards them. One relative told us, “Staff have respect, for [Person’s name] and us and our home.”

The provider did not demonstrate compassion or empathy to people when their care calls were late or the times changed. People told us they did not get told when staff were going to be late and they had to telephone the office to find out when they would receive their care. However, they found their telephones calls often went unanswered. One relative told us, “When [Person’s name] was discharged from hospital I was told the staff would come at a specific time, but when the staff were late the first day, they said to me; don’t pay attention to the rota – you can’t go by that time.” Another relative told us their family member was often left in wet bedding because they had soiled themselves waiting for their care staff to arrive. This did not support people’s dignity.
 

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

At our previous assessment, we identified people did not always have their preferences met regarding the gender of staff who provided their personal care. At this assessment, no improvement had been made and some people continued to receive care which did not fully respect their personal preferences. One person told us, “A male carer turned up recently and I didn’t know he was coming; it was meant to be a female. This was a little bit disturbing as I didn’t know he was coming so he let himself in and all I heard was the door rattling with him trying to get it open, then he appeared.” Another person told us, “I've still got dignity. I don't want a male supporting me with my personal care. Any other call is fine, just not personal care.” We checked people’s care plans, and people’s preferences had not been recorded. The registered manager told us people were not routinely asked their preference for male or female carers, as it was assumed they had no preference unless otherwise specified in the local authority’s pre-care assessment.

People were not always treated as individuals because their cultural backgrounds, preferences and lived experiences had not been fully explored when planning their care. Although initial assessments included some questions about beliefs, customs and identity, these focused largely on religion and failed to comprehensively assess other aspects of people’s cultural needs and preferences. As a result, care records did not provide sufficient information for staff to understand how a person’s culture, background or identity could influence the way they wished to receive care and support. This meant people were at risk of receiving care which was not personalised to their individual needs and preferences.
 

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.

People did not have choice and control over their care as they did not receive care which was consistent and as agreed. Feedback from people and relatives was of them not receiving care call rotas so they did not know which staff were coming and at what time. They also experienced late calls and not being told when their care call times or staff changed. One person told us, “I often don't get a rota or get told about any changes, so I don't know who's coming. It is a worry not getting the rota, it's making me so low.” Another person told us they found it difficult to organise anything because they never knew when staff were coming.

People told us when they had their regular care staff, things ran smoothly. However, they also told us there was little consistency of care staff which meant they often did not feel they had choice or control over what happened. One person spoke about being frustrated because they had to tell each different staff member what to do at their care call.
 

The provider had not listened to people’s views or wishes and therefore had not minimised preventable discomfort, concern or distress. Although people had requested same gender care staff and to have a copy of their care call rotas this had not been provided. This had resulted in people feeling uncomfortable, distressed, and their dignity and personal choices not respected by the provider.

People found communicating with some staff difficult because they were not able to speak English clearly. The registered manager told us they were seeking training for staff.

People found some staffs food preparation skills were poor. One person told us they had to have a fried egg with their salad, rather than the boiled egg they wanted because the staff member could not boil an egg. The registered manager told us training had been provided to staff on the basics of cooking skills, such as making drinks and simple meals.

People and relatives had difficulty getting hold of office staff and they told us their telephone calls and emails were often not answered. This was also true for care staff, and one told us, “Sometimes it can be alright, but it can be hard to get someone on the phone. It is risky; what would happen in an emergency?”
 

The provider did not always promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

We received differing feedback from staff about how their wellbeing was promoted. Staff spoke about them not receiving adequate breaks and not feeling valued. If a break was rostered into their working day, some staff told us this was often filled with additional care calls, which they were not asked to do prior to them being added. One staff member told us, “It is nice to be on same run every week, so I get to know the clients, but the runs are a bit too long. I had a break from 1.30pm to 3pm today but they added another person, so I won’t get a break at all. I get paid for about 12 hours but I’m working about 15 hours.” Other staff spoke about feeling stressed because of the pressure to do more care calls.

Staff rotas showed care calls were not always scheduled to allow staff enough time to arrive to each call on time. Some rotas did not give staff any travel time between calls. This had an impact on the care people received as they often talked about feeling rushed and staff arriving late.

The registered manager told us they valued staff and had taken some steps to improve staff wellbeing. A recent staff survey had identified themes where staff did not feel listened to or appreciated and felt they were working too many hours. In response, the registered manager introduced team meetings and a staff group chat and thanked staff for their work at the end of each day. They also made sure staff who walked to care calls did not finish their shifts too far from home and encouraged them to confirm through the group chat when they had arrived home safely. However, these improvements had not acted to improve staff’s sense of wellbeing or feeling valued.

The registered manager explained many staff had working patterns which accommodated their childcare responsibilities and school hours. In addition, staff had received a Christmas card and monetary voucher from the provider as recognition for their contribution.