Willow Home Care Ltd

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

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

This meant services were not planned or delivered in ways that met people’s needs.
 

This service scored 29 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not consistently supported to achieve their personal goals, and care was not planned or delivered in a person-centred way. Although some people had identified goals within their care plans, there was no evidence these were used to inform care delivery, monitor progress or review outcomes. One person had expressed a goal of getting out of bed more often so they could eventually go out of their house for a coffee. However, there was no plan in place to support them to achieve this goal and no records demonstrating any progress had been considered. This failure to translate people's wishes and aspirations into meaningful care planning meant people did not always receive person-centred care.

Not all people and relatives felt involved in their care. Some were not aware of what a care plan was and did not recollect seeing one. Risk assessments were generic and were not always relevant to each person or did not meet people’s needs. People and relatives told us they were not routinely offered opportunities to review the care and support in place. However, 1 person told us, “Someone, I don’t know who they are, comes out every month to ask if I’m ok and if everything is going ok.”

People told us they wanted continuity of care. They told us their “regular” carers were very good but there were too many different staff. One relative told us, “[Person’s name] gets a heck of a lot of different staff, sometimes 15 or 16 different staff in one week. There is no consistency and they are constantly changing staff weekly.”
 

Care provision was not always coordinated across the organisation, with care and office staff not always working together for the benefit of people. People’s care records did not consistently demonstrate effective monitoring, follow-up, or continuity of care. Where concerns relating to skin integrity, such as redness or soreness to pressure areas, were identified, staff did not always record subsequent observations or outcomes. Therefore, it was not always clear whether the person’s condition had improved, deteriorated, or remained unchanged.

In addition, records did not consistently show how concerns were handed over between staff. For example, where one staff member documented redness or soreness to a person's skin, subsequent entries often lacked information about ongoing monitoring, actions taken, or the effectiveness of interventions. Although some records showed topical medicines had been applied, they provided limited detail about actions taken or escalation of concerns. One person’s care records showed multiple entries where care staff had recorded they had sore skin. However, these entries were intermittent and did not demonstrate a clear process of assessment, monitoring, or escalation. There was no evidence to show concerns had been reviewed by senior staff or referred appropriately for further assessment. Therefore, people could not be assured of a coordinated approach to managing changes in their skin condition and maintaining their wellbeing.

Staff understanding of escalation procedures was also inconsistent. One staff member told us they would only expect care staff to contact the office if a person had an open wound. This suggests staff may not always recognise the importance of reporting and escalating early signs of skin damage, such as redness or soreness, to ensure timely intervention and reduce the risk of deterioration.
 

Although people’s preferred communication methods were recorded in their care plan, this only went as far as stating if they preferred face to face or telephone communication. Little information was recorded to inform staff how they could effectively support people’s communication needs. One relative told us how staff had been telling their family member to get up and to “do this and do that”. They went on to say their family member was cared for in bed and had Dementia and they did not understand what staff were telling them to do. They said, “They didn’t know anything about [Person’s name].”

The provider did not meet the requirements of the Accessible Information Standard (AIS). The AIS sets out how providers and commissioners of NHS and publicly funded adult social care services should ensure disabled people and people with impairments or sensory loss can access and understand information about NHS and adult social care services and receive the communication support they need to use those services. The registered manager told us they were not aware of the AIS. However, their name was on the provider’s AIS policy as the person responsible for updating it and the policy had been last reviewed in February 2026.

The provider’s Accessible Information Standards Policy stated all staff would receive training on the Accessible Information Standards. However, the provider’s training matrix showed staff had not completed this training.
 

The provider's arrangements for listening to people, responding to concerns, and using feedback to improve the service were not consistently effective. People could not always be assured their views would be heard, acted upon, and used to influence service improvements. At our previous assessment, we had concerns because people told us they could not always contact the office after they had made a complaint. At this assessment, these concerns remained.

People and their relatives did not consistently feel listened to or involved by the provider. However, some people we spoke with told us they did feel individual staff involved them in their own care and did listen to them. These positive experiences were most often associated with having consistent care staff who knew people well. People and relatives described occasions where they did not always receive a response to emails or telephone calls when they had raised concerns. This left some people feeling their concerns had not been acknowledged or acted upon in a timely manner. One person told us they felt “punished” for raising concerns. There was little evidence of evaluating themes and improving people’s outcomes based on the complaints the provider received.

The provider used questionnaires to obtain people’s feedback. Although the provider had produced a report following a questionnaire completed in February 2026, which stated 95% of feedback received was positive, the report did not include information about the number of people who responded or the overall response rate. This made it difficult to determine how representative the findings were of people's experiences.

The positive findings reported by the provider were not fully reflective of the feedback we received from people during this assessment. Although the provider had identified actions they intended to take to improve the service, the provider did not have evidence to demonstrate all these actions had been taken and achieved.
 

The provider did not make sure that people could access the care, support and treatment they needed when they needed it.

People did not receive equity in access to their own care. As part of care planning, people were asked, “What barriers would limit or disrupt my care and support?” One person identified lack of access to their prescribed medicines as a barrier. However, despite repeatedly informing staff they did not have their medicines, no action was taken. This demonstrates a failure by the provider to respond to identified access needs and ensure equitable provision of care, resulting in the person experiencing unmet care requirements.

The lateness of some care calls meant people did not receive accessible, timely care and support. Late visits created barriers to equitable access, as people were unable to rely on their care being delivered when needed. The provider was not consistently reliable, which impacted people’s ability to receive care in line with their assessed needs and preferences.
 

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this.

People’s care plans did not comprehensively reflect people's needs relating to their protected characteristics under the Equality Act 2010. Although care records included a section relating to equality, diversity and human rights, the information gathered was limited and primarily focused on religious beliefs, hidden disabilities and the person’s experiences of discrimination. Key protected characteristics, including race, sexual orientation and marital status, were not recorded or explored. Therefore, the provider could not be assured people’s care was planned and delivered in a way which promoted equity of experiences and outcomes for all people. This placed people at risk of receiving care which did not fully recognise or respond to their diverse needs and circumstances.

People gave us differing feedback about their experiences of having care provided by Willow Home Care. Some people benefited from positive experiences and outcomes, while others did not. This inequitable care delivery increased the risk people's needs would not be consistently met.
 

There was little consistency in the recording of people’s future wishes or discussing what mattered to them. People’s care plans mentioned if a Recommended Summary Plan for Emergency Care and Treatment form (ReSPECT) was in place. A ReSPECT form is a summary of personalised preferences and care recommendations, including whether they wished to be resuscitated in a future emergency in which they cannot make decisions or to express wishes. These are completed with the person and a health professional, such as a GP. However, care plans gave no detail about what resuscitation or treatment preferences the person wanted should they require emergency treatment. People’s care plans did not show forward planning, including how people’s needs may change over time or how their preferences would be respected as their circumstances evolved.

There was improvement since our previous assessment and the provider’s training matrix now showed staff had received training in end of life care. When people were at the end of their life a care plan was in place to record their preferred place of death, their palliative and clinical support resources with a focus on emotional support and comfort.