Archived: Willow House Care

Willow House Care provides care and support to people living in a number of 'supported living' settings so that they can live as independently as possible.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection, the service was supporting 11 people with their personal care needs.

People's experience of using the service and what we found

We identified some improvements needed to the provider's governance systems to ensure they evidenced continuous learning and improvement to the service. There were no audits or checks in place and no formal review or analysis of accidents and incidents. This meant we could not be certain that action was being taken where necessary to improve the service.

We have made a recommendation regarding this.

Some records relating to the overall management of the service were not being stored in line with the services' registration condition. We found some records were being stored in people's homes. The provider took immediate action to address this and submitted a request to change their registered location to enable records to be stored correctly.

Some improvements were needed to the provider's recruitment processes. Whilst relevant safety checks had been completed on new applicants, interviews had not been formally recorded and gaps in employment history had not been explored and an explanation provided.

We have made a recommendation regarding this.

Family members told us they felt there were enough staff to keep people safe and provide them with the right support. Risks to people's health and well-being had been assessed and care plans provided detailed information for staff to follow in order to support people safely.

People told us they felt safe whilst being supported by staff at Willow House and family members were reassured their relatives were well-cared for. Staff received safeguarding training and knew how to identify and respond to allegations of abuse. Safeguarding concerns and accidents and incidents were acted on appropriately by staff. Records showed relevant professional were contacted and investigations completed where necessary.

People's needs had been fully assessed and staff had access to relevant information and guidance to provide effective care and support for people to achieve good outcomes. People had access to health and social care professionals when needed and staff sought advice where people's needs changed.

Staff had the relevant skills, knowledge and support to carry out their role. Family members told us staff knew their relative well and how best to support them. One family member said, “They [staff] are excellent. They know [relative] really well and know exactly how to support him.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were at the centre of their care and were supported to be as independent as

possible. Managers and staff empowered people to make their own decisions about their care and support.

We received positive feedback from people and family members about the service provided and the positive outcomes people experienced. One person said, “I love Willow House Care Group and all the staff for what they do for me. I wouldn’t want any other care group”. Staff felt able to speak up if they were concerned and told us they were well-supported by the provider.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 14 October 2017).

Why we inspected

The inspection was prompted in part due to concerns received about possible closed culture and restrictions placed on people's day to day lives. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Willow House Care on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Situated in Banks, a small village on the outskirts of the seaside town of Southport, Willow House Care is a new service which began providing care to people in November 2016. The service is provided by Willow House Care Limited and offers support to people with learning disabilities in a supported living setting. The home is situated over three floors and has a large kitchen diner, lounge and a garden at the rear. At the time of our inspection, three people were using the service.

At this inspection, we have given the service an overall rating of good.

People we spoke with were complimentary about the staff, the registered manager and the service in general. People's relatives told us they were happy with the care their loved ones had received. They told us; “We feel as though we’ve hit the jackpot”, “We’re very pleased with the service”, and “The service is very, very positive. I can’t fault it”.

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.

Care files showed staff had completed risk assessments to assess and monitor people’s health and safety. These assessments were completed in a manner that promoted both independence and safety for people living at Willow House Care.

Staff understood safeguarding issues, and were able to describe the course of action they would take if they felt anyone was at risk of harm or abuse; this included 'whistleblowing' to external organisations.

We found that people’s medication was stored securely and administered safely by staff that had been appropriately trained.

A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.

Our observations and discussions with staff confirmed that the staffing levels were sufficient for the support which needed to be provided. The registered manager had systems and processes in place to ensure that staff who worked at the service were recruited safely.

The registered manager provided us with a staff training plan and this showed staff received training to ensure they had the skills and knowledge to support people living at Willow House Care. The majority of staff had achieved, or were working towards, an NVQ level 2 or above. Records showed that all staff training was in date.

The service had a supervision schedule in place. Staff also felt confident to raise any issues or support needs informally.

The service operated within the principles of the Mental Capacity Act 2005 (MCA). Records demonstrated that processes were in place to assess people’s capacity and make decisions in their best interests. People were supported to have maximum choice and control of their lives and records demonstrated that staff supported them in the least restrictive way possible.

People were supported to maintain a healthy diet, and people's dietary needs and preferences were catered for. People and their relatives told us that they were involved in choosing their food and devising the weekly menu.

The service worked with external professionals to support and maintain people's health. Staff knew how to make referrals to external professionals where additional support was needed. Care plans contained evidence of the involvement of GPs and other professionals.

Staff adopted a caring approach towards people living at Willow House Care which was evident through our conversations with staff and through observations of staff interaction with people.

Staff worked with the aim of improving people’s independence and this was evident throughout the care records which reminded staff to consider the person’s ‘steps to independence’ in relation to a variety of areas of care planning.

Care was planned and delivered in way that responded to people's assessed needs. Care plans contained key information on people's personal preferences in an 'About Me' document. The service also completed daily records which outlined the care people were receiving and any changes in their support needs.

People were supported to raise complaints or concerns about the service through the use of an easy-read complaint policy. At the time of our inspection, there had been no complaints regarding the service. People we spoke to, and their relatives, told us they were happy with the service and had no reason to complain.

People told us they took part in a range of activities both inside the home and in the local community.

We received positive feedback about the manager from people who lived at the home and their relatives. Staff described the manager as ‘supportive’ and ‘passionate’ and ensured the home ran well.

The manager was a visible presence at the service, and was actively involved in monitoring standards and promoting good practice.

Further information is in the detailed findings below.