Willow Tree Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to identify and embed good practice.

There was a system in place to record incidents and accidents and ensure action was taken to reduce future risks. Staff told us, information about any changes needed to people’s support was shared with them in handover meetings.

The registered manager told us, “I have learned to document and date everything and record what you are doing and the solutions for people.” Incidents and accidents were reviewed to identify any potential trends. People and their relatives told us they felt the service was safe and responded well to incidents. One relative said, “[My relative] is safe here. The care home is very good because the care is excellent. Accidents happen from time to time but the staff are quick to respond and always keep me informed if they must call the doctor or if [my relative is] not feeling well.”

The registered manager and staff worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People’s needs were assessed prior to them moving into the service to enable staff to prepare to support the person and ease the persons transition to the home.

If people needed referrals to other services, such as occupational therapists or speech and language, these were completed by the registered manager or the deputy manager. One person told us, “They [staff] help with everything, I see the chiropodist every eight weeks [the optician] comes here and if I need anything else the staff will support me to access it.”

Staff worked with people to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

Staff understood what safeguarding was and had received training which was refreshed annually. They knew how to report issues and staff felt confident to do so. Staff shared concerns quickly and appropriately. One staff told us, “Safeguarding is about protecting people from harm, like abuse and neglect. I would report anything to the senior and document what I did, who I spoke to and what I saw”.

People and their relatives told us they were happy to speak up if they had any worries. One person said, “I feel happy to raise any concerns the staff and manager is always around to listen.” When concerns arose, the registered manager reported these to the local authority as appropriate. Concerns were investigated and action taken. Staff understood how to whistleblow. Staff told us they would take action to raise concerns if they felt issues were not being appropriately addressed by the manager or the provider.

Staff provided care to meet people’s needs which was safe, supportive and enabled people to do the things that mattered to them. People, their friends and relatives and partners all told us staff knew people well and understood their needs. One relative told us, “They look after [my relative] very well, it is lovely knowing [they are] safe and well cared for.”

Staff knew people well and understood how to support people safely. For example, staff knew how to identify if a person was becoming unwell with a health condition such as diabetes or an infection and raised concerns with the nurse as needed.

There were areas where some care plans needed to be improved. Some risk assessments included a good level of detail. However, others did not. The service had recently transferred from paper care plans to electronic plans and some information had not been carried over. For example, information on how to support people with hoisting did not include appropriate levels of guidance for staff. We raised this with the registered manager. The care plans we reviewed were updated the day of the inspection to improve them. The registered manager also put a plan in place to ensure other care plans were quickly reviewed and updated.

The provider and registered manager detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff told us they felt the environment was safe and had improved in the last 3 years, especially internally with more colour and some new wet rooms. Staff confirmed people’s equipment such as wheelchairs and hoists/slings, were routinely cleaned and maintained. One member of staff told us, “If there is anything broken like a toilet flush, we document this in the maintenance book and jobs like this get done within a couple of days”. Checks had been completed to ensure the utilities in the service were safe. Action had been taken to support staff if there was a need to evacuate people in the event of an emergency. For example, evacuation equipment was in place and staff had practiced fire drills. Checks were completed to ensure emergency lighting was working.

The registered manager made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care which met people’s individual needs.

Staff agreed there was enough staff. Staff said, “We are busy but not rushed. We have enough time to spend with people and support them to eat if they require.” Another staff member said, “If we see anyone looking lonely or sad, we go to them and ask them how we can help, and sit with them, hold their hand or offer them a cup of tea”. Feedback from people about staffing was positive. One person said, “They are generally quick to come when I call.”

Staff told us they had received comprehensive training that supported them in their role. Some staff told us they preferred the face-to-face training but could ask for support anytime from their colleagues and the deputy manager if needed. Staff had a good understanding of peoples risks and how to provide people with support. One relative told us, “I think the staff have all been trained, a lot of the staff have been here a long time so they know everyone well.”

Staff told us they received regular supervision and valued the 1:1 time it gave them to speak openly. They told us they felt the supervision was a supportive and encouraging experience. New staff shadowed more experienced staff to learn about people and their needs prior to working alone. Staff were recruited safely. For example, Disclosure and Barring service (DBS) checks were undertaken. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The registered manager assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was clean. Domestic staff undertook cleaning within the service and there were cleaning schedules in place. Staff understood the importance of infection prevention control, wearing the correct personal protection equipment (PPE) and disposing of it safely. People and their relatives confirmed staff used PPE appropriately.

Staff knew what to do if there was an outbreak of infection in the service. One staff told us, “I know there is a contingency plan for something like this, and how we would try to isolate any outbreak by moving people and using the building differently to contain the virus”.

The registered manager and deputy manager made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People’s medicines were ordered, stored and disposed of safely by staff who had the training and guidance they needed to support people safely. People told us they were happy with the support they received with their medicines and medicines were administered on time.

Where medicines were time sensitive staff had not always recorded the exact time they were administered. However, this was immediately addressed during the inspection, and we did not identify any harm to people. Other records were complete as required.

The support people needed with their medicines had been assessed. People’s medicines were reviewed regularly and as needed. For example, when people needed more support to manage pain.

Where people had ‘as and when’ medicines (PRN) such as, pain medicines, there was information for staff about these medicines such as how often the medicine could be given and the maximum dose within 24 hours. Medical equipment such as blood glucose monitors were regularly calibrated to ensure they were accurate.