Willowbank

We found the following examples of good practice;

• The home was closed to visitors but there were systems in place to ensure professional visitors were prevented from catching or spreading infections. People were still able to speak to relatives on the phone and through video calls.

• The provider had re-arranged furniture to ensure social distancing was promoted.

• The home participated in regular coronavirus testing for people and staff.

• The provider had adequate supplies of Personal Protective Equipment (PPE) and this was used appropriately by staff.

Further information is in the detailed findings below.

At our last inspection we rated the service good, with an outstanding rating in responsive. At this inspection we found the evidence continued to support the rating of good in three domains and outstanding for responsive and caring. There was no evidence or information from our inspection and ongoing monitoring that demonstrated risks or concerns.

There was a registered manager in post. 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. They provided leadership to the home to ensure that the values of respecting each individual and providing exceptional care was embedded.

Staff provided sensitive, compassionate care and responded very promptly to people’s needs. They understood each individual’s diverse requirements and ensured they met them. This included adaptations to maintain and encourage their independence. They worked in partnership with people’s families to ensure that their personal histories were understood. The staff also adopted different communication methods to ensure that they could assist everyone to make choices about their care.

People continued to receive outstanding personalised care and support which was built on their preferences. There was close collaboration with other professionals to get the best outcomes for people to maintain their health and wellbeing. The outcomes of careful assessment with the professionals and with families led to extremely detailed care plans. All staff had an excellent knowledge about people’s needs and ensured that they were met and regularly reviewed. They also used this knowledge to plan activities and interaction which promoted people’s mental and physical wellbeing. This included developing community partnerships and employing specialists.

The staff team were well trained and supported to have the skills to achieve good outcomes for people. This included in delivering end of life care and families we spoke with told us they were exceptional in supporting people through this time. They also were trained to develop their skills in clinical observations so that they could work in partnership with other professionals to respond swiftly to changes in people’s health. This included detailed analysis of any accidents or incidents to ensure that appropriate actions and referrals were made.

People continued to receive safe care. There were enough staff to support them and they were recruited to ensure that they were safe to work with people. Staffing levels were planned around individual need to keep people safe from harm. People were protected from the risk of harm because staff understood how to support them safely including using equipment. Medicines were administered to each person in an individualised way. They were recorded, stored and disposed of safely. The risk of infection was controlled because the home was clean and hygienic.

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. They had enough to eat and drink and staff were extremely attentive in supporting them in this. The environment was modernised and had signs and pictures in it to assist people to be safe and to be able to orientate.

There was a strong commitment of continual improvement from every staff member; from the leadership team to staff whose roles were not in direct care. There were innovative approaches to developing the service. The whole staff team worked closely with other professionals and valued their input in assisting them to get good outcomes for people. Governance systems were fully embedded and closely monitored and reviewed.

We considered all the evidence we had gathered under the outcomes we inspected.

This is a summary of what we found.

Is the service safe?

We observed people were treated with respect and dignity by the staff. One person living

at the home told us, "They do their best for me here." People told us that they felt safe and were reassured by staff if they were concerned about anything. Procedures were in place to protect people from abuse or neglect. People had been cared for in an environment that was safe, clean and hygienic. There were effective systems in place to reduce the risk and spread of infection. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Systems were in place to monitor the quality of care people received and record any incidents and accidents. This helped reduce risks to people and helped the service to continually improve. We found special equipment was provided for people and checks were completed to ensure it was safe. A plan was in place for dealing with emergencies so that people were not put at risk. The medication system in place was safe. Enough staff were mostly provided to meet people's care needs. A plan was in place for responding to unexpected events that could affect the running of the service, for example fire or loss of the power or water supply.

Is the service effective?

We found people's needs were assessed and care files included information about any diagnosed health conditions. Care plans were reviewed regularly to ensure their needs were being met. People's health and care needs were assessed with them. They were involved in writing and agreeing their plans. Where people did not have the capacity to consent to their care, relatives were involved to ensure their best interests were followed.

Is the service caring?

People told us they were happy with the care they received at the service. We observed that staff communicated well with people and were keen to involve them in activities if they chose to do this. Care planning took account of people's wishes, preferences and background which helped ensure staff could provide personalised care that met their needs.

Is the service responsive?

Systems were in place for obtaining people's views about the service provided. People told us they knew how to make a complaint if they were unhappy. They also told us staff responded well if they had any concerns. We saw the provider assessed the quality of care people received and that action was taken where improvements were needed. People were aware how to make a complaint. There were clear procedures stating how complaints would be handled. No complaints had been received since our last inspection.

Is the service well-led?

Checks and audits of medication, infection control systems and other aspects of safety and practice were in place at the home. People using the service, their relatives and other people involved with the service completed an annual satisfaction survey and records showed action was taken where any improvements were required . Meetings were held with people living at the home and also relatives and friends to discuss what was going well and any concerns. As a result, the managers were able to plan any improvements that were needed to the way people's care was delivered and the service was provided.

We found that people's needs were assessed and their care planned and delivered appropriately at Willowbank. We observed people receving personalised care that ensured their welfare and safety.

We saw that people's consent was obtained for their care, and that proper procedures were used if they could not make their own decisions, for example due to dementia.

We saw that staff received training to meet people's needs and that they were well supported by the manager.

We saw that procedures were in place to ensure complaints and comments about the service were responded to appropriately by the manager.

During our visit we spoke to eight people who lived at the home, the relatives of two people and three visiting professionals. We also spoke to three members of staff.

One person living at the home told us ''I am very happy here, it's a wonderful place. Another person told us ''I like it here, if I didn't I wouldn't stay.'' Relatives of one person told us ''She loves it here. I am very happy with the her care. She enjoys the food.''

A visiting professional told us ''It's very good here, the staff are excellent. I have been coming here for years, the people are always well looked after.'' One member of staff said ''I enjoy working here, it is a lovely place. It's sometimes busy. I know how to report any abuse and I am confident that the manager would deal with any issue I raised.''