The Willows

Updated 17 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection which took place on10 and 12 April 2018 and was unannounced on the first day.

The inspection was carried out by one adult social care inspector, a nurse specialist advisor and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection, we reviewed all the information we held about the service, including previous inspection reports and statutory notifications sent to us by the provider. Statutory notifications contain information about changes, events or incidents that the provider is legally required to send us. We contacted the local authority who had no concerns about the service. We also read the latest Health watch report. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

Before the inspection, the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we met and spoke with 11people who used the service, as well as five visiting relatives. We also spoke with 11 staff, including the deputy manager and the registered manager. As some people living at The Willows were not able to tell us about their experiences, we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us.

We spent time looking at documents and records related to people's care and the management of the service. We looked at nine people's care plans and other daily charts.

Updated 17 May 2018

We undertook an unannounced inspection at The Willows on 10 and 12 April 2018.

The Willows is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Willows accommodates 61 people across two separate units. One of the units specialises in providing care to people living with dementia. At the time of the inspection there were 50 people living at the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained good.

There was a registered manager in post. A registered manager is a person who has registered with CQC 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.

People and their relatives were very complimentary about the care they received.

People were protected from abuse and avoidable harm. Staff had completed safeguarding training and understood the provider's safeguarding policy. The culture was open and staff told us they felt able to report any concerns which would be acted upon by the management team.

There was enough staff to support people effectively. Throughout the inspection we saw staff supporting people, meeting their needs and spending time socialising with them. There was a recruitment plan in place, especially for night staff.

The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Appropriate arrangements were in place for the safe management and administration of medicines.

Staff assessed risks to people's safety and developed plans to manage and mitigate those risks. Risk assessments were regularly reviewed and in line with changes in people's health and/or support needs. The home was very clean and well maintained.

Staff were supported to provide care to people through regular training, supervision and appraisal.

People were offered appropriate support with eating and drinking. Overall people were satisfied with the food available although some comments received suggested that the food could be variable. People’s health needs were kept under review and referrals were made to health professionals where required.

Staff understood the importance in seeking people's consent. During the inspection we heard staff asking for people's consent before they assisted them with any support. Staff had received training in and understood the principles of The Mental Capacity Act 2005 (MCA).

The provider and staff team placed emphasis on the importance of people’s well-being. Throughout the inspection we observed staff who were friendly and caring in their approach. They knew people well and talked about things that were important and relevant to the person.

People told us that they were treated with dignity and respect. Staff had a good understanding of how to respect people's right to privacy.

There was a wide and varied range of activities available for people to take part in should they choose. There was a programme of activities, including music therapy and reflexology. People were supported to maintain their spiritual well –being and a chaplain was employed by the service. There was a “seize the day” initiative” which supported people to achieve specific goals.

Staff were responsive to people’s needs and provided support in an individualised way.

Care plans were being re-written onto new documentation. We found that the care plans contained personalised information to help staff support people as individuals in a way that suited them best. There were some variations and some contained more individualised information than others. Staff received appropriate training in care planning.

We found occasional gaps in chart s which recorded the care that staff had provided to people. The registered manager told us she would address this.

Staff told us that communication was good and that a handover was undertaken at the start of each shift to update staff and share important information.

The provider had an effective complaints procedure in place and people who used the service and their relatives were aware of how to make a complaint.

People who used the service and their relatives spoke positively about the registered manager and the staff. They said that they were very approachable.

The provider had a robust quality assurance process in place. People who used the service, relatives and staff were regularly consulted about the quality of the service through meetings and surveys.