Archived: Willow Tree (New Milton) Also known as Willow Tree Homecare Ltd

This was because some care and support we looked at plans contained insufficient information about the actions care workers had to take to meet people's needs. For example they contained none contained information about how people's oral hygiene or foot care was to be provided. We also found some people's plans lacked information about what action care workers had to take when individuals lacked capacity to understand risks to themselves and declined to accept help set out in their care and support plans that was necessary to ensure their welfare.

On this occasion we saw this essential information had been included in people's care and support plans. However we did find that not all personal records kept about people who used were complete and accurate.

During our inspection we looked at a random sample of 10 care and support plans. We also spoke with the service's acting manager and a care co-ordinator who helped develop care plans with people who used the service.

The evidence we gathered against the outcome we inspected helped us answer our key question.

Is the service safe?

Below is a summary of what we found.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

The service is not as safe as it could be.

Arrangements were in place that enabled the support and help people required to be planned and delivered in a way that ensured their safety and welfare. However people were not always protected from the risks of unsafe or inappropriate care and treatment because information about them was not always complete and accurate. A compliance action has been made in relation to this and we have asked the provider to tell us how they intend to improve.

At the time of our inspection the Willow Tree(New Milton), (the agency), provided care and support to around 190 people in their own homes. People lived in the Waterside areas of the New Forest and Lymington, New Milton, Ringwood and Fordingbridge areas of Hampshire.

During our inspection we followed up an action we had required of the agency as a result of our last inspection on 25 March 2014. On that occasion we had found the agency's recruitment procedures had not been sufficiently robust. On this occasion we found they had taken steps that had improved and strengthened their procedures.

Our inspection took place over three days. On the first day we visited the agency's office and looked at documentation such as care plans, visit schedules, policies and procedures, training records, staff records, surveys and audit material. We spoke with the proposed new manager of the branch, a manager from a branch operated by the provider in Bournemouth, an area manager and a team leader.

On our second day, accompanied by a team leader, we met and spoke with six people and or their relatives in their homes. We had randomly selected them from a list of all the people who received a service from the agency. We did this in order to hear about their experiences of the service the agency provided. We also met and spoke with two care workers during our visits.

On the third day we telephoned 23 people who used the service and spoke with them or their relatives in order to obtain their views about the agency. We also telephoned 13 care workers to hear what they had to say about some of the training they had received.

We gathered evidence against the outcomes we inspected to help answer our five key questions.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found.

If you want to see the evidence supporting our summary please read our full report.

Is the service caring?

Care and treatment was not always planned and delivered in a way that ensured people's safety and welfare. Plans did not always contain enough information about how to meet people's personal care needs and how to support people who had been identified as potentially lacking capacity to make safe decisions about their care needs.

Is the service responsive?

The support and assistance people required had been identified before they received a service from the agency to ensure it could provide the service people wanted. People's care needs were reassessed/reviewed regularly and/or when their needs changed.

Is the service safe?

People were protected from risks associated with medicines because the provider had appropriate arrangements in place to manage medicines and were cared for, or supported by, suitably qualified, skilled and experienced staff.

Is the service effective?

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

Is the service well led?

The provider had systems in place to regularly check and monitor the quality of the service and identify, assess and manage risks to the health, safety and welfare of people using their service and others.

We examined recruitment and training files for six members of staff. We spoke with the registered manager for the service.

We found that the provider had not ensured a full employment history was completed for each member of staff. All of the staff had appropriate disclosure and barring service checks carried out before starting employment.

We found that staff received appropriate support and training to carry out their duties. This included a three day induction, the opportunity to received further training and regular supervision and appraisal.

Our inspection took place over two days. We looked at documentation held at agency's office such as care plans, visit schedules, policies and procedures, training records, staff records, surveys and audit material.

We met with seven care workers and talked with them about their training and some of their working practices.

Accompanied by a member of the agency's management team we met with four people we had randomly selected to visit in their own homes. This was to see if care workers arrived on time and obtain the views of people or their relatives about the agency. Where it was appropriate we also observed the care and support people received.

We sent questionnaires to a random sample of 61 people who received a service from the agency. This was in order to obtain views about the service they received. We received 24 responses.

People were treated with respect, given appropriate information about the service the agency provided and involved in making decisions about the support they wanted.

The agency had arrangements in place that ensured; people received the help and support they wanted and needed; were protected from harm; appropriate checks were carried out before people were employed to work for the agency; enough staff were available to meet the needs of people who received a service; the quality of the service was monitored

At this unannounced inspection we spoke with the manager, four members of staff, two relatives and three people who used the service provided by Willow Tree.

During this inspection we visited four people in their own homes and talked to them and their relatives about the care they received from Willow Tree. All of the people we spoke with told us they were very happy with the service they received.

We spoke with three members of staff. They stated the agency had provided thorough training and gave them good support in order for them to provide effective personal care.

Willow Tree had appropriate processes and procedures when new staff were recruited, to ensure people were supported by suitable staff. This meant that people were protected from harm.

Medicines were handled appropriately.

We saw the provider had a quality assurance system in place to ensure standards were maintained.