The Willows

Updated 12 July 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced.

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be staff at the service to speak with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

People were not able to talk to us to share their views of the service, due to complex communication and support needs. Therefore, we observed six people’s experiences living at The Willows, including meal-times, activities and interactions with staff. We spoke with five members of staff including the registered manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We also pathway tracked two people. This is where we check that the records for people match the care and support they receive from staff.

After the inspection

We spoke with four professionals who regularly visit the service and one relative.

Updated 12 July 2019

About the service

The Willows is a residential care home providing personal care for up to six people. At the time of inspection, six people were living at the service. People living at the Willows had learning disabilities and some physical disabilities.

The Willows was an adapted building, in a bungalow style. The building was wheelchair accessible and had a large garden, that people liked to use.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent.

People were not able to tell us that they felt safe, however we observed them to feel relaxed around staff that knew them, and their support needs well. Risks to people were well known and there were robust assessments to address concerns.

There were enough staff to ensure people’s needs and routines were met, and staff were recruited safely. The building was kept clean and safe through regular health and safety checks. People received their medicines safely from trained and competent staff.

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.

Staff had all received a variety of training to meet people’s needs, such as epilepsy and managing behaviours that challenged. Staff had also received more specialised training in advanced communication techniques.

People’s nutritional needs were consistently met, and guidance given by professionals followed by staff. People could choose what they wanted to eat and drink each day. People also received regular support from health and social care professionals to ensure their physical and emotional wellbeing.

Everyone we spoke to was consistent in their views that staff were kind, caring and attentive. One professional said, “Any interactions with residents I have seen during my visits have always been very supportive and caring.” We observed that strong relationships had been built between people and staff, based on mutual respect and trust. People’s dignity, privacy and independence was continually promoted.

People received personalised support centred around their support needs, preferences and choices. This was regularly reviewed with people, their relatives and professionals. People were engaged in a variety of activities of their choosing each day, based on their interests. This included building relationships with members of the community.

Staff, professionals and a relative spoke highly of the registered manager and felt the service was well-led. Audit processes were robust which meant that the registered manager had clear oversight of the service and people’s experiences. The registered manager valued continuous learning and had on-going plans to improve the skills and knowledge of staff. They also sought regular feedback from people, relatives, staff and professionals to improve the service provided.

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 August 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.