Willow Lodge

Updated 7 February 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 2 inspectors 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.

Service and service type

Willow Lodge Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Willow Lodge Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The current manager had not made an application to the CQC to become the registered manager.

Notice of inspection

This inspection was unannounced.

The inspection was undertaken on 28 November 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 2 people that used the service and 6 relatives. We spoke with 9 members of staff including the nominated individual, care staff and nursing staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We asked to look at a range of records including policies and procedures, people’s care and medicine records, and audits. We looked a recruitment records and health and safety documents.

Updated 7 February 2023

About the service

Willow Lodge Nursing Home is a residential care home providing personal and nursing care to up to 22 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 11 people using the service.

The home is set over 2 floors which are accessible via a lift. There is a communal area available, with a garden and car park.

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

People were not always kept safe as systems to manage the safety of the environment were not effective. Some improvements had been made in managing medicines, however further work was required to embed the changes. Improvements had been made regarding the incident recording process to make sure mistakes were not repeated. People were looked after by enough staff who knew them well. A relative said, “There are lots of changes of staff, but the permanent ones know him especially well.” The home was kept clean.

People were not always kept safe as recruitment processes needed improving. We have made a recommendation about systems to monitor staff training and competencies. People had limited fresh food options. People’s bedrooms looked bare and were not decorated according to their preferences. The manager completed appropriate assessments regarding health and well-being, and decisions were made in people’s best interests.

People and their relatives spoke highly of the staff and said they were very kind, friendly and caring. Some relatives mentioned that agency staff did not always have the same rapport, or knowledge about people’s individual needs and preferences.

People did not have many opportunities for going into the local area or to participate in activities within the home. The registered provider needed to make improvements regarding using different communication strategies. Although complaints were recorded it was not clear what processes were used to resolve them and make sure people’s care was improved.

People were at risk of receiving poor quality care because the registered provider had failed to ensure effective oversight of risks, quality of care and the environment. The registered provider did not always request feedback from people, their relatives or staff. However, staff enjoyed their jobs and were committed to providing good care for the people that used the service.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 26 October 2022) and there were breaches of 3 regulations. The provider was asked to complete an action plan after the last inspection to show what they would do and by when to improve however this was not received. At this inspection we found the provider remained in breach of 2 regulations.

At our last inspection we recommended that the provider look at their incident recording processes, and at this inspection we found that some improvements had been made.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has remained inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections off this full report.

Enforcement

We have identified breaches in relation to the safety of the premises, recruitment and the governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

The registered provider made the decision to close Willow Lodge Nursing Home in the days following the inspection. However, until this process has been finalised CQC will continue their normal processes for services rated inadequate and in special measures as follows:

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.