Background to this inspection
Updated
23 April 2020
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
This inspection was carried out by two inspectors on the first day and completed by one inspector on the second day.
Service and service type
Willows Lull is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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
The inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because the service is small, and we wanted to be sure that children were receiving a respite service at the time of our inspection.
What we did before the inspection
We reviewed information we had received about the service since it registered with CQC. We sought feedback from the local authority who works with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We observed staff interactions with one child in the service. We spoke with the registered manager, a second manager, the chair of the board of trustees, a nurse and two care staff.
We reviewed a range of records. This included two children’s care records and two medication records. We looked at three 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.
After the inspection
We received written feedback from three families and spoke with two relatives on the telephone about their experiences of the service.
Updated
23 April 2020
About the service
Willows Lull is a residential care service providing personal and nursing overnight care for up to five children aged 0 to 18 years. At the time of our inspection there was one child using the overnight service.
The service was provided in one adapted building, with bedrooms and communal spaces on the ground floor and office space on the first floor. The service specialised in providing support to children with complex needs and life limiting conditions on a short stay (respite) basis.
People’s experience of using this service and what we found
Managers needed to do more to assure themselves of the quality of care and support provided by staff at the home, such as monitoring that staff training had been effective and practice was appropriate. This would help reduce risk to children’s health and safety. We have made a recommendation in the report about this.
Staff did not receive level three safeguarding supervision or face to face, multi-agency or multi-disciplinary element training. This does not meet current intercollegiate guidance (January 2019, safeguarding children and young people, roles and responsibilities). We have made a recommendation in the report about this.
Safety checks and documents were not always in place. This included water temperature checks, risk assessments for bedrooms and management plans where restraints, such as wheelchair lap and foot straps, were used for children’s safety. The registered manager worked with us during the inspection and took immediate action on all issues raised.
Parents said the service was safe and staff were caring and compassionate with their children. They said staff were very supportive of families and children alike.
The registered manager followed recruitment checks to employ suitable staff, and there were sufficient staff employed to ensure care and support were carried out in a timely way. Children's medicines were managed safely.
Staff received appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on medical conditions such as epilepsy and learning disabilities. Staff received supervision to fulfil their roles effectively (this was not specific to safeguarding) and had yearly appraisals to monitor their work performance.
Parents and carers were kept well informed about their child's progress and were able to access further support for themselves through the service-led support group called ‘The Hub’.
Staff were caring, kind and patient with children. Person-centred care was being given and children were given the opportunity for learning and development. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Activities were tailored to the needs and abilities of each child. Appropriate play equipment was used to aid child independence and learning. Children had access to outside space, which was secure and allowed creative play.
Voice of the child was well recorded, and the service had identified and written good specific care plans such as for epilepsy. Children had input from health care professionals and the service engaged well with other agencies; attending meetings where invited to do so.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection
This is a new service which has yet to be rated.
Why we inspected
This was a planned inspection based on our programme of inspections for new services.
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.