24 February 2020
During a routine inspection
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.