Archived: Willow House

Updated 7 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 22 February 2016 and was announced. The provider was given 48 hours’ notice because the location provides a short term support service for adults with a learning disability; we therefore needed to be sure that someone would be in. Due to the small size of the service the inspection team consisted of one adult social care inspector.

Prior to our inspection of the service, we reviewed the completed provider information return (PIR); this is a document that asks the provider to give us some key information about the service, what the service does well and any improvements they are planning to make. We also contacted the local authority safeguarding and commissioning teams and the local Healthwatch organisation. They raised no concerns about the service with us.

During the inspection we spoke with the one person using the service who was able to comment on the care and support they received. We also undertook observations in the communal areas of the service to see how people were cared for.

We spoke the registered manager, the operations manager and two support workers. We also spoke with a relative who visited the service during the inspection.

We looked at the care and medication records for three people who were using the service. We also looked at a range of records relating to how the service was managed; these included two staff personnel files, staff training records and policies and procedures.

Updated 7 April 2016

This was an announced inspection which took place on 22 February 2016. This was the first inspection since the provider had registered the service with the Care Quality Commission (CQC) in October 2013.

Willow House provides short term support for up to five adults who have a learning disability. People who have an additional physical disability or sensory impairment are also able to access Willow House. The service provides three single bedrooms and two self-contained flats. One of the flats is situated on the first floor. Specialist equipment such as tracking hoists and adapted bathing facilities are provided. At the time of this inspection there were four people using the service.

The provider had a registered manager in place as required by the conditions of their registration with the Care Quality Commission (CQC). A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was supported by an operations manager who was responsible for the day to day running of the service.

During this inspection we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because improvements needed to be made to the way medicines were managed and recorded. The registered manager had also failed to take the necessary action to ensure the rights of people were upheld when they were unable to consent to their care in the service.

Staff had received training in safeguarding adults. They were able to tell us of the action they had taken to protect people who used the service from the risk of abuse. Staff told us they would have no hesitation in reporting poor practice of colleagues using the whistleblowing policy. They were confident their concerns would be taken seriously by the managers in the service.

Systems were in place to ensure staff were safely recruited. The staff rota was flexible to meet the individual needs of people who accessed the service. During the inspection we observed kind, caring and sensitive interactions between staff and people who used the service. Staff demonstrated a commitment to providing high quality personalised care for the individuals who accessed the service. People were also supported to be as independent as possible during their stay in the service.

Staff told us they received the training and supervision they needed to be able to carry out their roles effectively.

Care records we reviewed included information about the risks people might experience. Plans were in place to inform staff about the action they should take to manage the identified risks. The health needs of individuals were also recorded, including how staff should care for people if they experienced a seizure. Systems were in place to help ensure staff were aware of any changes to a person’s needs since their previous stay in the service.

Regular checks took place to ensure the safety of the environment and equipment used by staff. Although we had no concerns regarding the cleanliness of the service, we noted the provider had not completed an infection control audit since August 2013. The operations manager told us this would be introduced as soon as possible. We have made a recommendation regarding the prevention and control of infections in the service.

Staff we spoke with told us they enjoyed working in the service and felt valued by both the registered manager and operations manager. Staff felt able to raise any issues of concern or make suggestions to improve the service in supervision and staff meetings.

Staff told us they would always encourage people to choose healthy food options. However, they also recognised that sometimes people chose to eat less healthy meals during their stay in the service and that these choices should be respected.

People who used the service and their families had opportunities to comment on the care provided in Willow House. Systems were in place to record and investigate any complaints received in the service. Staff demonstrated a commitment to learning from any complaints people might make.

Quality assurance systems were in place including regular audits and checks completed by the operations manager. The registered manager told us the provider was in the process of developing further quality assurance tools to help drive forward improvements in the service.