Willow Tree Lodge

Updated 18 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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. A service provider is the legal organisation responsible for carrying on the adult social care services we regulate.

This inspection of Willow Tree Lodge took place on 11and 12 September 2017 and was unannounced.

Before the inspection we read all of the notifications received about the home. Notifications are changes, events or incidents the provider is legally required to let us know about. We also contacted the local authority commissioners of the service, the clinical commissioning group (CCG) and the local Healthwatch. The area manager had completed a Provider Information Return (PIR) about the home. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we spoke with the four people living at the home, some of whom had limited verbal communication. We used a range of different methods to help us understand the experiences of people using the service who were not always able to tell us about their experience. These included observations and pathway tracking. Pathway tracking is a process which enables us to look in detail at the care received by an individual in the home. We pathway tracked the care of each person.

We observed how staff interacted and cared for people across the course of the day, including when medicines were administered. We spoke with the staff including the area manager, the positive support coordinator, the provider’s positive support lead, two shift leaders, two senior staff and seven staff. We also spoke with a person’s relative and a deputy manager from another home within the provider’s care group.

We reviewed each person’s care records and looked at staff recruitment, supervision and training files. We also looked at the provider’s policies and procedures and other records relating to the management of the service, such as staff rotas covering August and September 2017, health and safety audits, medicine management audits, infection control audits, emergency contingency plans and minutes of staff meetings. We considered how people’s, relatives’ and staff comments were used to drive improvements in the service.

Following the visit we spoke with the five relatives of people living in the home, and three health and social care professionals who were involved in their support.

Updated 18 October 2017

Willow Tree Lodge provides accommodation and personal care to a maximum of four people who live with a learning disability and/or associated health needs, who may experience behaviours that challenge staff. At the time of inspection four people were living at the home.

This inspection took place on 11 and 12 September 2017. The inspection was unannounced, this meant the staff and provider did not know we would be visiting.

At the last inspection in 22 October 2015 the service was rated 'Good'. At this inspection we found the service remained 'Good'.

The service did not have a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The registered manager had recently left the home and had cancelled their registration with the CQC. The area manager and positive support coordinator were providing management cover to the home whilst a new registered manager was appointed.

People were kept safe from harm and staff knew what to do in order to maintain their safety. Risks to people were assessed and action was taken to minimise potential risks. Medicines were managed safely and administered as prescribed. The provider operated thorough recruitment procedures to ensure staff were safe to work with the people. There were always enough staff to provide care and support to meet people’s needs.

People were supported by staff who had the skills and training to meet their needs. The manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were involved in making every day decisions and choices about how they wanted to live their lives and were supported by staff in the least restrictive way possible.

Arrangements were made for people to see their GP and other healthcare professionals when they needed to do so. People were supported to have a healthy balanced diet and had access to the food and drink of their choice, when they wanted it. The physical environment was personalised to meet people's individual needs.

People were supported by regular staff who were kind and caring. There was a warm and positive atmosphere within the service where people were relaxed and reassured by the presence of staff.

People's independence was promoted and support workers encouraged them to do as much for themselves as possible. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights. People were encouraged and enabled to be involved as much as possible in making decisions about how their support needs were met.

The service was responsive and involved people in developing their support plans which were detailed and personalised to ensure their individual preferences were known. People were supported to take part in activities that they enjoyed. Arrangements were in place to obtain the views of people and their relatives and a complaints procedure was available for people and their relatives to use if they had the need.

The service was well led. There was a clear management structure in place and staff understood their roles and responsibilities. The vision, values and culture of the service were understood by all staff, which they demonstrated when supporting people. Staff consistently said they had received good support from the management team who were always available to give advice and guidance, especially whilst awaiting the appointment of a new registered manager. The safety and quality of support people received was effectively monitored and identified shortfalls were acted upon to drive continuous improvement of the service.

Further information is in the detailed findings below.