Willow Court

Updated 14 December 2021

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.

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

Three inspectors, a medicines inspector and an Expert by Experience carried out the inspection. 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 Court 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from stakeholders, including the local infection prevention and safeguarding teams, Healthwatch, commissioners and fire safety 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. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and eight relatives about their experience of the care provided. We are improving how we hear people's experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. We checked this was a suitable communication method and people were happy to use it with us. We did this by reading their care and communication plans and speaking to staff or relatives and the person themselves. In this report, we used this communication tool with one person which enabled them to tell us their experience. We spoke with 13 members of staff including the deputy manager, nurse, senior care workers, care workers, provider, registered manager and peripatetic manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at staff records and a variety of records relating to the management of the service.

Updated 14 December 2021

About the service

Willow Court is a residential care home providing personal and nursing care to people with a physical disability, a sensory impairment, a learning disability and autistic people. The service can accommodate up to 19 people. Nineteen people were using the service at the time of the inspection.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Although people’s care and support was provided in a safe, clean, well equipped, well-furnished and well-maintained environment which met people's sensory and physical needs, the service was situated on a site which was separate to the local residential area so did not integrate well within the community.

People were not kept safe from avoidable harm because unexplained injuries such as bruising and scratches were not routinely followed up and investigated to establish potential causes.

The care provided was personalised despite shortfalls in the assessment and care review process. People were not always supported to identify and achieve goals and aspirations. Care plans were detailed and guided staff.

Activities were not part of people’s planned care and there were limited opportunities for people to engage in person centred activities. The service had started to organise activities to improve people’s quality of life.

People’s communication needs were met and information was shared in a way that people could understand.

Most staff knew people well, but people sometimes received support from inexperienced staff who did not have a good understanding of their needs. The service had carried out a recent recruitment drive, which would provide a more stable workforce.

The provider had their own therapy services such as speech and language therapists who helped people maximise skills and maintain independence.

People told us they felt safe and liked living at Willow Court. Family members told us people received kind and compassionate care.

The service understood staff required training and support, but this was not always provided consistently.

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.

Medicines were managed safely and administered in a safe and caring way.

The service had systems for preventing and controlling infection. The service had only had a low level of COVID-19 infection with no deaths. The management team were proud of this achievement.

Governance systems did not ensure people were kept safe and received a high quality of care and support in line with their personal needs.

The management team were responsive to the inspection findings. They told us how they were improving their systems and processes to ensure people received safe, quality care.

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

Rating at last inspection

The last rating for this service was Good (published 28 August 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to safeguarding people from avoidable harm and good governance at this inspection.

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

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.