The Willows

Updated 3 March 2022

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.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 22 February 2022 and was announced. We gave the service two days notice of the inspection.

Updated 3 March 2022

This inspection took place on 13 and 14 December 2018 and was unannounced. The previous inspection was completed in October 2017 and the service was rated overall as requires improvement. There were two breaches of regulation identified at the previous inspection. These were because risks to people’s safety were not being appropriately mitigated and statutory notifications had not always been submitted to CQC when required.

At this inspection we found that the required improvements had been made and the service is now rated good overall.

The Willows 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 Willows can accommodate up to 10 people and at the time of the inspection there were nine people living there. The home is three-storey, with bedrooms and a bathroom on each floor. Bedrooms were spacious and personalised. The ground floor had a staff office, the kitchen, dining room, and living room. There was also a games room with a pool table, computer, and garden access.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

There was a registered manager in post and available throughout the inspection. 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.

People were supported to achieve positive healthcare outcomes. There was a reduction in medicines administration due to improved positive behaviour support plans being developed and followed. Medicines were stored, recorded and administered safely.

Risks to people’s safety were identified and assessed to ensure people could maintain their independence. Risk assessments were personalised to people’s interests and the activities they took part in.

The staff team learned from any incidents, and reflective meetings took place. These were to help equip staff with the skills needed to support people’s behaviours. Positive behaviour support plans were in place and these detailed how staff could identify changes in the person’s behaviours, as well as what support was required.

Complex behaviour and communication needs were understood and supported by the staff team. These were documented in person-centred care plans. People’s emotional support needs were met by a kind and supportive staff team.

Health and social care referrals were made in a timely manner and where appropriate. Records showed that input was tailored to people’s needs. One person met with a nutritionist and went shopping to identify foods suitable for their diabetic needs. Another person was supported to meet with a community health care professional, to discuss relationships. Information from professionals was included in people’s care and support plans.

There were suitable numbers of trained staff available to support people’s needs. There were safe staff recruitment and selection processes.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and could apply these to the support that they provided to people. People’s capacity to consent to specific decisions was assessed when required.

Information was provided to people in accordance with the Accessible Information Standard 2016. People knew how to raise concerns and had access to an independent mental capacity advocacy service for ‘drop-in’ sessions. These were designed to support people in decisions relating to their care.

People were supported by staff equipped with the skills and knowledge required. Staff received training via online modules and the registered manager was experienced in delivering positive behaviour support training.

People and the staff team were kind and courteous to one another. New people moving into the home were welcomed and people accompanied one another for activities.

Activities at the home and in the community were designed based on what people wanted to do, achieve, and be involved in. The sessions included being part of community groups such as those for singing and music.

People’s social outcomes were explored and understood. There were many examples of people achieving their personal goals, including one person who was excited to have been offered an employment placement.

People enjoyed holidays overseas and to destinations in the UK of their choosing. They had scrap books including photographs of their personal highlights from places they had visited and things they had achieved. This was to encourage people to continue to want to achieve new things and explore opportunities to spend time with others in the community.

The kitchen had been re-designed to support people being involved in activities within the home, including cooking. People were supported to make healthier lifestyle choices. Those diagnosed with diabetes were encouraged to research healthier recipes and to work together in preparing and baking these.

Audits were completed, and the registered manager had a strong overview of what was happening in all areas of the service. Staff were supported to take ownership and responsibility of different roles and to contribute to a combined management and staff team approach to continuous improvement.

There was very much an open door to the management office, with people regularly popping in to chat and spend time with the registered and deputy managers. The management team believed in role-modelling good support and challenging where improvements were required.