Willow View

Updated 16 May 2018

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 20 and 28 March 2018 and was unannounced. The second day was planned so that notice could be given to the person living at the service. They do not always tolerate visits from people that are not known to them. We completed a one page profile of ourselves so that the person could be supported with a social story of our site visit.

Before the inspection, we asked the provider to complete a Provider Information return (PIR). This is a form that asks the provider to give us some key information about the service, what the service does well and any improvements they plan to make. We looked at the information that we hold about the service prior to our inspection. This included statutory notifications from the provider that they are required to send us by law about events that occur at the home such as deaths, accidents/incidents and safeguarding alerts.

We looked at two recruitment files, medicines administration records, a care and support plan, activity records, training records, supervision records and other records relating to the management of the service. We spoke with the manager, residential care director, team leader, two support workers, a relative and one healthcare professional.

The person living at the service was not able to give us their views but they did use some non-verbal communication to share feedback with us.

Updated 16 May 2018

This inspection was unannounced and took place on 20 and 28 March 2018. The service was last inspected in January 2017 when it was rated as Requires Improvement. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found the required improvements had been made.

Willow View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Willow View is a small residential home for two people with learning disabilities. At the time of our inspection, one person was living at the service. There were no plans for any other person to move into the service at this time. The home is detached with a private garden and situated in a quiet side street in the town of Warminster. The provider also had another service nearby. Both services shared the same manager.

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.

There was not a registered manager in post. 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. There was a manager in post who had applied to become registered for the service.

Activity provision was not as varied as it could be. Staff and the manager recognised this and had plans to improve and widen the provision. Key activities that were important to the person had stopped, the manager told us they would be resuming in the near future.

There was a complaints procedure in place however it was only available in one format, which the person would struggle to use.

At our last inspection we found that risk assessments were not always detailed enough to minimise the levels of risk and care plans lacked detail on the person’s preferences. At this inspection, we found these areas had improved. There were a range of risk assessments in place that identified environmental risks and risks to the person such as nutrition and development of pressure ulcers. All risk assessments were completed in full and reviewed regularly. There were behavioural care and support plans in place that identified triggers and clear strategies for staff to deploy to keep people safe.

Staff were well supported. There were systems and processes in place to support lone working, and staff had regular opportunity to have formal supervision with their line manager. This meant they could discuss any concerns or training needs they might have.

Appropriate recruitment checks were undertaken before staff commenced employment. Staff were well trained and could ask for additional training if they wished.

The provider had systems and processes in place to safeguard people from the risk of abuse. Staff we spoke with were aware of safeguarding procedures and knew how to use the provider’s policies to report any concerns.

Medicines were managed safely. All staff had received medicines training and were observed administrating medicines by the provider so that their competence could be checked.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Where people had their liberty restricted, the service had completed the related assessments and decisions had been properly taken. Staff had been trained and understood the general requirements of the Mental Capacity Act (2005).

The premises were clean and in good repair and the risks of cross infection were minimised. Records demonstrated that staff received infection prevention and control training and food hygiene training.

A visiting director completed quality monitoring regularly and action plans produced if needed. Feedback from the person was sought regularly and the service had access to a local advocacy service if needed.