We carried out a review of the data available to us about Willow House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Willow House, you can give feedback on this service.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Willow House is a residential care home providing accommodation and personal care to up to five people. The service specialises in providing support to people diagnosed with learning disabilities and/or autistic spectrum disorders. At the time of the inspection three people were using the service.
People’s experience of using this service and what we found
Right Support
People were encouraged to take part in a range of activities at the service and in the wider community. A staff member said, “The residents are lovely, and I like being on the go with them. They get lots of opportunities to go out and they have a good quality of life here.” Staff involved relatives in people’s care and support and kept them up to date on their progress and achievements. A relative said, “Every week pictures are sent to me, so I know what they have been doing.” People had increased their independence since being at the service. 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 premises were spacious, safe, and comfortable with a large secure garden at the back.
Right Care
Staff provided people with personalised care and support. They knew people well and communicated effectively with them using language, pictures and signs. People had a say in all aspects of their lives and staff encouraged them to make choices about their daily routines and activities. People were treated with dignity and respect. Staff protected their privacy and knew how to do this safely without undermining their independence. People were supported to be healthy, to eat well, and to be active and involved in the local community.
Right culture
The service’s directors, manager, and staff team were committed to providing good quality care in a warm and caring environment. A relative said, “The service is well led without a shadow of doubt.” People’s needs and wishes were at the centre of the service and staff supported them to lead confident, inclusive and empowered lives. They sought advice and feedback from those involved in people's care including relatives and health and social care professionals. The service had a calm and happy atmosphere. Staff followed best practice guidance for supporting people diagnosed with learning disabilities and/or autistic spectrum disorders.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (report published on 06 January 2018).
Why we inspected
The inspection was prompted in part due to concerns received about staffing and people’s safety. A decision was made for us to inspect and examine those risks and to assess that the service is applying the principles of Right support right care right culture.
We also looked at infection prevention and control measures under the Safe and Well-led key questions. 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.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
The service was very clean and tidy throughout. Staff followed cleaning schedules including additional cleaning of high touch areas.
Visitors were screened before entering the service and could only do so with a negative COVID-19 test result. Professionals were asked for proof of COVID-19 vaccinations.
Staff understood people's individual needs. They managed social distancing and infection prevention in a person centred way so that people understood and did not become anxious.
There were enough staff to meet people's needs and staff knew and understood people's needs and preferences.
Willow House provides accommodation, care and support for up to five people with learning disabilities. At the time of our inspection five people were using the service. At the last inspection on 23 August 2016 the service was rated as requires improvement. At this inspection we found most of the required improvements had been made and the service was rated as good overall.
The service had a manager who was in the process of registering with the Care Quality Commission. Their application had been submitted. 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’s environment had been assessed to make sure it was safe. However one person had damaged property and measures had not been taken to reduce the likelihood of this happening again. Checks on the building and equipment in use had been completed including fire safety checks and drills.
People were protected from the risk of harm at the service because staff knew their responsibilities to keep people safe from harm and abuse. Staff knew how to report any concerns they had about people’s welfare.
There were effective systems in place to manage risks and this helped staff to know how to support people safely. Where risks had been identified measures to reduce these were in place.
There were enough staff to meet people’s needs. The provider had safe recruitment practices. Staff had been checked for their suitability before they started their employment.
There were plans to keep people safe during significant events such as a fire. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.
People’s medicines were handled safely and were given to them in accordance with their prescriptions. Staff had been trained to administer medicines and had been assessed for their competency to do this.
Staff received appropriate support through an induction, support and guidance. There was an on-going training programme to ensure staff had the skills and up to date knowledge to meet people’s needs.
People were supported to maintain good health and have enough to eat and drink. People had access to healthcare services.
People were supported to make their own decisions. Staff and managers had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Assessments of mental capacity had been completed. Staff sought people’s consent before delivering their support.
People developed positive relationships with staff who were caring and treated them with respect, kindness and compassion.
People received care and support that was responsive to their needs and preferences. Support plans provided information about people so staff knew what they liked and enjoyed.
People were encouraged to maintain and develop their independence and they took part in activities they enjoyed.
People and their relatives knew how to make a complaint. The provider had implemented effective systems to manage any complaints they may receive.
Systems were in place which assessed and monitored the quality of the service and identified areas for improvement. Policies and procedures were in place and gave staff guidance on their role.
People and staff felt the service was well managed. The service was led by a manager who understood the responsibilities of a registered manager. Staff felt supported by the manager.
People had been asked for feedback on the quality of the service that they received to drive continuous improvement.
We have made three recommendations about ensuring hot surfaces are covered, checking references are verified and seeking medical advice if there are medicines errors.
Willow House is a care home registered to provide accommodation for up to five people who have a learning disability or who are on the autistic spectrum. The home is located on two floors. Each person had their own room. The home had a communal lounge, kitchen and dining room where people could spend time together. At the time of inspection there were five people using the service. Building works were in the process of being completed to extend the home.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.
People felt safe with the support offered. Staff could describe and understood their responsibilities to support people to protect from abuse and avoidable harm.
There were effective systems in place to manage risks and this helped staff to know how to support people safely. Where people displayed behaviour that may be deemed as challenging guidance given to staff helped them to manage situations in a consistent way that protected the person, other people using the service and staff.
People’s equipment was regularly checked. The building was well maintained and kept in a safe condition. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.
People’s medicines were handled safely and were given to them in accordance with their prescriptions.
There were enough staff to meet people’s needs. They were recruited using procedures to make sure people were supported by staff with the right skills and attributes.
Staff received appropriate support through a structured induction and regular supervision. There was an on-going training programme to update staff on safe ways of working. However some staff felt that the training was not specific for the needs of the people who used the service. This meant that staff were not confident tha they had completed enough training to enable them to support people with specific needs.
People were prompted to maintain a balanced diet and guidance from health professionals in relation to eating and drinking was followed. We saw that people were able to choose their meals and were involved in making them. People had access to healthcare services to promote their well- being.
People were supported to make their own decisions. The registered manager had an understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). We found that appropriate DoLS applications had been made. Assessments of people’s capacity to make a specific decision had not been carried out. Support plans provided guidance on how to involve people in making their own decisions. Staff told us that they sought people’s consent before delivering their support.
People received support from staff who showed kindness and compassion. Their dignity and privacy was protected. This included staff responding to people discreetly and discussing people in a professional manner. Staff knew people’s communication preferences. They did not always use communication tools to help improve communication. People were supported to develop and maintain their independence. People were involved in decisions about their support where they could be.
People knew how to make a complaint. There was a complaints policy in place that was available for people and their relatives. Complaints that had been received had been managed in line with the policy.
People received care and support that was responsive to their needs and preferences. Support plans provided detailed information about most people so staff knew what people liked and what they enjoyed. People took part in activities that they enjoyed. People participated in developing their support plans.
People and staff felt the service was well managed. The service was led by a registered manager who understood most of their responsibilities under the Care Quality Commission (Registration) Regulations 2009. However, statutory notifications of DoLS applications that had been approved had not been submitted to CQC.
Systems were in place which assessed and monitored the quality of the service. This included obtaining feedback from people who used the service and their relatives.
The inspection took place on 30 July 2015 and was unannounced.
This is the first inspection for Willow House since it was registered on 14 October 2014.
Willow House provides accommodation for up to five people who are aged over 18 and who have learning disabilities or Autistic Spectrum Disorder. The home has five single bedrooms, a lounge, dining room, and kitchen. The home had a large garden. At the time of our inspection there were two people using the service.
The service had a registered manager. 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.
Arrangements were in place to ensure that staff had all of the relevant information they required before they people moved into the service. Detailed care plans were then put in place that provided staff with information about people’s likes, dislikes and preferences and guidance on how staff were able to meet these. Risks associated with people’s care were assessed and actions taken to ensure that risks were reduced. We saw that the service promoted positive risk taking and supported people in this way.
People were supported to attend activities of their choice and to pursue their individual hobbies and interests.
There was a robust recruitment procedure in place to ensure that staff were suitable to carry out their roles. A recent photograph of staff had not been kept as is required. There were no clear records in place that showed what training staff required, had started or had completed.
The service was in its infancy and there were a number of areas where practices need to be embedded. These included regular staff meetings and staff supervisions. The registered manager was working on these areas.
We found that people’s capacity to consent to their care and treatment and others areas associated with their care had been considered, there had not been any decision specific capacity assessments carried out.
The registered manager understood their responsibilities and they were supported by the provider in their role. Staff were all aware of the aims and vision of the service and spoke highly about the care that was provided.