Archived: Willows Residential Care Home

Willows Residential Care Home is registered to provide accommodation and personal care for a maximum of ten people. The service specialises in providing care to older people, people who are frail and some people living with dementia. There were eight people living in the service. Willows Residential Care Home is in Minster-on-Sea on the Isle of Sheppey.

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

People’s experience of using this service:

People were treated with kindness, respect and compassion. We saw staff listening to people, answering questions and taking an interest in what people were saying. People were supported to express their views and be actively involved in making decisions about their care and support. People's privacy, dignity and independence were respected and promoted. One relative review commented, "My Mum is there, real caring home, fantastic care."

People were protected from abuse. Staff received regular safeguarding training, knew how to identify potential signs of abuse and knew how to report concerns. Risks to people and the environment were assessed and minimised. Risks associated with people’s care had been identified and appropriate risk assessments were in place.

Staff were knowledgeable about the Mental Capacity Act 2005, knew how to seek consent for care and knew the process to help those who lacked capacity to make decisions. People’s needs were met by the adaptation, design and decoration of the service.

People told us they felt safe with staff. People when asked if they felt safe said, “I am safe here, this is my home”, and “The staff make sure it is safe.”

People had good relationships with staff, who were knowledgeable of their physical and emotional needs, as well as likes, dislikes and interests. Staff were responsive to changes in people's health needs. If needed, they sought advice from relevant professionals.

There were sufficient numbers of staff to keep people safe and meet their needs.

The registered manager recruited staff with relevant experience and the right attitude to work with people. New staff were given an induction and all staff received on-going training.

Staff were deployed in a planned way, with the correct training, skills and experience to meet people’s needs.

People’s needs were assessed, and their care was delivered in line with current legislation.

People felt included in planning their care. People were supported to live the lifestyle of their choice. People told us they were listened to by the management of the service. One person said, “I can always ask the staff if I have any concerns. I do not have anything to worry about.”

People could involve relatives and others who were important to them when they chose the care they wanted.

People received a person-centred service that met their needs and helped them to achieve their goals and ambitions. People were encouraged to be as independent as possible.

People were fully involved in their care planning and received information in a way that they understood. The care plans used were consistently reviewed and updated.

Care planning informed staff what people could do independently and what staff needed to do to support people.

Staff supported people to maintain a balanced diet and monitor their nutritional health. People had access to GP’s and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell.

Medicines were stored and managed safely. There were policies and procedures in place for the safe administration of medicines. People received their medicines when they needed them from staff who had been trained and competency checked.

People were protected by the prevention and control of infection.

People felt comfortable raising any complaints with staff and the registered manager.

People were asked for feedback about the service they received.

People said the registered manager was approachable and supportive.

Accidents and incidents were reported by staff in line with the provider’s policy, and the registered manager took steps to ensure that lessons were learned when things went wrong.

The provider and registered manager made sure they monitored the service in various ways to ensure they continued to provide a good quality service that maintained people’s safety.

The provider, registered manager and staff were working with a clear vision for the service.

Rating at last inspection:

This service was rated, ‘Good’ at the last inspection (published on 22 December 2016).

At this inspection, we found the service continued to meet the characteristics of Good in all domains.

Why we inspected:

This was a planned comprehensive inspection.

Follow up:

We will continue to monitor the service through the information we receive.

Willows residential home is a service providing accommodation and support for up to ten older people who are frail and may be living with dementia. The building is set over two floors with stairs access only to the first floor. At the time of the inspection nine people lived at the service.

We last inspected the service on the 25 November 2015, when we made requirements for improvement in relation to administration of medicines, and implementing an effective system to assess, monitor and improve the quality and safety of the service being provided. At this inspection we found that the provider/registered manager had taken action and improvements had been made.

The provider/registered manager of the service had been in post since March 2015. 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.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Applications were being completed in relation to DoLS. The providers understood when an application should be made. The service needs to make further applications to meet the requirements of the Deprivation of Liberty Safeguards.

The provider/registered manager and staff had received training about the Mental Capacity Act 2005 and understood when and how to support peoples best interest if they lacked capacity to make certain decisions about their care.

People said they felt safe. People were protected against the risk of abuse. Staff received training about protecting people and recognised the signs of abuse or neglect and what to look out for. Management and staff understood their role and responsibilities to report any concerns and were confident in doing so. Staff told us they knew what to do if they needed to blow the whistle, and there was a whistleblowing policy available.

There were enough staff with the skills required to meet people’s needs. The service had a low turnover of staff and there had been no new staff since the last inspection. Current staff had been recruited safely. Staff were trained to meet people’s needs, and training was booked to ensure that staff were kept up to date and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

People told us and demonstrated that they were happy at the service by showing open affection for example a smile, to the staff who were supporting them. Staff were available throughout the day, and responded quickly to people’s requests for care. Staff communicated well with people, and supported them when they needed it.

There were risk assessments in place for the environment, and for each person who received care. Assessments were kept updated and were individual for each person. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.

Individual person centred care planning documentation had changed and improved. People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. Staff contacted other health and social care professionals for support and advice, such as doctors, speech and language therapist (SALT) and dieticians.

People were provided with food and drink that met their needs and wishes. Menus offered a choice. People said they liked the home cooked food. Staff made sure that people had plenty of drinks offered through the day. We observed lunch being served and people were happy with their choice. Staff gave appropriate support to people who needed assistance to eat their meal.

People were given individual support to take part in their preferred hobbies and interests. There was an increased range of activities available to people.

Improvements had been made and the medicine system in use ensured that medicines were stored, administered and disposed of safely. There were policies and a procedure in place for the safe administration of medicines. People had access to GPs and other health care professionals. Prompt referrals were made for access to specialist health care professionals.

People were aware of the complaints procedure and they knew who to talk to if they were worried or concerned about anything. The provider/registered manager said there had been no formal complaints made since the last inspection.

There were systems in place to obtain people’s views about the service. These included reviews and informal meetings with people and their families.

The provider/registered manager regularly assessed and monitored the quality of care to ensure standards were met and records maintained.

Since the last inspection the provider/registered manager had received planning permission to extend the property, to give more space and include a lift for easy movement around the home.