Willow Home Care Ltd

Willow Home Care Limited is a domiciliary care service that provides personal care to people living in their own homes. At the time of our inspection, the service was providing personal care support to 42 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

At our previous inspection in June 2021, the provider was in breach of regulation 12, Safe care and treatment and regulation 17, Good governance. At this inspection we found significant improvements. However, the provider remained in breach of these regulations.

Right Support

People raised concerns about late and missed calls. People were placed at risk of avoidable infection because staff did not always apply good practices with regards to infection, prevention and control.

Right Care

During the course of the inspection we identified staff did not have access to detailed risk assessments and the registered manager addressed this immediately. People told us they felt safe whilst receiving a service. All staff had received safeguarding training and were equipped with the skills and knowledge to recognise abuse and to protect people from this. People told us staff were kind, friendly and caring.

Right culture

The provider’s governance was not effective to identify the shortfalls found at this inspection. People were involved in staff recruitment to enable them to choose who worked with them. People were cared for by staff who had been recruited safely to ensure they were suitable to work in their homes.

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. The provider had recently appointed a new manager who was enthusiastic in developing the service and to be compliant with the regulations ensuring people receive a safe and effective service. Staff had access to supervisions and meetings to keep them abreast of changes to the service. The provider worked with other agencies to provide a specific service for the individual.

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.

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 requires improvement (published 20 August 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Willow Home Care Limited on our website at www.cqc.org.uk

Enforcement and Recommendations

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 and will take further action if needed.

We have identified breaches in relation to risk management and late and missed calls which, had an impact with regards to people’s care and support.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Willow Home Care Ltd is a domiciliary care service providing personal care and support to people in their own homes. They were providing a service to 57 people at the time of inspection. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

People were not always being provided safe care and treatment. Risks to people's safety and health were not always assessed or mitigated which exposed them to risk of harm. Medicines were not always given as prescribed and the guidance for staff was not effective, leaving people at risk of their health deteriorating.

We found significant concerns about the management of the service. Their systems were either not in place or not effective to assess, monitor, and improve the quality and safety of the service. Their systems had failed to ensure risks were properly assessed, documented and mitigated. The provider had failed to ensure care staff had guidance in place to provide safe care and treatment to people.

People did not have personalised Covid-19 risk assessment but were supported by staff who understood how to reduce risks associated with Infection Prevention and Control. People said staff wore and disposed of Personal Protective Equipment (PPE) safely. We have made a recommendation about managing Covid-19 risks. People felt safe with the care they received and knew how to raise concerns with the service. Staff understood how to raise concerns regarding people’s safety.

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 20 November 2019).

Why we inspected

The inspection was prompted by risk information we held about the service, As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating of the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Willow Home Care Ltd on our website at www.cqc.org.uk.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so. We have identified breaches in relation to people's safe care and treatment, managing risks to people's safety; governance and oversight of the service at this inspection.

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

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. We will work alongside the provider and local authority to monitor progress. If we receive any concerning information we may inspect sooner.

Willow Home Care Ltd is a domiciliary care agency providing personal care to 55 people at the time of the inspection. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People were safe as staff had received training in safeguarding and had a good understanding of the types and signs of abuse. Staff knew how to report concerns and were confident to do so.

People received their medicines on time. Staff engaged with local health professionals and pharmacies to ensure people had the right medicine and health support when they needed it.

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.

Staff had a good understanding of consent and how to support people to make decisions. They were aware of reporting concerns of capacity where people's abilities had changed.

People were supported by staff to follow their own preferred diets whilst helping them to maintain healthy eating.

People told us staff were kind and caring and never rushed them. Staff supported people to review their care needs regularly involving their relatives and health professionals as requested.

People were supported to live independently and receive care that was in line with their preferences. People were confident they would be listened to if they raised a concern.

People were encouraged to give feedback on the service and suggest ideas for improvements. The provider had created an open, person centred culture and had a clear vision for providing quality personalised 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 20 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

Willow Home Care Ltd is an agency that provides a domiciliary service to people living in their own homes. At the time of the inspection, personal care was being provided to 20 people living in the North Shropshire area.

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 registered manager in post at the time of the inspection.

This service was first registered with the Care Quality Commission (CQC) on the 25 May 2016 and had not been previously inspected.

People told us they felt safe and confident with the care staff provided in their own homes.

Staff had received training in and understood how to protect people from any harm and abuse. The provider followed safe recruitment practices that ensured staff who provided care were suitable to work in people’s own homes.

The provider had assessed and managed the risks connected with people’s individual care and support needs. Staff were able to tell us of the risks people faced and the action they took to support them.

People were supported by sufficient numbers of staff to safely meet their needs. The provider followed safe recruitment practices that ensured staff who provided care were suitable to work in people’s own homes.

People had the support they needed to take their prescribed medicines safely.

Staff had received training to give them the skills and knowledge they needed to meet people's needs.

Staff asked people’s permission before they helped them with any care or support. People’s right to make their own decisions about their own care and treatment were supported by staff.

People were supported by staff who knew them well and had developed good relationships with them. People felt involved in their own care and that staff and the provider listened to what they wanted. People were treated with dignity and respect and staff understood how important this was in the way they cared for people.

The provider promoted an open and inclusive culture within the service. The provider had systems in place to seek out people’s views and experiences of their care, and address any concerns or complaints.

The provider monitored the quality of the service to ensure improvements could be made.