Archived: Willow House Care

Updated 28 September 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was completed by an inspector and a medicines inspector.

Service and service type

This service provides care and support to people living in three ‘supported living’ settings so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post, however they had recently resigned from their post and were working their required notice period. The provider, whos was also the nominated individual, told us they would be taking over the management of the service and would be registering with CQC.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 17 August 2022 and ended on 30 August 2022. We visited two of the houses on 17 and 19 August 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We received feedback from three people receiving support and three family members about their experiences of the service provided. We spoke with three staff members, the registered manager and provider/nominated individual.

We reviewed a range of records including three people's care records, three people's medicine administration records and five staff files in relation to recruitment. We also reviewed a variety of records relating to the management and governance of the service.

Updated 28 September 2022

About the service

Willow House Care provides care and support to people living in a number of 'supported living' settings so that they can live as independently as possible.

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. At the time of the inspection, the service was supporting 11 people with their personal care needs.

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

We identified some improvements needed to the provider's governance systems to ensure they evidenced continuous learning and improvement to the service. There were no audits or checks in place and no formal review or analysis of accidents and incidents. This meant we could not be certain that action was being taken where necessary to improve the service.

We have made a recommendation regarding this.

Some records relating to the overall management of the service were not being stored in line with the services' registration condition. We found some records were being stored in people's homes. The provider took immediate action to address this and submitted a request to change their registered location to enable records to be stored correctly.

Some improvements were needed to the provider's recruitment processes. Whilst relevant safety checks had been completed on new applicants, interviews had not been formally recorded and gaps in employment history had not been explored and an explanation provided.

We have made a recommendation regarding this.

Family members told us they felt there were enough staff to keep people safe and provide them with the right support. Risks to people's health and well-being had been assessed and care plans provided detailed information for staff to follow in order to support people safely.

People told us they felt safe whilst being supported by staff at Willow House and family members were reassured their relatives were well-cared for. Staff received safeguarding training and knew how to identify and respond to allegations of abuse. Safeguarding concerns and accidents and incidents were acted on appropriately by staff. Records showed relevant professional were contacted and investigations completed where necessary.

People's needs had been fully assessed and staff had access to relevant information and guidance to provide effective care and support for people to achieve good outcomes. People had access to health and social care professionals when needed and staff sought advice where people's needs changed.

Staff had the relevant skills, knowledge and support to carry out their role. Family members told us staff knew their relative well and how best to support them. One family member said, “They [staff] are excellent. They know [relative] really well and know exactly how to support him.”

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were at the centre of their care and were supported to be as independent as

possible. Managers and staff empowered people to make their own decisions about their care and support.

We received positive feedback from people and family members about the service provided and the positive outcomes people experienced. One person said, “I love Willow House Care Group and all the staff for what they do for me. I wouldn’t want any other care group”. Staff felt able to speak up if they were concerned and told us they were well-supported by the provider.

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 14 October 2017).

Why we inspected

The inspection was prompted in part due to concerns received about possible closed culture and restrictions placed on people's day to day lives. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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

Follow up

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