Archived: The Willows

Updated 22 June 2015

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 was 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.

Before the inspection the provider completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR and additional information we held about the service, including its inspection history and the notifications that we had received from the provider. A notification is information about important events which the service is required to send us by law. We also contacted the local authority and who had funding responsibility for people who used the service.

This inspection took place on 20 April 2015 and was unannounced. The inspection was completed by one inspector, a specialist advisor who was a qualified nurse and an Expert by Experience. An Expert by Experience is a person who has personal experience of using services or caring for someone who requires this type of service.

We spoke with 11 people who used the service and three visiting relatives about their views of the service. We also spoke with the acting manager, deputy manager who was the nurse on duty at the time and three care workers.

We reviewed a range of records about people’s care and how the home was managed. This included four people’s plans of care, four staff records and records in relation to the management of the service such as audits, checks, policies and procedures.

Updated 22 June 2015

An unannounced inspection took place on 20 April 2015. Our previous inspection of 17 September 2014 found the provider was not meeting three regulations at that time. These were in relation to care and welfare, management of medicines and assessing and monitoring the quality of service provision. Following that inspection the provider sent us an action plan to tell us the improvements they were going to make. At this inspection we found that the actions we required had been completed and these regulations were now met.

The Willows provides care and support for up to 60 older adults with a variety of needs including people who require nursing care. At the time of our inspection there were 25 people using the service. The home has two floors with a number of communal areas and a garden available for people to use.

The registered manager was no longer 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 person’s. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The provider had tried to recruit a new registered manager and been unsuccessful. The home had been managed by four different managers within the last 12 months.

People and their relatives were satisfied with the care and support provided and all felt their individual needs and wishes were known and understood. Staff had a good rapport with people and were kind and gentle in their approaches. People felt involved in the planning and delivery of their care and had opportunities to be involved in the development of the service. People were confident approaching staff and were comfortable raising any concerns or issues they may have.

We saw that people were well supported by a staff team that understood their individual needs. We observed that staff treated people with respect and promoted people’s dignity and independence. Staff we spoke with had a good understanding of people’s needs and were clear about the care and support people required.

Staff recruitment procedures were robust and ensured that appropriate checks were carried out before staff started work. Staff told us they had received appropriate training. Nursing staff had sufficient support for their continuing professional development. Some people felt staffing levels were insufficient but staff we spoke with told us they were able to meet people’s needs appropriately. We observed this to be the case on the day of our inspection.

Staff were aware of how to protect people from avoidable harm and were aware of safeguarding procedures to ensure that any allegations of abuse were reported and referred to the appropriate authority. This meant that systems were in place to ensure care was provided with regard to people’s safety.

People had been asked for their consent to care and treatment and their wishes and decisions respected. The requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards were known but there were inconsistencies with how they had been applied.

Medicines were safely stored and administered and people received their regular medicines as prescribed.

Improvements had been made in the planning and delivery of people’s care and people had received the care and support they required. People’s needs were assessed and plans were in place to meet those needs. Risks to people’s health and well-being were identified and plans were in place to manage those risks. However, we found concerns with regard to the management of two people’s health conditions which the acting manager and nurse on duty agreed to review on the day of our inspection.

People were supported to access additional healthcare professionals whenever they needed to and their advice and guidance had been incorporated into people’s care plans. People’s nutritional and dietary requirements had been assessed and a nutritionally balanced diet was provided.

The home had been well maintained and offered a pleasant environment for the people living there. People’s bedrooms had been personalised and people were encouraged to spend their time where they pleased.

There were effective systems in place to assess and monitor the quality of the service. This included gathering the views and opinions of people who used the service and monitoring the quality of service provided. People’s complaints and issues of concern had been responded to promptly and appropriately.