The Care Quality Commission
  • Care Home
  • Care home

Archived: The Willows

Overall: Requires improvement read more about inspection ratings

14 The Lant, Shepshed, Loughborough, Leicestershire, LE12 9PD (01509) 650559

Provided and run by:
Four Seasons (Evedale) Limited

Important: The provider of this service changed. See new profile
Important: The provider of this service changed. See old profile

All Inspections

20 April 2015

During a routine inspection

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.

17 September 2014

During an inspection in response to concerns

As part of this inspection we spoke with five people who used the service, five relatives and two friends who were visiting at the time of our visit and eight members of the staff team. We also spoke to the registered nurse on duty at the time of our visit and the manager. We looked at records including people's personal care records, medication records and records kept in relation to the management of the service.

We also used observation to understand people's experience, as some people had communication needs and were unable to tell us their views and experiences.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask. This is a summary of what we found:

Is the service safe?

People told us that they felt safe living at The Willows and that they were treated well. One person told us, 'The staff are kind and treat us well.' Another explained, 'I couldn't grumble, I feel quite safe here.'

Visiting relatives told us that they felt that their relative was cared for and were kept safe from harm. One relative explained, 'She [their relative] is in good hands, I don't worry about her one little bit.'

The manager completed a pre-assessment of people's needs before people moved in to the service. This ensured that they were aware of each person's care and support needs and they were confident that those needs could be met by the staff working at the service.

Care plans had been developed and risk assessments had also been completed. This meant that the care workers knew the needs of the people they were supporting and were aware of the risks associated with their care.

On checking the medication records we found that on a number of occasions, the nurse in charge had failed to sign to say that they had dispensed people's medicine. There were also occasions where the nurse in charge had signed to say that they had given someone their medication, when in fact, it was still in the blister pack. This meant that people were not getting their medication in line with their doctor's instructions.

Is the service effective?

People told us that they were satisfied with the care and support they received. One person explained, 'I am quite happy here.' Another told us, 'It couldn't be better.'

Relatives were able to visit the service at any time. One relative told us, 'I can come any time, any day and when I come, it's like coming home.'

The provider cooperated with other health and social care professionals to deliver a coordinated approach to people's health and care needs. This included obtaining support from the local speech and language team, doctors and tissue viability nurses.

Is the service caring?

We observed the staff going about their work. They treated the people they were supporting in a kind and respectful way and they provided them with the time that they needed in order to carry out a task. This included assisting people with their meals and assisting them to use the bathroom.

The people who used the service told us that they were treated with respect and we observed staff knocking on doors and calling people by their preferred name.

Relatives told us that they thought that their relative was well cared for and treated well. One relative told us, 'The young ones [care workers] are enthusiastic; the older ones are really thoughtful.'

An activities leader was employed for 26 hours a week. We observed them spending time with the people who used the service both in groups and providing personal one to one time. This provided the people who used the service with a more stimulating and interesting environment in which to live.

Is the service responsive?

The needs of the people who used the service had been assessed before they moved into the service and they and their relatives/advocates had been involved in this process.

Relevant professionals had been involved in people's care. Records showed that visits had been arranged when necessary. These included visits from their doctor, the local speech and language team and the tissue viability nursing team. This ensured that people who used the service received the care and treatment they required. One person however did miss an important appointment due to transport issues. This had not been followed up and meant that they did not get the treatment they required.

Is the service well-led?

A monitoring system was in place but the effectiveness of this was questioned because of the shortfalls that were identified during our visit.

Care plans had been reviewed on a monthly basis. This enabled the staff team to monitor people's needs. Where changes in people's health and welfare had been identified; these documents had been updated to reflect this. Risk assessments had not always been reviewed monthly. This meant that the people who used the service were at risk of having their health and safety compromised.

Staff meetings had been held. These provided the staff team with the opportunity to have a say on how the service was run. A meeting for the people who used the service, their relatives and their advocates had also been arranged for the end of September this year. This meant that they would be provided with an opportunity to have a say about the overall service being provided.

29 July 2013

During a routine inspection

We spoke with eight people using the service, four relatives and two healthcare professionals. We also spoke to five members of staff.

We found people were able to make informed decisions about their care and support. One person told us 'they [the staff] do everything for me and they are always on hand when I need them.' A relative explained to us 'they [the staff] know mum well. They know what she likes and doesn't. And they always make us feel welcome.'

We found that care and support was not always delivered in a way that met people's needs and ensured their safety and welfare. Although we found people's care needs had been assessed, we found risk assessments were not always being completed in a reliable way. We found there was little social stimulation available for people using the service.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We found the provider had robust systems in place relating to the management of medicines.

Staff were supported in their work and were confident that they were able to provide the care required.

We found systems were in place to regularly obtain people's views about the care and service they receive. We found the provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service.

27 June 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector who was accompanied by an 'expert by experience' (people who have experience of using services and who can provide that perspective).

During our inspection visit to The Willows we met a number of people who used the service and some of their visiting relatives. We spoke in detail with four of the people who used the service and one of the visiting relatives to ask them for their views on the service they received.

People we spoke with felt that their personal care was carried out in a way which maintained their privacy and dignity.

One of the visiting relative's told us, 'The way we have been involved cannot be faulted.'

Some of the people we spoke with felt more consideration could be given to their individual preferences. One told us they wanted to be able to have greater flexibility when choosing the time they went to bed each evening. Another told us they would like to be able to discuss their health concerns with their GP alone, rather than being accompanied by a member of staff.

People told us that the staff treated them well and were friendly. One person told us. 'The staff are caring, considerate and honest.'

Some of the people we spoke with told us they occasionally experienced delays when they asked for help at mealtimes or in the early evening when preparing for bed.