The Office

Updated 30 November 2019

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. This inspection was planned to check 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 Care Act 2014.

Inspection team

The inspection was conducted by two inspectors on the first day of inspection and one inspector on day two.

Service and service type

This service provides care and support to people living in two ‘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.

The service had a manager registered with CQC. 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.

Notice of inspection

We gave the service 12 hours’ notice of the inspection. This was because people are often out and we wanted to be sure there would be people at home to speak with us.

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 who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service. We spoke with seven staff, including the registered manager, manager, deputy manager, nominated individual and three care workers.

We looked at records related to people’s care and the management of the service. We viewed four people's care records, medication records, two staff recruitment and induction files, training and supervision information, staff rotas and records used to monitor the quality and safety of the service.

After the inspection

We continued to review evidence from the inspection and spoke with two visiting healthcare professionals.

Updated 30 November 2019

About the service:

Willow Tree House is a supported living service that was providing personal care to 20 people with a learning disability, autistic spectrum condition or mental health needs at the time of the inspection. The service supports people at two sites in York; one in Haxby and another in Heworth. At both of these properties people have a tenancy agreement and their own flat.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People received a safe and responsive service, but aspects of record keeping required improvement. In particular, records in relation to the Mental Capacity Act which had not been addressed since our last inspection. There were also some anomalies and gaps in other records, which had not been effectively identified and addressed by the provider’s quality assurance system. This meant there was a risk staff may not always have all the accurate information they needed to support people effectively.

We have made a recommendation in this report in relation to quality assessment and monitoring.

People were satisfied with the service and told us they were safe and happy. Staff were aware of risks to people’s safety and acted to mitigate these. Systems were in place to ensure people received their medicines as prescribed, but there were some minor recording issues which the manager agreed to address.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way, but records needed to improve to evidence this more clearly. People were supported with their health needs and had regular health checks. They had access to healthcare professionals when needed.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

People told us staff were kind and respectful, gave them privacy and involved them in decisions. People’s independence was promoted; the amount of support each person received was tailored to their needs. People accessed activities in the community, independently or with the support of staff.

Staff received an induction and supervision. The manager was taking action to bring refresher training up to date for all staff. Staff felt supported and told us the team worked well together. People, staff and visiting professionals spoke positively about the manager.

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

Rating at last inspection:

At the last inspection the service was rated good (published 12 April 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 re-inspection programme. If we receive any concerning information we may inspect sooner.