Archived: The Willows

In August 2016 we received concerns in relation to the environment, the availability of fresh food and cleaning products. As a result we planned this focused inspection to look specifically at these areas. During the inspection we also had concerns regarding staffing levels. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Willows on our website at www.cqc.org.uk

The Willows provides care and accommodation for up to three people who have autistic spectrum disorders. It is part of the Spectrum group who have several similar services in the county. At the time of the inspection two people were living at the service. There was a registered manager 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 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. The registered manager was no longer working at the service although they had not applied to cancel their registration at the time of the inspection. The divisional manager with oversight of The Willows was managing the service until it closed which was planned to take place by the end of September 2016. Spectrum had informed us of this short term arrangement.

Both people had been assessed as needing one to one support for ten hours a day. Evidence in rotas and staff signing in sheets showed that, over the previous seventeen days, there had only been four occasions when staffing levels had been at this commissioned level for the full ten hours. On seven days there had only been one member of staff on duty for the whole day. This impacted on people as both required one to one support in the community and a drop in staff levels meant they were unable to go out.

Planned improvements to the building had not been carried out due to a change in circumstances. The service was due to close in the next few weeks and both people living there were to move to different Spectrum locations. No improvements to the environment or furnishings had been made since the last inspection in September 2015.

People had access to fresh food and were able to make choices about what they ate. There was a good stock of cleaning products in place.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the end of the full version of the report.

There was evidence that people were supported to develop independent living skills. We observed one person hoovering and being supported to do the recycling. We saw another person helping to sweep the outside area.

We spoke to a relative who said, 'It's wonderful, the staff are so good. They keep you informed'.

We found that people who used the service were involved in making day to day decisions and participated in tasks at home, such as cooking, cleaning and doing their laundry. The records showed that they went out frequently and saw healthcare professionals when they needed to.

Staff told us that they felt there was sufficient staff on duty to allow them to support people effectively.

We saw that robust quality assurance processes were in place.

The care plans were in the process of being re-written however we found that there was no agreements from multi professional teams around people being restrained or kept in their rooms, if they were distressed.

Staff were well supported and well trained.

The house was poorly maintained and people were exposed to unnecessary risks, for example chemicals were not properly stored. Checks were being made to ensure that the home is safe however these were not effective as they did not identify that people were not being kept safe.