Archived: The Willows

The registered manager was away at the time of the inspection. The deputy manager was managing the home in the registered manager's absence. The deputy manager however, was on annual leave during the inspection. A senior manager from the organisation was providing management support and advice to the home.

We spent some time observing the interactions between staff and people using the service in the communal areas of the home. We spoke with nine people who used the service. We also spoke with two senior care workers, four care workers, one housekeeper, two administration staff, a volunteer, a cook, the activity organiser, seven relatives of people who used the service and a senior manager. Following the inspection we spoke with a healthcare professional and a hairdresser who regularly visited the home.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People who used the service told us that they felt safe, staff were friendly and treated them well. We saw staff interacted with people who used the service in a respectful manner. Relatives of people were confident that people were safe. A visiting relative said their relative living in the home had told them it 'feels very safe here.'

Staff understood their role in safeguarding people they supported. The premises were clean and regular health & safety checks had been carried out.

Arrangements were in place to keep staffing levels and skill mix under review so people's needs were met.

The home had systems in place to identify, assess and manage risks relating to the health, welfare and safety of people who used the service. Arrangements were in place for managing medicines safely.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff understood when an application should be made to deprive someone of their liberty.

Is the service effective?

People told us that they were happy living in the home. They said they received the care and support that they wanted and needed. Comments from people about the staff included 'day and night staff are brilliant,' and 'I am happy with the way they care for me.'

Staff we spoke with told us that they felt well supported and received appropriate training and supervision to enable them to carry out their responsibilities and to care for people appropriately.

People's care needs had been assessed and care and treatment were planned and delivered in a way that promoted people's safety and welfare. Risk assessments had been carried out where necessary.

Is the service caring?

We saw that people were supported by kind, attentive staff who approached people in a friendly manner. People who used the service told us that they liked the staff who they said were kind to them and treated them well. A person said 'I am happy with the way they care for me.' Relatives of people who used the service told us that people were well cared for and were treated with respect by staff.

Care plans contained information about each person's specific needs for staff to follow. Staff were knowledgeable regarding the care needs of people and respected the choices that people made. People told us that they were supported to make decisions about their care, treatment and support.

People's privacy and dignity were respected. A person who used the service told us that staff 'always knocked on the door before entering.'

Is the service responsive?

People received individualised care that was responsive to their interests and preferences. People's care and health were monitored closely. People were confident they would receive the support they needed quickly should their health needs change.

The service facilitated and enabled people to take part in a variety of activities. People were supported by staff to keep relationships that matter to them, such as family, and other social links.

People who used the service told us that if they had any concerns or complaints, they would feel comfortable raising them with staff. People told us they were supported and encouraged to feedback their experience of the service including the care they received and to raise any issues or concerns they may have.

Is the service well-led?

The deputy manager was managing the home in the registered manager's absence with support from senior management staff. Monitoring checks of systems in the home were carried out. Improvements were made when needed.

Staff were clear about their roles and responsibilities and staff meetings took place regularly so staff views about the service were taken into account. People told us they felt listened to and involved with the service. There were regular residents' meetings and relatives' meetings where people who used the service and staff could express their views about the service. Improvements to the service were made when needed. People commented 'It's a nice home,' 'We can visit anytime,' 'The home is far superior to anywhere else we visited,' and 'My relative came for respite and liked it so much they stayed.'

People told us that they made decisions about their care. We saw staff supported people to make choices. Staff interacted with people who used the service in a respectful and sensitive manner. Comments from people who used the service included 'staff listen to me,' and 'I am happy here.'

Each person who used the service had a plan of care that included up to date information about the individual support and care they needed. People's health, safety and welfare were protected as they received the advice and treatment that they needed from a range of health and social care professionals. Staff had the skills to meet people's needs and they received appropriate support and advice from senior staff including the manager.

There were effective systems in place to regularly assess and monitor the quality of service that people receive. Complaints people made were responded to appropriately.

During this follow up inspection we spoke to fifteen people who used the service and to one relative of a person living in the home. We also spoke to four staff and checked records to make a judgement as to whether the provider had met the compliance actions Outcome 5 Meeting nutritional needs Regulation 14 (HSCA 2008 Regulated Activities) Regulations 2010, and Outcome 8 Cleanliness and infection control, Regulation 12 (HSCA 2008 Regulated Activities) Regulations 2010.

At this inspection we found that the provider had taken proper steps to ensure that people who used the service had their nutritional needs met, food items were stored safely and appropriate action had been taken with regard to infection control.

People, and their carers, told us that they were happy with the care provided at the home. "Staff are like family". We saw that staff interacted with people appropriately, and were friendly, kind and patient when meeting their needs.

Some people told us that the standard of food was variable. People had complained, but nothing had improved.

We found that arrangements for managing infection control had not protected people from the risk of infection.