The Willows

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

At the last inspection responsive was rated requires improvement and we recommended the activities programme be reviewed and resources made available to provide meaningful activities for people. Some improvements were found however the deployment of staff made it difficult for meaningful engagement to happen consistently. The registered manager took immediate action to rectify this which had a positive impact on activities and engagement. They acknowledged that this needed to be sustained. Staff had identified if people were at particular risk of discrimination and social isolation and positive action had been taken to integrate people with the local community. People’s health care needs were well understood and staff worked well with other professionals to make sure people received appropriate and timely health care.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People spoke positively about the care they received, however some people commented they were involved in care planning, whilst others said not. There was limited evidence of involvement within records, including care plans and ‘resident of the day’ records. Relatives and resident meetings were held, and feedback was sought through surveys. You Said, We Did posters and newsletters were available for people and family members which evidenced actions taken by the provider in response to feedback. For example, improvements to the exterior areas of the home. No formal complaints had been received, however, minor concerns raised were responded to and addressed.

Staff had attended training in working in a person-centred way and were aware of people’s needs. Information was available in care records to ensure people received person-centred care. An advocate was involved in some people’s care and staff had spoken with people about the role advocates play in speaking up for people.

Staff deployment impacted on the provision of person-centred care and activities however changes were introduced by the registered manager and on day two staff were observed to be attentive to people’s needs and some activities were being offered. The registered manager accepted that improvements were needed in this area.

People received support from a staff team who worked well with other professionals. People told us staff worked with their GP, community nurse and social worker. A range of healthcare professionals were involved in people's care, and this was reflected in care records. Multi-disciplinary team meetings took place with people and their social workers, care managers, advocates, and staff which ensured care was joined up and aligned to people's individual needs.

The registered manager and staff understood the diverse health and care needs of people. The care provided was flexible and staff worked well with other professionals to ensure continuity.

Processes were in place to support a range of healthcare professionals to be involved in people’s care. Hospital transfer forms were used which set out people’s needs, from clinical baseline information to their communication needs which supported a more streamlined transfer from home to hospital care. ‘This is Me’ documents were also completed and demonstrated a positive approach to ensuring joined up care, which external professionals corroborated.

Feedback from partners was positive and healthcare professionals said staff worked well with them. One community nurse said, "[Person] had a shoulder injury and staff helped with their rehab. They know the residents really well and act if they think something is wrong. The manager fought for [person] with staff at the hospital as she knew they were really unwell. She is so very kind and caring. Genuinely think the staff and manager are really good.” External professionals also commented on the way staff spoke sensitively to people about significant choices to enable full understanding.

Policies and procedures were in place in relation to the Accessible Information Standard and General Data Protection Regulations (GDPR). There were useful links with the policies to organisations that may be able to support with specific communication needs.

Information could be provided in different formats to meet people’s needs if required.

Communication care plans were in place which identified any individual needs in relation to communication and understanding. The provider had the ability to provide appropriate, accurate and up-to-date information in formats suitable to individual needs. Staff told us this included larger print when needed.

People said they had been involved in meetings about future planning. One person said, "We had a meeting, they changed the meals, and the menu." Another person said, "Oh yes they encourage feedback." There were lots of compliments about the service, including, “Cannot fault the care they provide,” and, “Staff are very helpful we have no complaints.”

No formal complaints had been received; however various systems were in place to seek feedback from people. There was limited evidence that people were involved in decisions about their care, and this was noted as an area to develop. A suggestions book had been recently introduced for feedback on meals, compliments and suggestions which seemed popular with family members.

A formal complaints policy and procedure was in place for recording, investigation and learning from complaints but none had been received. Resident and relatives’ meetings took place which were well attended by people. Surveys were also completed, and any minor concerns or suggestions were addressed individually. Newsletters and You said, We did posters were completed which summarised feedback received and action taken by the provider.

A pro-active approach from staff and management was evident in relation to ensuring people accessed appropriate care, support and treatment at times when they needed it. This was supported by feedback from people, stakeholders and processes. People's care records showed they had access to care, support and referrals were made for treatment when they needed it.

We received positive feedback from clinicians and external social care professionals regarding the staff’s understanding of people's diverse needs and their attempts to ensure care was joined up. Many examples were shared of staff seeking advice, working positively with multi-disciplinary teams, flagging issues quickly and the registered manager maintaining strong relationships with external health and care professionals to ensure people receive care, support and treatment when they needed it.

The registered manager ensured everyone could access the care, support and treatment they needed when they need it. A healthcare professsional from the GP practice visited weekly and people were supported with attending appointments to other healthcare professionals. People and their families said staff supported them well.

The provider had in place some positive processes to help reduce inequalities in care, particularly the hospital transfer form, which set out a range of people's needs, from clinical baseline information to their communication needs. This is Me documentation was completed which supported a person-centred approach to continuity of care.

Policies and procedures were in place in relation to equity, equality and diversity. Feedback and observations supported the fact that staff had implemented learning and a culture had been created of individualised care.

Staff completed equality and diversity training and observations confirmed staff respected people. The registered manager actively listened to people who were most at risk of experiencing inequality. Care and support was tailored to their needs.

There was a positive culture within the staff team and staff tailored care and support to meet people’s diverse needs. Staff were aware of people who were at risk of potential discrimination and ensured appropriate support was in place for them.

Records showed that information about people's end of life wishes were in place for a small number of people. The registered manager had identified improvements, including appointing an End-of-life champion to be responsible for this area of care and ensuring records accurately reflected people's current wishes.

An End-of-Life policy was in place and training had been sourced to support staff with discussing peoples end of life wishes. The registered manager said this was an area to improve and following the training all care plans were going to be reviewed. The registered manager was aware of the need to have this crucial information formally recorded and said it would be addressed.

Peoples experience of the support offered with planning for the future differed. Some people said they had been involved in meetings about future planning, and some people had Emergency Health Care Plans and Do Not Attempt Cardio Pulmonary Resuscitation orders. It was not always evident if people had had the opportunity to discuss their future plans, including end of life wishes.