The Care Quality Commission (CQC) has rated Willow View Care Home in Stockton-on-Tees, inadequate, and placed it in special measures following an inspection in May.
Willow View Care Home provides personal care for up to 77 people. It provides support to older people, some of whom may be living with dementia, physical disability or sensory impairment. At the time of this inspection there were 69 people living at the home.
The last rating for this service was requires improvement and breaches of regulations were found. The provider completed an action plan to show what improvements they planned to make and by when. This inspection was carried out to check on the progress of these improvements, and to follow up on information of concern received by CQC about medicines, staffing levels, and systems to monitor the quality and safety of the service.
At this latest inspection the provider remained in breach of regulations regarding assessing risk, medicines management, as well as records and governance systems. Also, further breaches were found in relation to dignity and respect, and consent.
Following the inspection, the overall rating for the home, as well as for how safe and well-led it is, has declined from requires improvement to inadequate. The ratings for being caring and responsive have gone down from good to requires improvement. Being effective, was again rated as requires improvement.
The service has been placed in special measures which means it will be kept under review and re-inspected within six months to check for significant improvements.
Sarah Dronsfield, CQC deputy director of operations in the north, said:
“When we inspected Willow View Care Home, it was concerning the provider still hadn’t addressed the issues highlighted at previous inspections. There were significant shortfalls by the leadership team, the culture they’d created didn’t ensure the delivery of high-quality care.
“It was concerning to hear how worried staff were about being unable to meet people's care and support needs due to low staffing levels and poor support from management. They told us they didn’t always have time to change people's incontinence aids or get people out of bed because they didn’t have enough time. They also told us they regularly ran out of products such as incontinence aids and medicines as leaders didn’t have good systems in place to ensure staff had what they needed to support people.
“We saw people weren’t always treated with dignity and respect or have the independence they deserved to have a better quality of life that most people take for granted. Inspectors saw someone sat waiting for a cup of tea for a long period of time before they stepped in to assist and another person wasn’t able to shave their own face because they weren’t given access to a mirror.
“Staff weren’t managing medicines well, we saw they weren’t stored, recorded or administered safely. We found examples where people couldn’t always be given their prescribed medicine as there was no stock available which could result in people being in unnecessary pain.
“This standard of care is totally unacceptable. It was really concerning how people were made to feel, in a place that was supposed to be their home and leaders must take immediate action to improve the quality of care, as people living at Willow View deserve better.
“We will continue to monitor the service closely to ensure significant and urgent improvements are made. If we are not assured people are receiving safe care, we will not hesitate to take further enforcement action so people receive the high standard of care they deserve.”
Inspectors found:
- There was a significant lack of registered manager and provider oversight.
- Staffing levels weren’t always safe and a tool used to calculate this was using inaccurate data
- Adequate fire safety checks were not completed. Fire exits were blocked, and personal emergency evacuation plans were either not in place or did not reflect a person's current needs
- Infection, prevention and control measures in place were insufficient. Personal protective equipment was not being stored appropriately
- Some elements of the environment were not suitable for people living with dementia
- Records in all areas lacked up to date, person-centred information. Monitoring records had not been completed consistently so, there was no assurance people were receiving appropriate care and support
- When complaints had been raised, thorough records had not been kept, to ensure all areas of concern had been fully investigated
- People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice
- People's communication needs were not always met. There was a lack of available resources such as menus, picture menus and information presented in an easy read format
- Lessons had not been learnt when things went wrong.
However:
- People said they enjoyed the activities on offer
- People spoke highly of their regular staff for their caring approach
- Following the inspection, the provider informed CQC they had appointed an external consultancy to support with the improvements needed.