CQC report explained · a residential care home
What the CQC found at The Willows Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found individual risk assessments, enough staff, safe recruitment and medicines given as prescribed.
- Effective?
- Good
- People's needs were assessed and reviewed, and staff had the skills and training needed. People were supported with food, drink, healthcare and decisions about their care.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were supported to make choices, maintain independence and receive personalised support.
- Responsive?
- Good
- Care plans reflected people's preferences and changes in their needs. People had access to activities they enjoyed and could raise concerns with staff or the manager.
- Well-led?
- Good
- The home had effective checks on care, medicines, fire safety and the building. People, visitors and staff were asked for feedback, and the manager used learning and partnership working to improve care.
What inspectors found, June 2019
The Willows Care Home was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection on 09 May 2019. Inspectors reviewed information held about the home, spoke with people, visitors and staff, observed care, and checked care, medicines, recruitment and quality records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines procedures, suitable care plans, kind staff and support that respected people's choices, privacy and independence.
The previous inspection, published in April 2018, rated the home Requires Improvement. Inspectors said the home had improved its risk assessments, staffing, care planning, dignity and quality monitoring. No regulations were breached in this inspection.
Improved risk management
Inspectors found that risks were assessed, managed and reviewed. Staff understood the support people needed to stay safe.
“People's individual risks had been assessed and plans put in place to manage the risks.” from the report
Enough staff
People, visitors and staff said there were enough staff. Inspectors saw that people did not have to wait for support.
“There were enough staff to meet people's needs safely.” from the report
Kind and respectful care
Staff knew people well and respected their dignity, privacy, choices and independence.
“People were treated with kindness by staff who knew them well. People's privacy and dignity was respected, and their independence was encouraged.” from the report
Personalised support
Care plans recorded people's needs and preferences, and staff used this information to provide support in the way people preferred.
“Staff knew and understood people's preferences and used this knowledge to support people as they preferred.” from the report
Stronger management checks
Inspectors found that quality checks were being used to identify actions and make improvements. This was an improvement from the previous inspection.
“The provider had a range of checks in place to ensure people received the support they needed.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you decide whether there are enough staff for the current residents and their changing needs?
- 02How often will my relative's risk assessments and care plans be reviewed, and how will changes be shared with staff?
- 03How will you make sure medicines, including medicines given when needed for pain or anxiety, are given and recorded correctly?
- 04What activities and outings would be suitable for my relative, and how will their preferences be included?
- 05How can my relative or our family raise a concern, and how would you respond to it?
This was an unannounced planned inspection of the overall service, including all five rating areas, the premises and the care provided. This explanation was written from the published report of 11 June 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2019
Rated Requires Improvement; inspectors found unsafe care, missed training and poor dignity, and issued a warning notice.
This was an unannounced inspection on 18 April 2018. One inspector spoke with people, staff, the manager, the provider and a social care professional. They observed care and reviewed three care records, medicines and the home's quality checks.
The home was not consistently safe, effective, caring, responsive or well-led. Staff used unsafe ways to support two people, including holding one person without the right training and moving another person without suitable equipment or a risk assessment. Staffing levels had not been reviewed as people's needs changed.
There were also delays in getting health advice, gaps in staff training, and occasions when staff did not protect people's privacy or dignity. The home did safely manage medicines, infection control and recruitment. People were supported with food and drink, and the Mental Capacity Act processes were followed.
The overall rating and all five areas were Requires Improvement. The previous inspection in February 2016 had rated the service Good. CQC found one breach of regulation and served a warning notice.
Medicines and infection control
Inspectors saw medicines being stored and given safely. Staff followed infection control procedures and the home was clean.
“People's medicines were stored and administered safely.” from the report
Food and drink
People had choices and received help to eat and drink. Specialist diets and equipment were available when needed.
“People were supported to eat and drink sufficient amounts to remain healthy.” from the report
Dementia-friendly environment
The home had adapted its environment with clear signs, contrasting colours and equipment to support people with dementia and mobility needs.
“Every effort had been made to personalise and adapt the service to meet people's needs in relation to their dementia.” from the report
Kind interactions
Although some care practices were not appropriate, inspectors saw staff speaking patiently and compassionately and offering people choices.
“We observed that staff were kind and caring to people and spoke to people in a patient and compassionate way.” from the report
Unsafe moving and holding
seriousOne person was held without staff having the required training. Another person was moved unsafely because there was not enough room for a hoist, and no suitable risk assessment had been put in place.
“This put this person at risk of harm due to them receiving unsafe care and support.” from the report
Staffing levels
needs fixingStaffing had not been reassessed as people's needs became more complex. At times only two staff were available while also providing care, giving medicines and running the service.
“Staffing levels had not been assessed and agreed dependent on people's individual needs.” from the report
Privacy and dignity
needs fixingThree occasions were seen where staff entered bedrooms without knocking. Some moving and personal care practices were also undignified.
“We saw three occasions where two members of staff just walked into people's bedrooms without knocking whilst they were still in bed.” from the report
Weak management action
seriousThe manager knew that two people's needs were not being safely met, but prompt action was not taken. Safeguarding referrals were made on the inspection day.
“The registered manager had not took prompt action to ensure people were safe by alerting the local safeguarding authority.” from the report
- 01What changes have been made to ensure people are moved safely, including access to suitable equipment and current risk assessments?
- 02Have all staff completed training in safely supporting people who may become distressed or aggressive?
- 03How are staffing levels calculated now that some people's care needs have become more complex?
- 04How do you check that staff knock and wait before entering bedrooms and protect people's dignity during personal care?
- 05What process ensures staff seek medical help promptly when someone becomes unwell?
This was an unannounced inspection covering the accommodation and care provided, with ratings for all five key questions; the previous inspection in February 2016 had rated the service Good. This explanation was written from the published report of 19 April 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The Willows Care Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- June 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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