CQC report explained · a residential care home
What the CQC found at The Willows
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe, and staff understood safeguarding and people's risks. There were enough staff, medicines were recorded and stored appropriately, and action was taken after accidents.
- Effective?
- Good
- Staff received training, induction and regular supervision relevant to their roles and people's needs. People had support with food, healthcare, decision-making and access to suitable facilities.
- Caring?
- Good
- Inspectors saw staff being kind and taking time with people. People were involved in care planning and said staff respected their privacy, dignity and choices.
- Responsive?
- Good
- Care and activities were planned around people's needs, interests and goals. People were supported with social activities, education and employment interests, and complaints systems were in place.
- Well-led?
- Good
- Inspectors found a clear management structure and effective checks on medicines and care planning. People and staff were involved in meetings and the provider worked with health and social care professionals.
What inspectors found, May 2019
The Willows was rated Good; inspectors found safe, kind and personalised care, with improvements made since the previous inspection.
This was an unannounced inspection on 4 April 2019. One inspector spoke with four people using the service, staff and managers. They reviewed two care plans, risk assessments, medicines records, training, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough safely recruited staff, suitable medicines systems, personalised care and support for people's choices and activities.
The home had previously been rated Requires Improvement in January 2018 and had breached regulations about safe care and treatment and good governance. At this inspection, inspectors said the provider had acted to address all the earlier shortfalls.
Previous problems addressed
The provider had acted on the problems found at the last inspection. Inspectors said the earlier shortfalls had been addressed.
“The provider had taken action to address all the shortfalls identified at our previous inspection visit.” from the report
Safe staffing and medicines
There were enough staff, recruitment was safe and staff responsible for medicines had received training.
“People were cared for by sufficient numbers of staff who had been recruited safely.” from the report
Personalised support
People were involved in assessments, care reviews and decisions. Support included people's social interests, education, employment goals and rehabilitation.
“People were supported by staff to pursue their social interests.” from the report
Kind and respectful care
Inspectors saw staff treating people with care and respect. People said staff listened to them and respected their dignity.
“People told us that staff listened to their views and they were happy with the support provided to them.” from the report
Effective management checks
The provider had introduced checks covering medicines and care planning, and inspectors found the overall governance system effective.
“At this inspection the provider's governance was effective in reviewing and improving the service to ensure people received safe and effective care.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you check that the improvements made since the January 2018 inspection are still being maintained?
- 02How are staff trained and supervised to meet the specific needs of people with an acquired brain injury?
- 03How are people involved in reviewing their risk assessments and care plans?
- 04How do you support people to work towards goals such as employment, education, cooking and other rehabilitation activities?
- 05What arrangements would be made for end of life care, as no one was receiving this support during the inspection?
This was an unannounced inspection covering all five CQC questions and both the premises and care provided; no one was receiving end of life care at the time. This explanation was written from the published report of 16 May 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, May 2018
Rated Requires Improvement; inspectors found unlawful restrictions, unsafe risk management and staffing shortages, alongside kind staff and safe medicines practices.
This was an unannounced inspection on 15 and 16 January 2018. The inspector spoke with people living in the home, staff, a healthcare professional, a visitor and managers. They observed care and checked care records, medicines records, risk assessments and quality checks.
The home was not consistently safe, effective, caring, responsive or well-led. Inspectors found too few staff, weak risk management, gaps in staff training and care knowledge, and failures to follow mental capacity and liberty protection rules. One person's liberty was being restricted unlawfully.
There were also positive findings. People said they felt safe and described staff as kind and friendly. Medicines were managed safely, people had access to healthcare and equipment, and complaints were recorded and acted on.
The overall rating was Requires Improvement. This was a fall from Good at the previous inspection in January 2015. The provider was told to make improvements and send CQC a report explaining what action it would take.
Safe medicines
Medicines were stored safely, records showed they were given as prescribed, and staff had medicine training and competency checks.
“We observed that medicines were stored safely and the medicines administration records identified that people were given their medicines as prescribed.” from the report
Kind relationships
People described staff as kind and friendly. They said staff listened, supported them and helped them talk about worries.
“People were involved in their care planning and were supported by staff who they described as kind and friendly.” from the report
Healthcare support
People had access to relevant healthcare professionals, including mental health, nursing, physiotherapy and dietary support.
“People were supported by staff to access relevant healthcare services when needed.” from the report
Activities and family contact
Staff supported people with interests, activities and contact with important people. People could also raise complaints and were told what happened as a result.
“People were able to maintain contact with people important to them.” from the report
Unlawful restrictions
seriousThe home had not completed required mental capacity assessments or renewed a liberty protection authorisation. The manager acknowledged that people were being deprived of their liberty unlawfully.
“This meant people were being unlawfully deprived of their liberty.” from the report
Risk management
seriousRisks linked to furnishings, hot radiators, an uneven drive and a cracked garden wall were not consistently assessed, monitored or addressed. Some staff were also unaware of important care information, including an allergy.
“The risk of harm to people was not managed effectively to ensure their safety.” from the report
Staffing shortage
needs fixingThere were 169.5 vacant care hours each week. This reduced support for activities and aspirations and left the manager spending much of their time covering care and leave.
“We try to provide a person-centred service. However, this is compromised because of the shortage of staff.” from the report
Training and care knowledge
needs fixingThe home could not show what training staff had completed or whether they used the skills learned. Some staff had not read care plans and did not know people's diagnoses or dietary needs.
“The registered manager was unable to demonstrate what training staff had received.” from the report
Privacy and dignity
needs fixingInspectors observed personal care that did not protect one person's privacy and dignity. Other staff nearby did not challenge what happened.
“People's privacy and dignity was not consistently respected by all staff.” from the report
- 01How many care hours are currently vacant, and how will you make sure staffing is sufficient for outings, activities and personal care?
- 02Have all required mental capacity assessments and Deprivation of Liberty Safeguards applications been completed and kept up to date?
- 03How do you check that every staff member has read each person's care plan, diagnosis, allergies and dietary needs?
- 04What action has been taken to make sure staff consistently protect privacy and dignity during personal care?
- 05How do your current quality checks identify and resolve risks such as unsafe equipment, the drive and the garden wall?
This was an unannounced comprehensive inspection covering all five key questions, and the ratings fell from Good at the previous inspection in January 2015. This explanation was written from the published report of 19 May 2018 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
3 rated inspections over 4 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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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