CQC report explained · a residential care home
What the CQC found at Willow Bank House Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks, medicines, infection control and recruitment were managed safely, although one care record had not been fully updated after a change in mobility.
- Effective?
- Good
- People's needs were assessed and staff had suitable training and support. People received suitable food and drinks, healthcare support and care that respected consent and least restrictive practice.
- Caring?
- Good
- Staff were kind, respectful and supportive. People were involved in decisions, their privacy and dignity were maintained, and improvements had been made since the previous inspection.
- Responsive?
- Good
- Care was reviewed and changes were acted on promptly. People had communication aids and could follow their preferences, but feedback about activities was mixed and some people found there was little to do.
- Well-led?
- Good
- People, relatives and staff said the home was well run. Managers used checks, staff supervision, meetings and lessons from incidents and complaints to monitor and improve care.
What inspectors found, July 2022
Rated Good; inspectors found safe, kind and well-organised care, with some records and activities needing attention.
Inspectors visited unannounced on 7 and 8 June 2022. They spoke with people living in the home, relatives and staff. They observed care and reviewed care, medicine, staffing, recruitment, complaint and quality records.
People and relatives generally said people were safe and well cared for. Inspectors found enough staff at the time of the visit, safe medicines practice, suitable training and good support with food, health appointments and consent. Staff were described as kind and respectful.
The overall rating was Good, and all five areas were rated Good. Safe, Caring and Well-led improved from Requires Improvement at the previous inspection in 2018. Effective and Responsive remained Good. The report says the service will continue to be monitored.
Improved staffing
Staffing had been a challenge in previous months, but inspectors found permanent staffing had improved and staff were deployed effectively during the visit.
“Most people we spoke with felt there was enough staff to meet their needs and keep them safe.” from the report
Kind and respectful staff
Inspectors saw staff treating people with kindness and providing reassurance when people were upset or distressed.
“We saw staff were kind and caring towards people. Where people had become upset or distressed, staff provided reassurance and hugs, which we saw people felt comforted by.” from the report
Good food support
People were offered choices, drinks and food they enjoyed. Staff supported people to eat at their own pace and adapted meals to meet individual needs.
“We saw staff gave people visual offerings of different food options so people could make an informed choice.” from the report
Strong management checks
The management team monitored care, medicines and staff practice. Staff groups communicated well so care was consistent between shifts.
“Communication was effective between each staff group and each shift to ensure people received a consistent and co-ordinated service.” from the report
Care records not always updated
needs fixingInspectors found that some records did not fully reflect changes in people's needs. They gave the example of mobility and continence records not matching, although they found no negative impact on care.
“Records contained good detail about the person's needs, however we found some further work was required to ensure all aspects of the records were updated following any change.” from the report
Mixed views about activities
minorSome people enjoyed activities, but others said they waited for things to happen or found the home boring. Some dementia activities had stopped during the pandemic and were being reintroduced safely.
“We received mixed reviews from people about the activities in the home.” from the report
Clothing mix-ups
minorSome relatives said people were not always wearing their own clothes or had seen their clothes on someone else. The manager said staff would be reminded to check labels.
“Some relatives told us their family member may not always being wearing their own clothes, or that they have seen their family members clothes on another person.” from the report
- 01How do you make sure care records are updated promptly when a person's needs change?
- 02What activities are currently available for people who prefer individual activities or who live with dementia?
- 03How do you check that each person is wearing their own labelled clothes?
- 04How do you monitor staffing levels and respond if permanent staffing falls?
- 05How are people and relatives involved when care needs or end of life wishes change?
This was an unannounced inspection covering all five CQC questions, including infection prevention and control; the previous overall rating was Requires Improvement in 2018. This explanation was written from the published report of 21 July 2022 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, February 2020
Willow Bank House Residential Home was rated Requires Improvement; inspectors found good support with food, activities and healthcare, but concerns about staffing, personal care and management.
This was an unannounced inspection on 17 December 2019. Inspectors spoke with people living in the home, relatives and staff. They observed care and reviewed care plans, medicines records, staff files and management records.
The home was not always safe. Staff deployment did not always keep people with dementia supported, and prescribed creams were not always recorded accurately. The home was clean, but some areas had unpleasant smells. People told inspectors they felt safe and risks to their health were generally identified and managed.
The home was rated Good for effective care and responsive care. People had suitable food choices, access to healthcare, personalised care reviews and a range of activities. However, caring and well-led care were rated Requires Improvement because some people looked unkempt, and improvements in dementia care, staffing and record keeping were not yet consistent.
The overall rating was Requires Improvement, the same as at the previous inspection published in December 2018. Effective care improved from Requires Improvement to Good, while responsive care remained Good.
Food and nutrition
People enjoyed the food and were offered choices. Staff understood specialist diets and monitored people's weight.
“People told us they enjoyed their food and were given a choice of meals.” from the report
Healthcare support
People were supported to attend health appointments, and relatives said doctors were contacted promptly when people were unwell.
“Relatives confirmed if their family member was unwell a doctor was promptly called, and where appropriate, they were kept up to date with the wellbeing of their family member.” from the report
Activities and relationships
The home offered varied activities, outings and one-to-one support. People could spend time in ways that suited their preferences, and families were welcome to visit.
“The activities co-ordinator spent time with people on a one to one basis, where they supported people with their individual preferences” from the report
Care planning
People and relatives were involved in assessments and reviews. Staff knew people's preferences and responded when their needs changed.
“People confirmed they were involved in the planning of their care and their needs were met.” from the report
Staffing and dementia support
seriousStaff were not always visible or deployed where needed. People with dementia were sometimes left alone, and an area was closed while one staff member supported several people.
“There were occasions when people living with dementia were left alone in the corridors in the upstairs of the home, with no staff present to support, reassure and re-direct them.” from the report
Personal care and appearance
needs fixingSome people appeared unkempt, with concerns about hair, clothing, nails, dentures and teeth. Records did not show that personal care was repeatedly offered at different times when people initially refused.
“We saw some people looked unkempt, with unwashed and/or unbrushed hair, food on their clothing, dirty finger nails” from the report
Medicines records
needs fixingOral medicines were given when they should be, but the home could not be sure that prescribed creams had always been applied because records were incomplete.
“The provider could not be assured people always received their prescribed creams, as these were not always accurately recorded.” from the report
Management records
needs fixingManagement audits had identified gaps, but daily records still contained omissions. The system used to decide staffing levels could not be relied on fully because care records were incomplete.
“However, the provider could not evidence this was sufficient action, as at this inspection we found there continued to be gaps in daily records.” from the report
Unpleasant smells
minorThe home appeared clean and tidy, but unpleasant smells remained in different areas. The provider planned to replace carpets to address this.
“At this inspection while we found the home appeared clean and tidy, we found there continued to be some unpleasant odours within different areas of the home throughout the day.” from the report
- 01How are staff deployed at busy times and at weekends, particularly to support people living with dementia?
- 02How do you make sure people who initially refuse personal care are offered it again at a time that suits them?
- 03What checks now confirm that prescribed creams are applied and recorded accurately?
- 04What action has been completed to stop unpleasant odours, including the planned carpet replacement?
- 05How do you check that daily care records are complete and that improvements are sustained?
This was a planned, unannounced inspection covering all five CQC questions, including both the premises and the care provided; the previous rating was also considered. This explanation was written from the published report of 19 February 2020 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 Willow Bank House Residential Home
6 rated inspections over 6 years: the service has held its Good rating throughout.
- July 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Willow Bank House Residential Home →
- February 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Willow Bank House Residential Home →
- December 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- May 2018Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- June 2017Goodstayed GoodSafe: GoodWell-led: Good
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- February 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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