CQC report explained · a nursing home
What the CQC found at Willow Court Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, October 2022
Willow Court Nursing Home is rated Good; inspectors found safe care and sound management, with no registered manager and a few issues still being addressed.
This was an unannounced inspection on 30 August 2022. One inspector reviewed six staff recruitment records, four care records, medicines records and health and safety documents. Two people and eight staff were spoken with, and an Expert by Experience telephoned 12 relatives.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, medicines were managed safely, infection control was effective and there were enough staff at the time. They found no evidence that people were at risk from the skin integrity concerns that had prompted the inspection.
The home did not have a registered manager after the previous manager died. An acting manager was leading the service with support from the provider. Inspectors found open management, regular checks and a willingness to improve. The overall rating stayed Good, the same as at the previous inspection in 2018.
Safety and risk management
The home assessed risks to people, the building and equipment. Inspectors found good practice in preventing and healing pressure injuries, including plans to work more closely with tissue viability nurses.
“Risks were assessed and actions taken to reduce them and ensure people remained safe.” from the report
Medicines
Medicines were stored correctly, records were complete and staff were trained and checked before administering them. Inspectors found medicines were given at the right time and as directed.
“These were completed correctly and checked at the end of shifts to ensure all medicines had been administered and signed for.” from the report
Infection control
The home had cleaning schedules, trained staff and suitable arrangements for preventing and managing infections. Visiting was also enabled in line with current guidance.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Learning and openness
Accidents, incidents and near misses were recorded, reviewed and discussed with staff. Inspectors also found that managers were approachable and staff felt supported.
“Accidents, incidents and near misses were recorded and analysed to look for patterns and ways of minimising reoccurrences.” from the report
No registered manager
needs fixingThere was no registered manager when inspectors visited. An acting manager was leading the home with support from the provider, so families should check the current management position.
“At the time of our inspection there was not a registered manager in post.” from the report
Recruitment records
minorSome staff employment histories had small gaps. The provider agreed to obtain more information and had introduced a checklist for future recruitment.
“We found there were some minimal gaps in people's employment histories.” from the report
Lift emergency phone
needs fixingThe emergency phone in the lift was faulty during the inspection. Staff had temporary arrangements using mobile phones and walkie-talkies while the phone line was being repaired.
“there was a fault with the phone in the lift to use in emergencies.” from the report
- 01Is there now a registered manager in post, and who is responsible for the home until that appointment is made?
- 02Has the emergency phone in the lift been repaired and tested?
- 03What extra staffing was approved, and has the planned increase from one care assistant for five people to one for four happened?
- 04How does the home identify and manage pressure injuries when people arrive from hospital or the community?
- 05How are relatives kept updated now that regular relatives' meetings are no longer held?
This was an unannounced focused inspection of Safe and Well-led, prompted partly by concerns about skin integrity; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 1 October 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, September 2018
Rated Good; inspectors found safe, kind and personalised care, with improvements made since the previous inspection.
This was an unannounced inspection on 9 and 10 July 2018. Inspectors spoke with people living at the home, relatives, staff and managers. They reviewed care records, medicines records, recruitment files and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines arrangements, suitable training, personalised care, activities and systems for listening to people and relatives.
The home had been rated Requires Improvement at the previous inspection in September 2016. Inspectors found that action had been taken to improve staffing, food safety, activities and quality checks. They did see badly stained seating on the first day, but the home removed the chairs and ordered replacements immediately.
Enough staff
Inspectors found staffing levels were maintained and staff responded promptly to requests for support. Recruitment checks were completed before staff started work.
“There were sufficient staff to meet people's care needs.” from the report
Kind and respectful care
Staff understood people as individuals and supported them sensitively. Inspectors saw positive and friendly interactions and found that privacy and dignity were respected.
“All the interactions we observed between people and staff were positive and friendly.” from the report
Personalised support
Care plans contained detailed information about people's needs, preferences and how they wanted to receive care. Families were involved where appropriate.
“Care plans provided comprehensive information about how people wished to receive care and support.” from the report
Good activities and choice
People could choose from a range of activities and suggest others. The home had activities staff and adapted activities to people's interests and changing needs.
“There was a range of activities provided throughout the day.” from the report
Improved management checks
The home had improved its quality monitoring since the previous inspection. Audits were carried out and actions were followed up.
“The registered manager and deputy manager used a system of audits to monitor and assess the quality of the service provided.” from the report
Stained seating
minorInspectors saw badly stained chairs in parts of the home on the first day. The home removed them immediately and ordered replacements, but families should check that all furniture is clean and in good condition.
“However, on the first day of our inspection we observed badly stained seating with some chairs around the home.” from the report
- 01Have all the stained chairs been replaced, and how do you check that furniture and shared areas remain clean and suitable?
- 02How do you decide staffing levels when people's care needs change, and how do you check that people are not left waiting for help?
- 03How will you make sure my relative's food, drink, diet and choking risks are recorded and followed by staff?
- 04How are activities adapted for people who do not want group activities or whose needs change?
- 05What do your current audits show about medicines, care plans, nutrition and staffing, and what actions are still open?
This was an unannounced comprehensive inspection covering all five questions, including the premises and care provided; it also checked improvements identified at the September 2016 inspection. This explanation was written from the published report of 14 September 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 Willow Court Nursing Home
4 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- October 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- November 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
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