CQC report explained · a nursing home
What the CQC found at Willow Green Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks were identified and managed, medicines were stored and recorded safely, and there were enough staff. Safeguarding, fire safety and infection control systems were also found to be in place.
- Effective?
- Good
- Staff training, induction and supervision had improved. Staff understood people's dietary and healthcare needs, and mental capacity assessments and legal authorisations were completed when required.
- Caring?
- Good
- This key question was not covered by this focused inspection, so no current rating was given in this report.
- Responsive?
- Good
- Care plans were detailed, regularly reviewed and based on people's choices. Complaints were investigated and acted on, but feedback about activities was mixed.
- Well-led?
- Good
- The home had effective audits, action plans and systems for gathering feedback. Inspectors found a more positive culture and better teamwork than at the previous inspection.
What inspectors found, October 2023
Rated Good; inspectors found safe, kind and well-organised care, with some people wanting more activities.
This was an unannounced focused inspection. Inspectors visited on 12 September 2023 and spoke with people, relatives, staff and health professionals. They reviewed care plans, medicines records, staff files and the home’s management records.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were all rated Good. Inspectors found that risks and medicines were managed safely, staffing and training had improved, care plans reflected people’s needs, and quality checks were being used to improve the service.
The home had previously been rated Requires Improvement and had breached regulations. Inspectors found enough improvement had been made and that the home was no longer in breach. Some people gave mixed feedback about activities, with some wanting more opportunities to take part.
Safer care planning
Risks were identified and recorded, with clear plans to reduce them. Care plans reflected people's current needs and preferences.
“Risks to people had been identified and recorded. Thorough management plans were in place to reduce risks wherever possible” from the report
Medicines managed well
Medicines were stored, given and recorded safely. Staff had suitable training and their competence was checked.
“Medicines were stored, administered and recorded safely.” from the report
Improved leadership
Inspectors found better management systems, regular audits and a positive change in the culture of the home.
“The culture of the service had significantly improved and feedback from staff, people and professionals echoed this.” from the report
Person-centred care
People were involved in their care planning and staff supported them to make individual choices. Inspectors observed positive interactions.
“Care plans were detailed with clear information for staff to follow so they could support people safely and in the way they preferred.” from the report
Activities
minorFeedback about activities was mixed. Some people wanted more opportunities to take part, and the home was developing a wellbeing role to provide one-to-one activities.
“We received mixed feedback about activities at the home. Some people said they would like more opportunities to join in.” from the report
- 01What activities are now available, including one-to-one activities for people who do not join group activities?
- 02How do you check that each person's risk assessments and care plans remain up to date?
- 03How do you monitor medicines records and medicine stock after the improvements found at this inspection?
- 04How many agency staff are currently being used, and how do you maintain continuity for residents?
- 05How can relatives give feedback, and what recent changes have been made as a result?
This was a focused inspection of Safe, Effective, Responsive and Well-led; the report says the other key question ratings used ratings from the last inspection. This explanation was written from the published report of 7 October 2023 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 2022
Rated Requires Improvement, with Inadequate leadership and problems with medicines, staffing, records and social activities.
This was an inspection carried out over several visits from 20 June to 12 July 2022. Inspectors spoke with people, relatives and staff, checked care files, medicines and other records, and contacted professionals after the visits. They also checked infection control.
Inspectors found that people did not always receive medicines as prescribed or at the right time. There were gaps in risk assessments, care records, safeguarding records and food and fluid charts. Fire safety risks had not all been reduced, and there were not enough suitably skilled staff to provide person-centred care.
People had limited opportunities for meaningful activities and social contact. Management systems did not identify or correct problems reliably, and feedback was not gathered or used well. The home had started some improvements, including recruiting staff and strengthening management, but inspectors found these were not yet enough.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe, Effective and Responsive were rated Requires Improvement. Well-led was rated Inadequate. No new Caring rating is shown in this report.
Recruitment checks
The home had safe recruitment processes, including appropriate checks before staff started work.
“The provider had established safe recruitment processes to ensure appropriate pre-employment checks were carried out.” from the report
Healthcare support
People were supported to access healthcare services, with referrals to professionals such as dieticians and chiropodists when appropriate.
“People were supported to access healthcare services and support.” from the report
Visits and infection precautions
The home allowed visits, screened visitors for COVID-19 and staff used protective equipment safely and effectively.
“Staff used PPE safely and effectively and had received appropriate training.” from the report
End of life care
People receiving end of life care had plans, and most staff had relevant training.
“People receiving end of life care had plans in place reflecting how this would be delivered.” from the report
Medicines
seriousPeople did not always receive medicines as prescribed or at the correct times. Some medicines were out of stock, and audits did not reliably identify errors.
“People did not always have their medicines as prescribed or at the correct times.” from the report
Safety risks
seriousFire evacuation practice was not completed for staff, smoking-related fire risks had not been fully reduced, and some safety checks were not frequent enough.
“There were increased fire risks in the building, associated with a person smoking.” from the report
Staffing and training
seriousThere were not enough suitably skilled staff to provide person-centred care. People sometimes waited for care, while some staff lacked essential training, supervision or induction.
“There were not enough staff on duty to provide person centred care.” from the report
Social activities
seriousPeople were not consistently offered meaningful activities or social interaction based on their interests. This was particularly limited for people cared for in bed.
“People were not provided with opportunities to engage in meaningful activities and there was little social interaction between staff and people.” from the report
Records and oversight
seriousCare plans, risk assessments, safeguarding records, food and fluid charts and audits were not consistently accurate or complete. Management systems failed to identify and correct several problems.
“Auditing and oversight of the service were not robust.” from the report
Food records
seriousFood and fluid charts were not always completed fully, and one person's diet was recorded incorrectly on the meal preparation lists despite a possible choking risk.
“One person's diet was recorded incorrectly on the lists staff were using to prepare meals.” from the report
- 01What changes have you made to ensure every person's medicines are in stock, given correctly and checked promptly when there is an error?
- 02How many suitably trained staff are on duty on each shift, and how do you prevent people waiting for call bells or personal care?
- 03What fire safety actions have been completed, including evacuation practice and the risks linked to smoking?
- 04What meaningful activities are now available for each person, including people who are cared for in bed?
- 05How do you check that care plans, risk assessments, safeguarding records and food and fluid charts are accurate and up to date?
This was a focused inspection prompted by concerns about infection control, nutrition and management, and it was widened to include Responsive after inspectors found concerns about social needs; Caring was not given a new rating. This explanation was written from the published report of 21 September 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.
Every inspection of Willow Green Care Home
9 rated inspections over 8 years: the service has held its Good rating throughout.
- October 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2022Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- May 2021GoodEffective: Good
- January 2021Inspected but not ratedSafe: Inspected but not rated
- December 2020Requires improvementstayed Requires improvementSafe: GoodResponsive: GoodWell-led: Good
- October 2020Requires improvementstayed Requires improvementSafe: Inspected but not ratedWell-led: Inspected but not rated
- February 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2018Goodstayed GoodEffective: GoodWell-led: Good
- May 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- February 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- September 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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Most charge £970 to £1,230 a week. 35 can care for a couple. 11 years' experience on average.
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