CQC report explained · a residential care home
What the CQC found at Willow Health Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Risks were identified, but inspectors found that they were not always managed consistently. They found accessible substances, disorganised safety information, worn or damaged areas and staffing vacancies.
- Effective?
- Good
- People's needs were assessed and care plans were reviewed. Staff received induction, training and competency checks, and people had support with food, healthcare and decision-making.
- Caring?
- Good
- People were treated with dignity and respect. Staff knew people well, supported communication and offered choices and help with independence.
- Responsive?
- Good
- Care plans were detailed and focused more strongly on choice and individuality. People had communication support, family contact and a wider range of activities.
- Well-led?
- Good
- The manager was described as knowledgeable and approachable, and quality checks had improved. Staff and relatives reported better communication and positive changes in the home.
What inspectors found, July 2019
Rated Good overall; inspectors found kind, person-centred care, but safety needed improvement.
This was an unannounced inspection on 8 and 10 July 2019. The inspector spoke with people living in the home, relatives, staff and managers. They reviewed care plans, medicines records, recruitment records and quality checks.
The overall rating was Good. Effective, caring, responsive and well-led care were rated Good. People were treated with dignity, had choices, received personalised support and had access to activities and healthcare.
Safe was rated Requires Improvement. Inspectors found risks were identified but not always managed consistently. They found accessible cleaning substances, disorganised safety records, worn or damaged surfaces and staffing vacancies. The home took some immediate action and had plans for further work.
The rating had improved from Requires Improvement at the previous inspection. Responsive and well-led improved to Good, while Safe remained Requires Improvement.
Safe medicines support
Medicines were securely stored, given as prescribed and checked against records. Staff training and competency checks were also in place.
“Medicines were securely stored, and people received their medicines as prescribed.” from the report
Personalised care
Care plans gave detailed information about people's needs, preferences and communication. Staff supported people to make choices and become more independent.
“People had detailed care plans which set out their needs and how they should be met.” from the report
Kind and respectful staff
People appeared relaxed with staff. Inspectors saw warm interactions, respect for privacy and support for maintaining family relationships.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Activities and community life
People had individual activity timetables and access to local places and trips. Inspectors noted that participation had increased since the previous inspection.
“People's access to activities had improved since the last inspection and it was positive to note people were participating in a wider range of opportunities.” from the report
Risks were not always managed consistently
seriousInspectors found substances accessible in the laundry and concerns about the organisation of safety information. The report says this created an increased risk that people could be harmed.
“This meant some aspects of the service were not always safe and there was limited assurance about safety.” from the report
Worn and damaged areas
needs fixingSome flooring and wall tiles were cracked or broken, carpets were worn and stained, and a commode was corroding. These issues had been identified but had not yet been dealt with.
“Some flooring and wall tiles were cracked or broken. We saw several carpets were worn and stained.” from the report
Staffing vacancies
needs fixingThere were two vacancies, so bank and agency staff were being used. Staffing met immediate needs, but some activities had to take place as a group rather than being fully individualised.
“In the interim they were dependent on bank and agency staff to provide cover.” from the report
End of life wishes not recorded
minorNo one was receiving end of life care during the inspection, but people's care plans did not record their preferred care. The manager said this would be explored with families.
“People's care plans lacked information regarding their preferred end of life care.” from the report
- 01Have the cracked tiles, worn carpets and corroding commode now been repaired or replaced?
- 02How do you now organise and track safety certificates and inspections so that checks are not missed?
- 03Have the two staffing vacancies been filled, and how often are bank or agency staff used?
- 04How will you record and review each person's preferred end of life care?
- 05How will you make sure people can have individual activities and support rather than activities always being done as a group?
This was a planned, unannounced inspection covering all five CQC questions, including the premises and the care provided. This explanation was written from the published report of 27 July 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, July 2018
Willow Health Limited was rated Requires Improvement; care was kind and medicines had improved, but safety records, staffing, care plans and management needed further work.
The inspection was unannounced and took place on 22 May 2018. One inspector and an expert by experience visited. They spoke with people, relatives, staff and the manager. They observed care and checked care records, medicines, staffing, recruitment, training and quality checks.
The home had made progress since the previous inspection in April 2017. Medicines were stored more safely, safeguarding processes had improved and staff had a better understanding of people's rights and choices. People were treated kindly, supported with food and healthcare, and had more activities.
The inspectors still found important gaps. Safety records were not well organised, staffing vacancies meant the home relied on agency staff, and care plans were not always up to date or easy to use. Quality checks were not developed enough to identify and manage all problems.
Kind and respectful care
People appeared relaxed with staff. Staff supported people's dignity, independence, communication and family relationships.
“Staff were kind and respectful in their interactions.” from the report
Better activities
People had more varied activities and were living busier lives than at previous inspections.
“At this inspection we found that people's lives were busier and their access to activities had significantly improved.” from the report
Health and nutrition
People had access to health professionals, and their food and drink needs were met.
“People had good access to healthcare and were supported to lead healthier lives.” from the report
Safety records
seriousSafety information was not organised well enough to give reliable oversight. The report also found missing personal evacuation plans and gaps in some safety checks.
“The organisation of records did not always support effective oversight of safety and this meant that there were gaps which placed people at risk.” from the report
Staffing levels
needs fixingThere were two vacancies and the home relied on agency staff. Staff could meet immediate needs, but activities were often done as a group rather than being tailored to each person.
“There were some staffing vacancies and the service was dependent on agency staff.” from the report
Care plans
needs fixingCare plans contained duplication and were not always current or specific enough. They included little information about people's aspirations and goals.
“The folders were large, there was a lot of duplication which meant that information was not easy to find nor always specific enough.” from the report
Quality monitoring
needs fixingThe manager had started audits, but they were at an early stage. The provider had not yet supported the manager with a clear improvement plan and timescales.
“Quality assurance systems were in place but were not well developed.” from the report
- 01What has been done to make safety records complete and easy to check?
- 02Are all personal evacuation plans now in place and are fire safety checks up to date?
- 03How many permanent staff vacancies remain, and how often is agency staff used?
- 04Have all care plans been reviewed so they reflect current needs, communication methods and personal goals?
- 05What improvement plan is now in place, and how is progress checked by the provider?
This inspection considered all five key questions and followed up progress since the previous inspection in April 2017. This explanation was written from the published report of 27 July 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 Health Limited
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- July 2019Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 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 6 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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