CQC report explained · a residential care home
What the CQC found at Willow House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks were assessed and managed, medicines were given as prescribed, and there were enough staff.
- Effective?
- Good
- Staff had suitable training and understood people's complex needs. People were supported with consent, nutrition, hydration and their health needs.
- Caring?
- Good
- Staff were kind, respectful and knew people well. People were supported to make choices, maintain privacy and build independence.
- Responsive?
- Good
- Care was tailored to people's needs and preferences. People had meaningful activities, support to maintain relationships and ways to raise concerns.
- Well-led?
- Good
- The home had a registered manager and effective systems to monitor quality and safety. People and staff were positive about how it was managed.
What inspectors found, September 2018
Rated Good; inspectors found safe, kind and person-centred care, with improvements made after the previous inspection.
This was an unannounced inspection on 07 August 2018. One inspector and an expert by experience visited, spoke with people and staff, observed care and checked care plans, medicines, recruitment files, incident records, complaints and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitably checked staff, well-managed risks, safe medicines systems and clean surroundings. Staff understood people's needs and supported their health, communication, choices, privacy and independence.
The previous inspection in January 2017 found a breach of Regulation 17 and rated the service Requires Improvement. This inspection found the required improvements had been made, and the breach no longer applied.
Safe staffing and risk support
Inspectors found enough staff, with the flexibility to support appointments and activities. Staff understood people's risks inside and outside the home.
“We saw that people were supported by sufficient numbers of staff.” from the report
Kind and respectful care
People appeared relaxed around staff. Staff supported privacy, dignity, communication and personal choices.
“Staff were caring and treated people with respect.” from the report
Choice and independence
People were supported to make daily decisions, take part in activities and develop life skills. Activities included trips, college and use of public transport.
“People were encouraged to maintain their independence and live active and fulfilling lives” from the report
Improved management
The provider had strengthened its checks and monitoring since the previous inspection. The registered manager sought feedback and acted when issues were identified.
“The provider had a range of audits and checks to monitor the quality and safety of the service.” from the report
Laundry and cleaning security
needs fixingThe laundry was accessed through the kitchen and was not initially secured. A cupboard containing cleaning materials was also unlocked, although staff locked it when inspectors raised the issue and further action was taken afterwards.
“We saw that a cupboard containing cleaning materials was shut but not locked with the key that was in the lock.” from the report
Personal information displayed
minorSome personal goals were displayed in communal areas where visitors could read them. The manager took immediate steps to keep personal goals in private records.
“some of this information was of a personal nature and it was not appropriate for this to be displayed in communal areas” from the report
- 01How are the laundry room and cupboards containing cleaning materials kept locked now?
- 02How do you protect people's personal goals and other confidential information from being seen by visitors?
- 03How are incidents and accidents analysed now, and what changes have been made as a result?
- 04What is the current position on any outstanding Deprivation of Liberty Safeguards applications?
- 05How will you support my relative to choose activities and build independence in daily tasks?
This was an unannounced inspection covering all five key questions, with the previous Requires Improvement ratings and Regulation 17 breach reviewed. This explanation was written from the published report of 22 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.
What inspectors found, March 2017
Willow House was rated Requires Improvement; inspectors found kind care and good support with health needs, but risks, activities and management checks needed improvement.
This was an unannounced inspection on 19 January 2017. One inspector spoke with staff, managers, one person, relatives and health professionals. They observed care and checked care plans, risk records, medicines, staffing, complaints and quality checks.
The home was rated Good for Effective and Caring. Staff were trained and supported people with food, healthcare, communication, privacy and dignity. Relatives said people were cared for well, and inspectors saw kind and respectful support.
The home was rated Requires Improvement for Safe, Responsive and Well-led. Risk records did not always give staff enough guidance. Some as-needed medicine instructions were not clear. Activities inside the home were not consistently planned, and people were not always supported to be involved in their care or become more independent.
The provider had breached Regulation 17 because its systems did not effectively identify and manage risks or drive improvements. This was the first ratings inspection since registration in September 2015. The home did not have a registered manager at the time, although an acting manager was applying for registration.
Kind and respectful care
Inspectors saw staff treat people warmly and respond supportively to their communication. Relatives and staff also described caring relationships.
“During our visit we spent time in the communal areas and saw that staff interacted with people in a warm and kind way.” from the report
Trained staff
Staff had induction, relevant training and regular supervision. Training included areas linked to the needs of people living in the home.
“This meant that staff were supported to have the knowledge and skills they needed for their role.” from the report
Food and healthcare
People had enough varied food and drink suited to their preferences. Staff supported people to use health services and kept health action plans.
“We found that people had sufficient food and drink to meet their needs.” from the report
Enough familiar staff
Inspectors found enough staff to meet people's needs. People were supported by a core group of staff they knew.
“This meant that people were supported by staff they knew and were comfortable with.” from the report
Family contact and complaints
Relatives were welcomed and supported to stay in contact. Complaints were handled in line with the provider's process.
“Each of the complaints received had been dealt with appropriately in line with the provider's procedure.” from the report
Risk guidance was unclear
seriousStaff did not always know the level of support people needed or how to manage particular risks. One risk assessment was not updated for more than two weeks after an injury.
“People were not kept consistently safe as arrangements to manage risks did not give staff clear and sufficient guidance.” from the report
As-needed medicines
seriousInstructions did not explain clearly enough when some as-needed medicines should be given. One person's pain relief was not given until some days after it was first prescribed.
“We found that people did not always receive appropriate support where medicines were prescribed to be administered on an 'as required' basis (PRN).” from the report
Limited activities inside the home
needs fixingPeople took part in community activities, but meaningful activities and stimulation inside the home were not consistently planned. Inspectors saw staff respond to people but not proactively engage them.
“Individual stimulation and occupation for people when they were in the home was not consistently planned and provided.” from the report
Limited involvement and independence
needs fixingIt was unclear how people who did not communicate verbally were involved in care planning. Records and staff practice did not show enough focus on developing independence skills.
“People's records did not indicate that increasing people's independence skills had been considered as part of their care and support.” from the report
Weak quality monitoring
seriousAudits did not identify important problems with risk assessments and as-needed medicine guidance. Feedback from people and relatives was not formally collected and used to improve the home.
“The provider had not ensured that an effective system was in place to identify and manage risks and drive up improvements within the home.” from the report
- 01What new process is now used to make sure risk assessments are updated immediately when someone's needs or health changes?
- 02How do staff know when each person's as-needed medicine should be given, and how is this checked?
- 03What meaningful activities are now available inside the home for each person, including activities they have asked to do?
- 04How are people who do not communicate verbally involved in care planning and best-interest decisions?
- 05What quality checks and feedback systems are now used to identify problems and track improvements?
This was the first ratings inspection and covered all five key questions through observations, discussions and records reviewed on 19 January 2017. This explanation was written from the published report of 17 March 2017 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 House
2 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2015
Registered with the Care Quality Commission on 17 September 2015.
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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