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
- Inspectors found suitable staffing, safe medicines systems and processes to protect people from abuse. Some risk assessments were missing, but these were updated during the inspection.
- Effective?
- Good
- Care plans were detailed and individual, and staff received induction and training relevant to people's needs. Inspectors noted that some best-interests records did not include joint decisions with other professionals.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors observed respectful support that promoted privacy, dignity, independence and personal choices.
- Responsive?
- Good
- Care plans reflected people's preferences and communication needs. The home provided activities, one-to-one support and help to maintain relationships and community links.
- Well-led?
- Good
- Inspectors found an open, positive culture and regular checks on care, medicines, staff records and other areas. A service improvement plan tracked actions, deadlines and responsibility.
What inspectors found, August 2019
Willow House was rated Good; inspectors found safe, kind and personalised care, with some records needing improvement.
This was an unannounced planned inspection on 2 and 4 July 2019. One inspector spoke with people living in the home, relatives, staff, managers and two visiting professionals. They reviewed care records, staff files, medicines records and management records.
The home was rated Good overall and received Good ratings for Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitable staff, safe medicines procedures, well-trained staff and care that reflected people's needs and preferences.
There were some shortfalls. Some risk assessments were missing, although these were updated during the inspection. Records about some best-interests decisions did not show joint decisions with other professionals, and the manager agreed to review whether further liberty safeguards applications were needed.
Safe medicines and staffing
Staff were trained and checked as competent to give medicines. Inspectors found enough suitable staff and accurate, up-to-date medicines records.
“Records relating to medicines were accurate, complete and up to date.” from the report
Personalised care
Care plans contained detailed information about people's needs and preferences. Staff said the plans gave them clear instructions for providing individual support.
“People's needs were captured in comprehensive care plans which contained detailed information about how they wished to receive care and support.” from the report
Kind and respectful relationships
Inspectors saw warm and caring interactions. People were supported to make choices, retain their privacy and stay as independent as possible.
“People had developed caring and meaningful relationships with staff.” from the report
Activities and relationships
The home offered activities based on people's interests, including dementia-focused reminiscence work, outdoor activities and one-to-one support. It also helped people keep in touch with family and the community.
“This helped minimise the risk of social isolation. One to one activities were also offered to people who did not wish to engage in group activities.” from the report
Open management
The home had regular quality checks, feedback systems and an improvement plan. Inspectors described the culture as positive and empowering.
“There was a robust governance system in place to ensure there was appropriate oversight of the service to identify improvements needed.” from the report
Missing risk assessments
seriousSome people's risk assessments were missing. The manager said this was an electronic recording error and updated them during the inspection.
“We noted that some risk assessments were missing.” from the report
Best-interests records
needs fixingSome records documented best-interests decisions but did not show joint decisions with other professionals. The manager said future records would identify multi-agency decisions.
“Discussions and decisions had been documented in people's care files, however these did not include joint best interests decisions with other professionals.” from the report
Liberty safeguards review
needs fixingThe manager agreed to ask the local authority to review whether applications were needed for some people who might need to be prevented from leaving the home.
“The registered manager was going to contact the local authority to review whether applications needed to be made for some people.” from the report
- 01Have all current risk assessments been completed, and how are staff alerted when a person's risks change?
- 02How are best-interests decisions recorded now, including decisions made with other professionals?
- 03What was the outcome of the local authority review about applications for liberty safeguards?
- 04Which activities are available for people who prefer one-to-one support or do not want group activities?
- 05How are medicines records checked and any gaps followed up?
This was an unannounced planned inspection covering all five CQC questions, with the home, care records, staff records, medicines and management systems reviewed. This explanation was written from the published report of 31 August 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, January 2017
Willow House was rated Good; inspectors found kind, safe care and improvements since the previous inspection.
This was an unannounced, comprehensive inspection. Inspectors observed care, including mealtimes and medicines, spoke with people, staff, a relative and a healthcare professional, and checked care records, staff files, training records and safety checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines arrangements, personalised care, respectful support and activities that people enjoyed.
The previous inspection found breaches about staff recruitment and quality monitoring. At this inspection, the provider had improved these areas. New checks, better recruitment records, staff training and supervision systems were in place and were found to be effective.
Safe medicines
Inspectors found that medicines were stored, checked and given safely. Records showed people received the right medicines at the right times.
“The medication administration records seen, were accurate and showed that people had received the correct amount of medicine at the right times.” from the report
Kind relationships
People described staff as kind and unhurried. Inspectors saw warm, respectful interactions and support for people's privacy and dignity.
“We observed many warm and friendly interactions.” from the report
Personalised care
Care plans included people's background, preferences, routines and the help they needed. Staff used this information when providing care and conversation.
“Personal information was available for each person, which included details of the person's background and preferences, such as bed time routines so staff would know how to plan and deliver care.” from the report
Improved oversight
The provider introduced regular checks covering medicines, infection control, safety, care plans and risk assessments. These checks led to changes such as new fire doors and improved care planning.
“The provider had put new systems in place to monitor safety and drive improvements in the quality of the home.” from the report
Some decision records were still being updated
needs fixingThe manager found that some people's mental capacity to consent to care had not been recorded in their care plans. The records were being reviewed and assessments were being completed where needed.
“The registered manager had identified that some people's mental capacity to consent to their care had not been recorded in their care plans.” from the report
- 01Have all mental capacity assessments and best-interest decisions for my relative now been completed and recorded?
- 02How would staff support my relative's dementia, including their routines, communication and any anxiety?
- 03How many staff are normally on each shift, and how would staffing be covered if someone is off sick?
- 04What activities and support are available for people who prefer not to join group activities?
- 05How would my relative use the garden and shared bathroom facilities, and what privacy arrangements are in place?
This was an unannounced comprehensive inspection of all five areas, although the report gives inconsistent visit dates and says both 9 and 13 December and 9 and 12 December 2016. This explanation was written from the published report of 13 January 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
4 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 24 November 2010.
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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