This unannounced inspection of Willow Tree Lodge took place on 22 and 24 October 2015. The home provides accommodation and support for up to four people who have learning disabilities or autism. The primary aim at Willow Tree Lodge is to support people to lead a full and active life within their local communities and continue with life-long learning and personal development. The service is a detached bungalow, within a residential area, which has been furnished to meet individual needs.
At the time of the inspection there were four people living in the home. Three people had their own en-suite bedroom and one had a separate lounge, bathroom and bedroom, all of which had been specially adapted to meet their needs. The rear garden had been adapted to provide recreational areas to meet particular individual’s needs. A small garden at the front had been created to provide a peaceful haven for one of the people living at the home.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People and relatives told us they trusted the staff completely as they provided reassurance when people worried and made them feel safe. Staff had completed safeguarding training and had access to current legislation and guidance. Staff had identified and responded appropriately to safeguarding incidents to protect people from harm. People were safeguarded from the risk of abuse as incidents were reported and acted upon.
Where risks to people had been identified in their care plans measures were implemented to manage these. Staff understood the risks to people’s health and welfare, and followed guidance to manage them safely. People were kept safe by staff who demonstrated their understanding of people’s risk assessments and management plans.
There were sufficient numbers of staff deployed with the necessary experience and skills to support people safely. The registered manager completed a weekly staffing needs analysis in order to ensure that any changes in people’s needs were met by enough suitable staff.
Staff had undergone required pre-employment checks, to ensure people were protected from the risk of being supported by unsuitable staff. Staff had received an induction into their role, required training and regular supervision which prepared them to carry out their roles and responsibilities.
People were cared for by sufficient numbers of well trained staff who were effectively supported by the registered manager and senior staff.
Medicines were administered safely in a way people preferred, by trained staff who had their competency regularly assessed by the provider. Medicines were stored and disposed of safely, in accordance with current legislation and guidance.
People were actively involved in making decisions about their care and were always asked for their consent before any support was provided. Staff supported people to identify their individual wishes and needs by using their individual and unique methods of communication. People were encouraged to be as independent as they were able to be, as safely as possible.
Staff had completed training on the Mental Capacity Act (MCA) 2005 and understood their responsibilities. The MCA 2005 legislation provides a legal framework that sets out how to support people who do not have capacity to make a specific decision. Where people lacked the capacity to consent to their care, legal requirements had been followed by staff when decisions were made on their behalf. People were supported by staff to make day to day decisions.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide a lawful way to deprive someone of their liberty, where it is in their best interests or is necessary to protect them from harm. The registered manager had completed the required training and was aware of relevant case law. Since the last inspection the provider had made four DoLS applications, two of which had been authorised and appropriately notified to the CQC. The provider was awaiting the decision in relation to two further applications. The registered manager had taken the necessary action to ensure people’s human rights were recognised and protected.
People were provided with nutritious food and drink, which met their dietary preferences and requirements. People were supported to eat a healthy diet of their choice.
People’s dignity and privacy were respected at all times and supported by staff. Where people’s needs changed these were identified by staff and reported to relevant healthcare services promptly where required.
The provider had deployed sufficient staff to provide stimulating activities for people. The activities programme ensured people were supported to pursue social activities which protected them from social isolation.
Relatives told us they knew how to complain and that the provider encouraged them to raise concerns. No complaints had been made since the last inspection. When minor concerns were raised records showed they were investigated and action was taken by the provider to make improvements where required.
Staff had received training in the values of the provider, which we observed being demonstrated in practice. Relatives and staff told us the service was well managed, with an open and positive culture. People, relatives and staff told us the registered manager was very approachable, willing to listen and make any necessary changes to improve things for people. Staff told us the strength of their home compared to others was their commitment to people and that they did their very best to make sure people were happy and had fulfilling and rewarding lives. The senior staff provided clear and direct leadership and effectively operated systems to assure the quality of the home and drive improvements.
Records accurately reflected people’s needs and were up to date. Detailed care plans and risk assessments were fully completed and provided necessary guidance for staff to provide the required support to meet people’s needs. Other records relating to the running of the home such as audit records and health and safety maintenance records were accurate and up-to-date. People’s and staff records were stored securely, protecting their confidential information from unauthorised persons, whilst remaining accessible to authorised staff.