Archived: Willow House

Updated 24 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected the service on 23 September and 3 October 2016. The inspection was unannounced. This meant the registered provider and staff did not know we would be visiting. The inspection was completed by one Adult Social Care Inspector.

Before our inspection, we asked the registered provider to complete a Provider Information Return (PIR). This was completed and returned within the agreed timescales. The PIR is a form that asks registered providers to give some key information about the service, what the service does well and what improvements they plan to make. We looked at information we held about the service, which included information shared with the Care Quality Commission (CQC) via our public website and notifications sent to us since our last inspection of the service. Notifications are when registered providers send us information about certain changes, events or incidents that occur within the service. We used this information to plan our inspection.

During the inspection, we spoke with six people who used the service and four visitors who were their relatives or friends. We spoke with the head of service responsible for overseeing all of the registered provider’s services, a service manager, the deputy manager, three care staff and the cook.

We reviewed four people’s care files, recruitment, training and supervision records for three members of staff, medication records and a selection of records used to monitor the quality of the service. We observed interactions between staff and people who used the service and observed lunch being served in the main dining room.

Updated 24 November 2016

Willow House is a residential care service owned and run by City of York Council. It is registered to provide personal care and accommodation for up to 33 older people. The service is purpose built and accommodation is provided across two floors with lift access. The service is situated overlooking York city walls. There is parking available on-site.

At the time of our inspection, the registered provider was in the process of undertaking a consultation regarding the possible closure of Willow House. We inspected this service on 23 September and 3 October 2016. The inspection was unannounced. This meant the registered provider and staff did not know we would be visiting. At the time of our inspection, Willow House provided permanent accommodation, but also had 4 ‘step-down’ beds providing temporary accommodation for people being discharged from hospital. There were 23 people using the service; 22 people living at the service and one person staying there temporarily in a ‘step-down’ bed.

The service was last inspected in January 2014 and was compliant with the regulations in force at that time.

The registered provider is required to have a registered manager as a condition of their registration for this service. The service did have a manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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.

During our inspection, we received positive feedback about the management at Willow House. However, we identified a number of issues or concerns relating to the running of the service which demonstrated that the service had not been consistently well-led. Although work was on-going to address a number of these issues and concerns, further progress was needed.

We identified that care plans contained person centred information about people’s needs and how those needs should be met by staff. However, we found that care plans and risk assessments had not always been updated to reflect people’s changing needs and to provide up-to-date guidance to staff about how to safely support that person to meet their needs. We found that Personal Emergency Evacuation Plans (PEEPs) were completed, but had not consistently been added to the ‘emergency file’ when new people had moved into the service. We found that regular fire drills had not been completed.

We received mixed feedback about staffing levels and concerns about the cleanliness of the service. These issues were being addressed and steps taken to ensure that sufficient numbers of general assistants were deployed to keep the service clean. However, we made a recommendation about monitoring staffing levels and staff deployment in the body of our report.

Training records showed that staff training had not been kept up-to-date. The registered provider was in the process of addressing this at the time of our inspection. We have made a recommendation about monitoring staff training in the body of our report.

People who used the service told us there were not enough activities on offer at Willow House. We have made a recommendation about improving the support available to people to engage in meaningful activities in the body of our report.

People who used the service told us they felt safe and we found that people were safely supported to take prescribed medicines. The home environment and equipment used were checked regularly to ensure they were in safe working order.

People who used the service were supported to make decision and had choice and control over their care and support. Consent to care and treatment was sought in line with relevant legislation and guidance. The deprivation of liberty safeguards (DoLS) were appropriately used to ensure people’s human rights were protected.

People who used the service were positive about the food provided at Willow House and staff encouraged people to eat and drink enough. However, accurate records were not consistently kept of people’s food and fluid intake. Although the registered provider had addressed these concerns by the second day of our inspection this was evidence of reactive not proactive management.

People were supported to access healthcare services where necessary and appropriate advice and guidance was sought following accidents and incidents to promote good health and keep people safe.

Staff were generally described as kind and caring. Staff treated people who used the service in a way that maintained their privacy and dignity. Staff demonstrated that they understood people’s needs and how best to support them.

There were systems in place to gather feedback about the service provided, share information and manage complaints. The registered provider had a system of quality assurance audits to monitor and improve the safety and effectiveness of the service provided.

We found a breach of regulation relating to safe care and treatment. You can see what action we told the provider to take at the back of the full version of the report.