The Willows

Updated 7 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the 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.

The inspection visit was unannounced and took place on 08 and 09 November 2018.

On the first day of our inspection we visited The Willows and on the second day we visited the headquarters of the provider to review staff recruitment files, policies and procedures and other records not routinely kept at the home.

Prior to our inspection, we requested the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information had been completed and returned to us and was used in planning this inspection.

We reviewed all the information which the Care Quality Commission already held about the service, such as intelligence, statutory notifications or any information received from third parties. We also contacted the local authority to obtain their view of the quality of care delivered by the service. We took any information provided to us into account.

During the inspection, we spoke with the registered manager, one of the two deputy managers and three care staff. We met and observed three people receiving support from the service, we spoke with two relatives during our visit to The Willows and we later phoned and spoke with a further four relatives to seek their feedback on the service. We also phoned and spoke with three health and social care professionals.

We looked at four care files, six staff recruitment files, training records and other records relating to the running of the service such as audits and maintenance records. We observed the interactions of staff and people in and around the home throughout the first day.

Updated 7 February 2019

We completed a comprehensive inspection of this service on the 08 and 09 November 2018. The first day was unannounced; the second day was announced as we needed to be able to access various records at the headquarters of the provider.

At our last inspection in November 2015 the service was rated outstanding. In June 2017 CQC published Registering the Right Support. This along with associated good practice guidance sets out the values and standards of support expected for services supporting people with a learning disability.

At this inspection we assessed the service in line with this guidance and therefore after this inspection of The Willows we rated the service as good. This was because The Willows did not meet the values and principles of Registering the Right Support and associated guidance. Current good practice guidance encompasses the values of choice, independence, inclusion and living as ordinary a life as any citizen. The size, layout, staffing arrangements at The Willows meant that it does not feel or operate as the people's home. Certain physical aspects to the building and staff practices felt institutional and detracted from a homely atmosphere. As an example, we saw that the office was a hub within the home with staff and people living there spending a significant part of their time in or near to it. The building is on a campus and does not lie within the heart of the ordinary community which is difficult to access other than by a vehicle.

The Willows is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Willows is registered to accommodate eight people in one specially designed and purpose-built building. At the time of our inspection there were eight people living there. These people were unable to give us verbal feedback about their views on the service but we observed them and their interactions with staff, during our inspection. We ensured that we had as many opinions from their relatives and health and social care professionals to support our own observations.

The home requires a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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. There was a registered manager in place who had been in post for several years.

We found that the home was a safe environment for people, who were supported by properly recruited staff who administered their medication correctly and who followed the policies and procedures of the provider. There were appropriate staffing levels and people were treated without discrimination and their human rights were protected and promoted. Staff knew how to safeguard people from abuse and how to report any concerns about this or any other accident or incident.

The building had been purpose-built specifically for people who were on the autism spectrum. We saw that it was well maintained.

Staff were well-trained and supervised and had the skills and knowledge to deliver effective support to people living in the home. Staff were encouraged to develop their skills by attending local and nationally organised specialist events. They had an understanding of the Mental Capacity Act 2005 and worked with other agencies to ensure that people had the right support. The service was also effective by supporting people in their everyday lives, by using many technological methods, such as electronic tablets which helped people to communicate.

Staff treated everybody with kindness and compassion and involved them in decision-making. They actively promoted people’s equality and diversity, gave explanations and information in a way that people could understand and promoted people’s well-being and right to privacy.

We saw that all the staff treated people as individuals. Staff were involved in people’s care planning and the records we saw demonstrated that each care plan was individual to the person it was about. Relatives told us they were actively involved in any reviews about their family member’s care plans.

The people who lived in The Willows were engaged in various activities throughout each day and their relatives told us that they had seen many improvements in them, since our last inspection, such as improved overall health and being supported to make healthy lifestyle choices and another person having better communication.

Any information about the service, the activities available, or any individual information a person would need, was available in a format that they would understand.

The management of the service had developed and now included two part-time deputy managers, who were able to cover each other’s absences. All the management and the staff were open and transparent and were able to give us all the information we needed to complete our inspection. We saw that worked well with other health and social care professionals to provide holistic support to each individual person who lived in The Willows.

The service completed various quality checks and audits including questionnaires to people using it, their relative’s and health and social care professionals. We saw that they learned from any mistakes made.