Willow View Care Home

Updated 22 March 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors, an operations manager and a pharmacy inspector. An Expert by Experience made telephone calls to people following the site visits. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Willow View Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Willow View Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The previous registered manager had left the home in June 2023. Another manager was appointed but they left the service in November 2023. A new manager had been recruited and they commenced employment in December 2023, and they planned to register with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We reviewed a range of records. This included 8 people's care records and multiple medication records. We looked at 5 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

We spoke with 7 people who used the service and 8 relatives about their experience of the care provided. We spoke with 10 members of staff including the manager, deputy manager, clinical lead, senior carers, care staff, maintenance person and the chef. We also spent time observing staff interactions with people and conducted a tour of the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 22 March 2024

About the service

Willow View Care Home is a residential care home providing personal care to up to 77 people. The service provides support to older people, some of whom may be living with a dementia, physical disability or sensory impairment. The home is divided into 2 areas: Willow View and Willow Gardens. The 2 areas are joined by a covered walkway, and both areas comprise of 2 floors. At the time of our inspection there were 42 people living at the service.

People’s experience of using this service and what we found

Risks to people’s safety were assessed and recorded. However, risk assessments had not always been updated when changes occurred and some care plans contained contradictory information. Environmental risks had not always been identified and mitigated where possible. We found call bells that were inaccessible to people.

New recruitment processes were in place but they had not always been fully followed and gaps in recruitment records remained.

Improvements had been made to medicine management. However, records did not always reflect the prescriber instructions. Medicines prescribed to assist with bowel movements had not always been given in a timely manner.

Overall, some improvements had been made in relation to infection, prevention and control. However, Covid guidance was not being followed and dirty items were found in communal areas.

People had not always been provided with sufficient fluids and recommended modified diets had not always been followed.

Quality assurance processes were now in place. They failed to identify some of the shortfalls found during this inspection. Provider oversight had improved. Provider level audits were completed, but there was a lack of recorded evidence of action taken to address the shortfalls identified.

There was enough staff on duty to meet people’s needs. An effective dependency tool was now in place and used to help calculate safe staffing levels.

Staff had been provided with additional training following the last inspection. Staff told us they felt very well supported by the new manager.

People were supported to have maximum choice and control of their lives and staff supported /did them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Appropriate signed consent was now in place.

Staff were now working effectively with other professionals. Where staff had concerns, referrals had been made in a timely manner. Professionals spoke positively of the improvements made to the service since the new manager was appointed in December 2023.

People and relatives told us staff were kind and caring and treat them like family. A new activities coordinator had been recruited and a variety of activities were on offer. People and relatives had been asked to provide feedback on the service and felt their views were listened to and acted upon.

A new process was in place to ensure complaints were recorded and acted upon appropriately. Accidents and incidents were now fully recorded and appropriate post falls checks were in place.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (report published 12 July 2023).

At this inspection we found the provider remained in breach of some regulations.

This service has been in Special Measures since 12 July 2023. During this inspection the provider demonstrated that some improvements have been made. However, further improvements are needed, and the service remains rated inadequate in the Safe domain.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 4, 9, 10 and 22 May 2023. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve dignity and respect, consent, safe care and treatment, good governance and oversight and staffing levels and deployment.

We undertook this inspection to check they had followed their action plan and to confirm they now met legal requirements.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

We have found evidence that the provider still needs to make improvements. Please see the Safe, Effective and Well-led sections of this full report.

Enforcement and Recommendations

We have identified breaches in relation to medicine management, infection prevention and control, assessing risk and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.