Willow Brook

Updated 27 May 2020

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 Care Act 2014.

Inspection team

This inspection was carried out by two inspectors on day one and two of the inspection, and one inspector on day three of the inspection.

Service and service type

This service provides care and support to people living in five ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service did not have a manager registered with the Care Quality Commission. This means the provider is solely responsible, legally, for how the service is run and for the quality and safety of the care provided. However, a manager had applied to register with the Commission and their application was being processed.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We interacted with, and had limited conversations with, two people who used the service. However, most people using the service were not able to verbally express their views. We spoke with 10 members of staff including the manager, two operational managers, a deputy manager and some care workers.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at five 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 reviewed.

Updated 27 May 2020

About the service

Willow Brook is a domiciliary service that provides care and support for people with mental health needs, a learning difficulty and physical care needs. The service provides personal care to people living in five 'supported living' houses. Staff provided support to people in each of the houses on a 24/7 basis. At the time of our inspection the service was supporting seven people with personal care needs.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

‘As required’ medicine (PRN) protocols were not always detailed and PRN protocols were not completed for one person. Care plans and risk assessments did not always contain enough information to guide staff.

Best interest decisions had not always been recorded following a mental capacity assessment.

People were not always supported effectively with their communication needs. We made a recommendation about this.

The provider and the manager had taken steps to improve the service and ensured people received safer care. An action plan to address the warning notices issued by CQC had been implemented. All the requirements of the warning notices had been met.

Arrangements were in place for obtaining, storing, administering and disposing of medicines in accordance with best practice guidance. Staff knowledge had improved, and people received their medicines as required.

People were safeguarded from abuse and significant events were being reported to CQC as required.

An effective system had been developed and put in place to record and respond to complaints. Lessons learnt were shared throughout the staff team.

Recruitment was managed in line with the provider’s policy to ensure suitable staff were employed.

We observed people were treated with dignity and respect throughout the inspection.

End of life care plans were in place and managed in line with best practice guidance.

Systems and processes were in place for quality assurance and monitoring, these were being improved further. These needed to be embedded into practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 19 December 2019) when there were six breaches of regulation.

Following our last inspection, we served a warning notice on the provider. We required them to be compliant with Regulation 13 (Safeguarding service users from abuse and improper treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and, Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 by 8 February 2020. The provider sent us a monthly action plan detailing how they are going to progress and improve. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection started as a targeted inspection based on the warning notices, we served on the provider following our last inspection. CQC are conducting trials of targeted inspections to measure their effectiveness in services where we served a warning notice. However, due to the significant improvements that had been made we moved to a comprehensive inspection which meant we looked at all five key questions.

We undertook this inspection to check the provider now met legal requirements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Willowbrook on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.