Background to this inspection
Updated
14 July 2023
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by 1 inspector.
Service and service type
Willowbeech 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. Willowbeech 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 a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We sought feedback from the local authority and used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 1 person and 3 relatives about their experience of the care provided. We received feedback from 12 members of staff including the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received written responses from 5 health and social care professionals.
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.
We reviewed a range of records. This included 2 people's care and support records and 2 people’s medicine administration records. We looked at 2 staff files in relation to recruitment and training. We also reviewed a variety of records relating to the management of the service, including policies and procedures, staffing rotas, accident and incident records, safeguarding records and quality assurance reports.
Updated
14 July 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Willowbeech is a residential care home providing personal care to people with learning disabilities and autistic people. The service can support up to 5 people. At the time of the inspection 4 people were living there.
People’s experience of using this service and what we found
Right Support:
Not all risks to people had been assessed or reviewed. However, relatives told us staff understood people’s individual needs in practice as they often had familiar staff and those staff knew them well. We observed staff to be kind when providing support.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Right Care:
Support plans were not detailed, or person-centred. Support plans did not include current information to guide staff on how to provide care and support. A health and social care professional told us, “There is no effective use of care planning and care plans were outdated significantly. Additionally, strategies to promote effective care have been ignored.”
Staff understood how to protect people from abuse. Relatives told us they had been invited to the home to provide training to new staff about their loved one, including their family history and likes and dislikes. However, records had not been updated to reflect this. People could communicate with staff and during observations, appeared to understand information given to them because staff supported them consistently and understood their individual routines.
Right Culture:
The provider's monitoring processes were not always effective in helping to ensure people consistently received good quality care and support.
Staff told us they felt supported by the management of the service, and together with the registered manager, the team had identified opportunities for improvement which had provided people with more choice and freedom. An example of this was the home’s “Stay Up Late” campaign, with a focus on activities in the evening and the option of a house party. One staff member stated, “A lot of changes have already happened with the new registered manager. Things are fast paced and exciting at the moment. The registered manager also genuinely cares about staff welfare so we feel looked after too.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
This service was registered with us on 9 February 2022 and this is the first inspection.
The last rating for the service under the previous provider was good, published on 15 January 2020.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement and recommendations
We have identified breaches in relation to person-centred care and good governance at this inspection.
We made a recommendation about how the home meets the requirements of the Mental Capacity Act, a recommendation about complaints and a recommendation about people’s risk assessments.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.