Willowcroft

Willowcroft is situated in Spondon, Derby and is owned by Methodist Homes. Willowcroft is registered to provide personal care and accommodation for up to 60 older people. The service can support people that are living with dementia. At the time of the inspection 59 people were using the service.

We found the following examples of good practice.

During the outbreak of COVID-19 there were restrictions on visiting the service which were in line with current government guidance. The provider had ensured that people were able to maintain contact with relatives using technology and a pod was in place to enable visitors to see their relatives through a protective screen. The pod was accessed through patio doors which meant visitors did not have to walk through the home.

There was a system in place for visitors and appropriately placed signage to ensure they followed the current guidance on the use of personal protective equipment (PPE), testing and social distancing. We saw staff wearing PPE in line with the latest guidance.

The home looked clean and hygienic. Staff carried out regular cleaning which was clearly defined and documented. Additional cleaning, including disinfection of high touch points such as door handles or handrails was taking place.

The provider had processes in place that ensured the safe admission of new people to the home. The provider also assessed the impact of isolation on people’s wellbeing and completed risk assessments in line with current guidelines to reduce the risk.

Willowcroft is situated in Spondon, Derby and is owned by Methodist Homes. Willowcroft is registered to provide personal care and accommodation for up to 60 older people. The service can support people that are living with dementia. At the time of the inspection 57 people were using the service.

¿ A COVID -19 screening questionnaire and track and trace details was required for all visitors, to complete upon entry. Temperature checks, hand washing facilities and hand gel were in place to comply with the required guidance.

¿ A pod was in place to enable visitors to see their relatives through a protective screen. The pod was accessed through patio doors which meant visitors did not have to walk through the home. People were also supported to contact their relatives and friends through video calls and telephone calls.

¿ Enhanced cleaning schedules included regular cleaning of touch areas such as handrails and door handles. This reduced the risk of cross infection.

¿ The service consisted of four separate units. Staff did not work across different units. They changed into and out of their uniforms at work. This reduced the risk of infection spread.

¿ Staff had received additional training in infection prevent and control and the use of Personal Protective Equipment (PPE).

¿ Staff were observed wearing PPE appropriately.

¿ Staff employed by the service did not work in any other care setting. This meant the risk of cross infection was reduced.

¿ Agency staff were not required at the time of the inspection. The registered manager told us, if agency were needed the service used one agency. These staff would be risk assessed and receive testing weekly.

¿ Staff and people living in the service accessed regular testing for COVID -19. This meant action could be taken swiftly if anyone developed symptoms or had a positive test result.

¿ The infection prevention and control policy was up to date.

¿ People and staff had risk assessments in place to identify their individual risks associated with COVID -19. We saw protective measures were in place to keep people and staff safe.

Further information is in the detailed findings below.

Willowcroft is a residential care home providing personal care to 60 people at the time of the inspection. 58 people were living at the service at the time of the inspection.

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

Care plans and risk assessments for when people experienced behaviours that challenged needed more detail to help ensure staff provided consistent care.

Other risks regarding people’s health care needs, such as falls and risks from the general environment were assessed and managed. Actions were taken to ensure people were protected from abuse and avoidable harm. Medicines were managed in line with nationally recognised guidance for safe medicines management. The service was clean, and actions were taken to help prevent and control infections. The registered manager looked to identify any improvements and to learn from when things had gone wrong.

Enough staff were available to ensure people received timely care to meet their needs. The provider completed checks on staff as they were recruited to ensure they were suitable to work at the service.

People’s needs were assessed before they went to live at the service. Assessments covered all aspects of people’s health, care and well-being and reflected the requirements of the Equalities Act. Staff had been trained in areas relevant to people’s needs and their competence was checked. People received food and drink to meet their nutrition and hydration needs. Staff worked with other healthcare professionals to ensure their care needs were met effectively, including support for when people were required to attend hospital appointments. The building met people’s needs and had design features that helped people living with dementia. People’s own bedrooms were personalised to their own tastes.

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.

Staff had developed warm and caring relationships with people. Staff respected people’s equality and diversity needs. People were supported to be as independent as they could be; staff actively worked with people to promote their independence. People were cared for by staff who respected their privacy and dignity. People and their relatives were involved in expressing views about their care and treatment and the development of the service. These views were respected and listened to.

Staff knew people well and understood how to meet their needs and preferences. People enjoyed how they spent their times at the service and had a variety of activities to be involved in. People’s communication needs were assessed, and information was in care plans on how best to communicate with people. Procedures were in place to ensure any complaints would be investigated and managed. When people required care at the end of their lives, this was planned and personalised.

The registered manager was clear on her role and steps had been identified to strengthen the management support in the service. People, relatives and staff all found the registered manager to be approachable and fair. Audits and checks on the quality and safety of services were in place to help ensure people received quality care. Regular meetings were held so that people and their relatives could contribute their views to the development and running of the service. The service worked well with other professionals and looked to identify learning to contribute towards improving care for people.

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

Rating at last inspection

The last rating for this service was Good (published 15 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make some improvements. Please see the safe section of this full report.

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.

There was a registered manager at this service. 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. At our last inspection in January 2014 the provider was fully compliant in all areas inspected.

At our last inspection carried out in January 2015 we found three breaches in relation to Regulations. At this inspection we found these had been addressed.

During our inspection visit we observed that staff were friendly and approachable. They spent time sitting with people to offer them comfort or stimulation. We observed staff delivering care which met people’s individual needs and which supported them in a respectful and appropriate way.

There were training and processes in place for staff to follow to keep people safe and staff followed these. People’s physical and mental health was promoted. Staff were trained to care for people living with dementia. Medicines were stored appropriately and were administered and recorded as prescribed.

We saw staff ensured people were comfortable. We saw people were supported in a relaxed and unhurried manner. Staff were caring and communicated well with people. Lunch was the highlight of the day and care was taken to ensure people had time to socialise and to enjoy their food.

Staff focused on people they were caring for rather that the task they were carrying out. Staff spoke in a positive manner about the people they cared for and had taken the time to get to know people’s preferences and wishes. Staff had a good understanding of people’s needs and this was demonstrated in their responses to people and recognition of when people required additional support.

People’s privacy was respected. People had their independence promoted. Where possible they were offered choice on how they wanted their care delivered and were given choices throughout the day. Staff responded to body language of people who were without verbal communication.

People were supported to maintain relationships with family and friends. Visitors were welcomed at any time. Records we looked at were personalised and included decisions people had made about their care including their likes, dislikes and personal preferences. There was a varied activity programme for people based on individual and group preferences. Suitable occupation was offered to people living with dementia. This included reminiscence and other therapies. Activities also included one-to to-one time and outings, or time in pursuit of personal hobbies or interests.

People, relatives and staff spoke very highly of the registered manager and felt the home was well-led.

The service was managed in an inclusive manner. People and staff had their wishes and knowledge respected. Staff were aware of their roles and responsibilities for people’s care. The registered manager had systems in place to review the service and to ensure the service responded to ongoing needs of people.

People told us they were involved in making choices about their care, and we observed staff responding to and respecting people's choices.

We observed staff interacting with people who used the service in a caring and positive manner, but we saw that people's support plans were not always followed. This meant that some people were placed at risk of harm.

We saw there were systems in place to ensure staff were suitably trained and supported to meet people's needs.

We found that the safety of the premises were adequately monitored and maintained and the care environment was suitable to meet people's needs and keep people safe.

We saw that people's care records contained information about their preferences and interests, but some care records were not always kept up to date. This meant people were at risk of receiving inconsistent or unsafe care. Care records were not stored securely which meant that people's personal information was not kept safely.

Relatives we spoke with were also positive about the experiences of their family members and felt fully involved in their care planning.

We found that the home had a quality audit system in place. However,we found that there were incidences where systems and policies in relation to medication management were not followed. This meant that people were not always protected against the risks associated with poor medicines management.