Willoughby House

Willoughby House is a residential care home providing personal care and accommodation to up to 8 people. The service provides support to autistic people and people with a learning disability. At the time of our inspection there were 6 people using the service.

People’s experience of the service and what we found:

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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Staff supported people to take part in activities and pursue their interests in their local area with people who had shared interests.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

People had a choice about their living environment and were able to personalise their rooms.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Staff enabled people to access specialist health and social care support in the community and to play an active role in maintaining their own health and wellbeing.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their treatment/care and support because staff had the necessary skills to understand them.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.

Staff and people worked together to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

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.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them, including advocates, were involved in planning their care.

Systems to guide staff and record care and treatment needed reviewing and was being updated by the manager. They worked well with external professionals to meet people’s needs which ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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 28 June 2019).

Why we inspected

The inspection was prompted in part due to concerns received about how people were treated. A decision was made for us to inspect and examine those risks. During this inspection we found no evidence to support the risks identified.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. You can read the report from our last comprehensive inspection by selecting the ‘All inspection reports and timeline’ link for Willoughby House on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Willoughby House is a residential care home that was providing personal care to seven people at the time of the inspection. The service can support up to eight people with a learning disability or autistic spectrum disorder.

The care home accommodates people in one adapted building and all bedrooms are single occupancy with their own bathroom facility. People share the lounge, dining room, kitchen and garden. The size of service meets current best practice guidance. This promotes people living in a small domestic style property to enable them to have the opportunity of living a full life.

People’s experience of using the service and what we found.

People were safely supported and protected from harm. This was because safeguarding systems and ways of managing risk were carried out well. There were sufficient numbers of suitable staff employed who managed medicines safely and followed good infection control and prevention practices to protect people from harm. Staff learnt lessons when problems arose.

People’s needs were effectively met. This was because their needs were assessed and staff were suitably trained to support people with mobility, nutrition and health care, as well as any diagnosed conditions. People lived a comfortable life because the premises were suitably designed to meet their needs.

The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied. The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways: promotion of choice and control, independence, inclusion and engagement in the community. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff worked consistently well with other healthcare professionals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s equality, diversity, privacy, dignity and independence were respected. Their views on their care and support were listened to. They were supported by caring and compassionate staff and so their lives were pleasant.

Staff provided personalised care, which meant people experienced good support. This was achieved by producing and following person-centred support plans. People’s communication needs were well met using systems and good practice. Their concerns were satisfactorily addressed because complaints were responded to and well managed. People were assured a good end of life experience when the time came.

The registered manager promoted a positive culture among the workforce. They and the staff team understood and acted on their duty of care responsibilities to be open and honest. Staff were clear about their roles, monitored people’s changing needs and sought to improve the care people received. They engaged and involved people in deciding what care they were given and how. Partnership working was well established with other organisations or agencies for the benefit of people that used the service. All of this meant people experienced a well-run service where their needs were met.

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

Rating at last inspection.

At the last inspection the service was rated good (published 26 November 2016.)

Why we inspected.

This was a planned inspection based on the previous rating.

Follow up.

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

People living at the home were of mixed ages. Some people required more assistance either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks.

There was a registered manager in post. 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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect them. At the time of our inspection there were three people subject to such an authorisation.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.

People were treated with kindness and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

Staff had taken care in finding out what people wanted from their lives and had supported them in their choices. They had used family and friends as guides to obtain information whenever possible.

People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to help prepare the meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.

People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements.

The people we spoke with told us they knew staff kept notes on them and had taken part in reviews of those notes. They described the different sections of the notes and what they had given staff permission to help them with. One person told us, "I like help crossing the road and staff are always about to help me."

Each person who lived at the home had been assessed for their capabilities to administer their own medicines. No one could do this at the time of our visit. One person told us, "I like my medicines to be given to me."

Everyone we spoke with told us there were sufficient staff around at all times to fulfill their needs. They told us, when an escort was required or a car drive,r a staff member was always found. One person said, "I like regular trips out and someone always comes with me."

People who used the service described how they would make a complaint should the need arise. They told us their views were valued. A person told us, "I never have any fear about making a complaint, but I haven't had to do it."