Willowdene

Updated 26 November 2019

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

The inspection at Willowdene was carried out by one inspector.

Three inspectors and an assistant inspector visited the Thera group offices in Grantham to review the quality monitoring processes in place to support each provider under the Thera group umbrella. We gave the group one week’s notice of this part of the inspection which took place on 16th September 2019. We used some of the information this inspection team gathered to help us inspect and rate Willowdene.

Service and service type

Willowdene is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered 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 sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

The person using the service was not able to provide us with verbal feedback on the support provided. We observed the support provided to them and staff interactions. We spoke with four members of staff including the registered manager, a senior support worker, and two support workers.

We reviewed a range of records. This included one person’s care records including their medicines records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at additional records relating to the running of the service. We spoke with one relative and two health professionals. Following our inspection, the nominated individual contacted us to discuss our findings at our inspection and tell us how these had been used to help the service develop and improve. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 26 November 2019

About the service

Willowdene is a residential care home which provides personal care via a short break service to people with a learning disability. The service is registered to provide the regulated activity to one person at a time. At the time of the inspection one person was staying at the service and eight people were using the service on a regular basis. The service also provides a non-regulated day service for people who use the short break service on the same site.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

There were deliberately no identifying signs, intercom, cameras, or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were supported by a committed management team who had a good overview of the service provided. Formal quality monitoring systems were in place. However, these did not always appear to recognise the specific nature and potential risks inherent within a respite service. We have made a recommendation about the governance systems in the home.

People received their medicines as prescribed however the systems in place had not identified some minor discrepancies to people’s medicines. Individual and environmental risks to people were identified and responded to. There was a system in place to report any incidents, including safeguarding concerns, which were analysed for any themes or trends. Peoples’ staffing requirements were assessed individually and met. People were supported by enough staff who knew them well. The environment was clean and good infection control procedures were followed.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement. As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

People were supported by staff who understood the importance of utilising positive behavioural support and this was used in line with best practice guidance. Staff also worked with health and social care professionals to ensure the support provided met people’s needs. People were supported to choose their meals and staff provided healthy options. Staff were supported to provide good support through effective training and induction to the service. The environment had been adapted to meet the needs of the people using the service, this included the provision of a sensory room and garden activities. 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 provider had a clear vision which emphasised that people with a learning disability could, and should, be in control of their own lives. Staff demonstrated these values in their interactions with people. People were presented positively, and staff focused on people’s strengths and abilities. People were supported by staff who knew them very well and this helped them to provide person centred care. People were supported to identify goals they wanted to achieve and improve their independence.

The support provided was individual to the needs and preferences of the people using the service. The importance of consistency in people’s every day routines was understood and supported. Staff viewed people in a person centred and holistic manner. People’s interests were understood, and they were engaged to participate in these. Staff communicated with people’s families as required. A complaints process was in place and the registered manager understood their responsibilities in relation to this.

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.

The service was inclusive of people, relatives, and staff. Opportunities to have a say on the service provided were available. Staff enjoyed working in the service and morale was good. The registered manager was open and honest. Systems were in place to support learning and development of the service.

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 11 October 2016). Since this rating was awarded the registered provider of the service has changed. The provider has continued, however, as a member of Thera group which is a charitable group of companies led by Thera Trust. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This service was registered with us June 2018 and this is the first inspection.

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.