The Willows Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked at all 8 of the quality statements within the key question of safe. This means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question requires improvement. At this assessment this key question has improved to Good.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The majority of people spoken with told us appropriate actions were taken when incidents occurred. For example, one relative told us, “Recently my [family member] had an unexplained bruise on their hand, it was noticed, and I was told about it straight away. I believe they had knocked it and not said anything to the staff. I appreciate their promptness in noticing it and for letting me know.” Another relative described a time when their family member had a fall and told us paperwork had not been filled in correctly and procedures followed. They told us they felt this was caused by the staff member not being trained in what to do if incidents such as falls were to happen. All relatives confirmed any concerns raised had been addressed quickly by the manager.

Staff were positive and confident that the manager was open and honest, and this was expected of staff. Staff were confident they could raise any issues concerns directly with the manager and that they would be listened to. Staff said there would be learning from incidents and taken to reduce further risks. A staff member said, “The manager is quick to address any issues raised.”

Staff had received training in relevant topics such as medicine administration and safeguarding people. The complaints procedures and whistleblowing policies were available to staff to safeguard people if needed. The manager was found to be open and honest throughout the assessment and showed a commitment in wanting to further improve the service.

People and relatives said staff supported them in accessing healthcare services and worked in partnership with healthcare professionals to ensure they received the care they needed. For example, all relatives spoken with told us the GP visited on a regular basis.

The manager was aware of the need to complete pre-admission documentation to gather information about people's needs before moving into the service. The manager demonstrated good knowledge of their roles and responsibilities. We saw care plans had been updated where people's needs had changed.

There was evidence in care plans that the manager and staff had liaised with health professionals to ensure people received safe care.

Staff knew which health and social care professionals supported which people. Staff were able to explain what type of support they offered. Staff knew how to monitor people’s health conditions to ensure timely referrals were made to other services.

People and relatives spoken with felt involved in people’s care, and risks were managed appropriately. One relative said, “[Family member] is encouraged to do what they can for themselves within their own limits and discouraged from doing things that could jeopardise their safety. For example, only moving around with supervision.” Another relative told us, “I was fully involved when they did [family member] care plan, and I know if things change it is altered accordingly.” Relatives told us that their loved ones were not always able to verbally communicate their needs. However, they felt staff understood their loved ones communication methods, and knew their needs well to support people to keep them safe.

The manager told us how they had involved people in developing their risk assessments. Staff were able to tell us how they delivered person-centred care and treatment to people. This meant people’s risks were managed due to people’s individual needs being met.

We observed staff were knowledgeable about people. They knew people’s needs and preferences and how to manage people’s risks. For example, any risks associated with eating and drinking.

Care plans and risk assessments were up to date apart from a risk assessment to manage blood thinners, which meant staff did not have the relevant information to support the person safely. This was swiftly rectified by the manager who sent us this amended information. There was a detailed risk assessment for a person with diabetes, which clearly set out what action to take if the person became unwell.

We spoke with a family member who shared with us how their family member was supported to safely manage a risk associated with their health. Other relatives said that staff always involved people in how they wanted their care to be provided.

Staff knew people well. They said they were provided with enough information to support people. Staff explained what information was accessible to them. This included key information such as risks to individuals and how to support people to manage any risks. They said they were always aware that they needed to support people to maintain their independence. We saw a care plan for a person who had diabetes. This detailed staff to check the person’s feet daily and to report any concerns to management promptly.

We saw people were supported safely. People’s needs were clearly documented in their care plans, so staff had clear guidance on a person’s mental, physical, and social needs.

Care plans and risk assessments were up to date which meant staff had relevant information to support people safely. Staff were able to tell us how they delivered person-centred care and treatment to people. This meant people’s risks were managed due to people’s individual needs being met. S

People living at the home and their relatives said the home environment was safe. A person told us, "I like living here, it's like your own home, you wake up and people can help you. I feel secure.” Another person told us, “Its lovely and homely. I have a lovely room, and carpets. I couldn’t wish for a better place to be.” A relative said, “The Willows has such a nice, homely atmosphere when you go inside. I think this is helped by the manager and all the staff as they are all so kind and I feel they really care about my [family member].” One relative said their family member had a tendency to wander at night and had asked if they could be moved downstairs for safety needs. The manager confirmed this had been carried out.

Staff thought facilities were safe and did not pose a risk to peoples’ safety.

Overall we observed the environment to be safe. For example, safety features such as window restrictors were in place to reduce the risk of falls. We identified a threshold between rooms being a trip hazard. However, these were in an unoccupied locked bedroom. We discussed this with the provider who addressed this immediately.

The manager carried out a weekly home check to ensure facilities were safe and to follow up any safety issues.

Relatives spoken with were all complimentary about staff and were confident people were supported safely. However, it was said since there had been a recent reduction of staff on duty on each shift and had concerns that if both of those staff were busy, there was not another care staff member to deal with any incidents that could occur.

The manager said that people were independent and risks to their safety were at a low level. Only up to 3 people were in the lounge at any time as most people liked to stay in their bedrooms. It was discussed that if the staff on duty were not in the lounge to check peoples’ safety there was a risk of accidents and incidents occurring. The manager followed this up by placing her workstation near to the occupied lounge area so she could observe and react to ensure people were safe. One staff member said that there were too many domestic and catering tasks to carry out as well as care duties and staff prioritised care over other duties. However, the provider had complained at times about a lack of cleaning carried out by care staff.

We observed staff to be kind and patient with people and positive interactions were seen. Whilst we did not see anyone having to wait for care or assistance when needed, we observed a potential impact with only having 2 staff on duty on each shift. For example, during mealtimes. The majority of people ate their meals in the dining room. However, 1 person required support in their room with meals which left only 1 staff member in the dining room.

The manager had produced an audit showing that people were safe and had their needs met with current staffing levels. We viewed 5 staff files. All relevant recruitment checks had been carried out before employing new staff. These included checks of proof of identity, references, the right to work in the UK and Disclosure and Barring Service (DBS) checks. A DBS check is a way for employers to check an employee criminal record, to help decide whether they are suitable person to work for them. This protected people from receiving support from unsuitable staff.

People and relatives did not share any concerns about infection control. One relative said, “Where appropriate staff wear PPE.”

Staff knew what personal protective equipment they should wear and when. Staff knew how to put on and remove this equipment, in a safe way. This protected people from the spread of infection.

We identified some wear and tear such as chips in paintwork. We discussed this with the provider who assured us these issues would be addressed.

There were clear processes and policies, to ensure the environment was kept clean and hygienic. This protected people from the spread of infection. Staff had received training in infection control, how to put on protective equipment and how to keep people safe in the event of an infection outbreak.

People and relatives did not raise any concerns about the safe management and administration of medicines at the home. One person told us, “They (staff) give me medicines on time.” A relative said, “Staff stay with [family member] when giving them their tablets and they (staff) never leave them until they are sure they had taken them all.”

Care staff told us they could not administer peoples’ medicines unless they had received training and usually it was only senior staff who were able to do this. One staff member said, “I am due to have this training soon. Then I will be able to deal with giving medication to people.” No one reported any issues with prescribed medicines being properly supplied to people.

Medicines were being managed safely. Medicine Administration Records (MARs) showed medicines had been administered as prescribed. Where people had been prescribed ‘when required’ (PRN) medicines there were protocols which contained relevant information for the administration of these. We discussed specifying on PRN protocols how much cream to apply and where. There were no risk assessments in place for anticoagulants. The manager completed these without delay.