The Willows 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. At the time of our inspection there were eight people living at the service who had a visual impairment and learning disability amongst other care needs.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained good.

People were protected by staff who were aware of safeguarding procedures. Relatives told us they felt their loved ones were safe, and there were a just enough staff to meet people’s needs. Staff were recruited safely, and risks to people were identified and appropriately recorded and managed. Medicine administration and recording was safe, as were infection control practices. Accidents and incidents were recorded and monitored for trends.

Robust pre-assessments were completed to ensure that people’s needs could be met. 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 support this practice. Staff were aware of the principles of the Mental Capacity Act 2005 and people’s rights were protected. Staff were up to date with relevant training and had regular supervision with their line manager. People were supported to maintain their health and nutritional needs.

Staff treated people in a caring and kind manner, and staff were knowledgeable about people’s needs. People’s independence and privacy was respected and promoted. Staff were aware of how to support people to express their opinions, and people attended a representatives group to drive improvement in the service and at Seeability as a whole.

People received care and attended activities that were responsive to their needs. Rooms felt homely from people being able to personalise them with furniture, pictures and decorations. People were supported to maintain their faith and to raise complaints. End of life care plans were detailed and expressed people’s individual last wishes. Staff supported people following the recent death of a person who lived at the service.

There was a warm and positive culture in the service. Relatives and staff said that the deputy manager was approachable, and a new manager had been employed who would shortly be starting at the service. The provider actively sought feedback from people, relatives and staff, and there was strong engagement with a range of external stakeholders. There were robust quality governance systems in place to identify any issues which were resolved in a timely manner.

Further information is in the detailed findings below.

The Willows is a residential care home for eight people. There were eight people living at the home at the time of inspection. The home supports people with sight loss, learning disabilities, mental health diagnosis and physical disabilities. Some people’s behaviour presented challenges and was responded to with one to one support from staff.

People had varied communication needs and abilities. Some people were able to express themselves verbally; others used body language or makaton (type of sign language) and PECs (picture exchange system) to communicate their needs.

The service was run by a registered manager, who was present on the day of the inspection visit. ‘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 and associated Regulations about how the service is run.

People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

There were sufficient staff to keep people safe. There were robust recruitment practises in place to ensure that staff were safe to work with people.

Staff had written information about risks to people and how to manage these. Risk assessments were in place for a variety of tasks like personal care and the environment and were updated frequently.

People’s medicines were administered stored and disposed of safely. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

People’s human rights were protected as the registered manager ensured that the requirements of the Mental Capacity Act 2005 was followed. Where people were assessed to lack capacity to make some decisions, mental capacity assessment and best interest meetings were evidenced. Staff were heard to ask peoples consent before they provided care.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had sufficient to eat and drink. They had healthy home cooked meals. People were seen to be offered choice of what they would like to eat and drink.

People were supported to maintain their health and well-being. People had regular access to health and social care professionals.

Staff were trained and had sufficient skills and knowledge to support people effectively. There was a training programme in place and training to meet people’s needs. Staff received regular supervision.

Positive and caring relationships had been established. Staff interacted with people in a kind and caring manner.

People, their relatives and other professionals were involved in planning peoples care. People’s choices and views were respected by staff. People’s privacy and dignity was respected.

People received a personalised service. Staff knew people’s preferences and wishes and they were adhered to.

The service listened to people, staff and relative’s views. The management welcomed feedback from people and acted upon this if necessary. The management promoted an open and person centred culture.

Staff told us they felt supported by the registered manager. Relatives told us they felt that the management was approachable and responsive.

There were robust procedures in place to monitor, evaluate and improve the quality of care provided. Staff were motivated and aware of their responsibilities. The registered manager understood the requirements of CQC and sent appropriate notifications.

People who use the service had individual and complex communication needs. This meant that in most cases we were not able to hear their views directly. To gather information regarding their experiences we observed their care and spoke to staff. We saw staff communicating with people with respect and compassion and assisting them in making choices.

We read in care records that every person had a personalised care and support plan that was suitable to their needs and reviewed regularly. We saw from reading people's daily diaries and from observation that care plans were being followed by staff. We saw that there were regular home meetings where people's views were listened to and valued. We saw that regular audits of the service were completed by staff ensuring that people who used the service benefited from a service that constantly monitored its quality of care provided.

We found that staff had received regular training and support in order to provide high quality person-centred care. We saw that staff had appropriate qualifications and experience in order to meet the care needs of the people.

People using the service had individual and complex communication needs. In some cases, this meant that we were not able to hear their views directly. To understand these people’s experiences, we gathered evidence through observation and speaking to staff about how they supported people.

The people we spoke with told us that they enjoyed living at the home and that staff were available when they needed them. They felt safe and well cared for at the home and that staff treated them well. People said that they had opportunities to go out, which was important to them.

We found that people received person-centred care that reflected their individual needs and preferences. People had opportunities to give their views about the care and support they received and the home sought the input of families, friends, advocates and, where appropriate, healthcare professionals.

The home had made efforts to identity activities that people enjoyed and to provide opportunities for them to take part in these activities. People were supported to be part of their community and the home encouraged people to develop and maintain skills that promoted their independence.