The Willows Care Home provides accommodation, care and support to up to seven people with a learning disability. At the time of our inspection six people were using the service.

At our last inspection in September 2015 the service was rated good. At this inspection on 19 October 2017 the service remained good.

Staff understood their role in regards to safeguarding adults and continued to protect people from avoidable harm. The staff regularly reviewed and assessed risks to people’s safety and adapted risk management plans to ensure any risks to people’s health, safety and/or welfare were minimised. There were sufficient staff to meet people’s needs and safe recruitment practices continued to be followed. Medicines were stored securely and people received their medicines as prescribed.

Staff continued to refresh their knowledge and skills through regular training and supervision. Staff adhered to the principles of the Mental Capacity Act 2005 and conditions stipulated through the Deprivation of Liberty Safeguards. Staff provided any support people required to ensure they ate and drank sufficient amounts, and they had access to healthcare services when they required them.

Caring, friendly relationships were evident between staff and people. Staff spent time building trust with people. Staff were aware of people’s communication methods and enabled them, as much as possible, to make choices about their care. Staff respected people’s privacy and dignity, and supported people to maintain relationships with friends and family.

Staff provided people with the level of support appropriate to their needs. Detailed care records were maintained about people’s needs and how they were to be supported, taking into account people’s preferences. Staff encouraged people to participate in a range of activities at the service and in the community. A complaints process remained in place to ensure any concerns raised were dealt with appropriately.

A new manager had recently been appointed. They were clear about their expectations and how they would like the service to develop. Staff felt listened to and there was an open culture within the staff team. There continued to be mechanisms in place to obtain feedback from staff, people and relatives. Processes remained in place to review the quality of service delivery. The provider adhered to the requirements of their registration with the Care Quality Commission.

Further information is in the detailed findings below.

The inspection took place on the 9 September 2015 and was unannounced. We last inspected the service on 14 June 2013 and there were no breaches of legal requirements at the last inspection

The Willows is a care home that provides support and care for up to six people who have a learning disability and/or a physical disability. At the time of our inspection, there were five people living at the Willows.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

There were systems in place to make sure people were kept safe. Staff were knowledgeable about what they needed to do if they suspected someone was being abused. The provider had made appropriate arrangements for the management of medicines.

Staff’s recruitment was completed after a number of checks to ensure only people who were suitable were employed. Once in post staff had a comprehensive induction and training that was refreshed regularly. Staff were supported by management to understand their roles and responsibilities.

People who used the service had their needs assessed and met. Staff had a good understanding about people’s individual and diverse needs and knew how to care for them. There was clear information about each person and the support the staff needed to offer. There were enough staff on duty to ensure people’s needs were met.

There were assessments of risk in place and measures taken to minimise the risks in order to allow people to be as independent as possible. Accidents and incidents were monitored, analysed and trends and patterns were identified so the risks of a re-occurrence were minimised.

Staff were kind and caring. They had positive relationships with the people they cared for. Staff maintained people’s privacy and dignity when providing care and support them people.

People had the opportunity to participate in social and recreational activities dependent upon their interests and preferences.

People were asked their consent before care was provided. If people were not able to consent verbally, other communication methods were used to determine their views.

The provider had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff were knowledgeable about the procedures and how they should be applied. DoLS is a way of making sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

People had access to the healthcare services they needed. Their nutritional needs were met.

There were systems to monitor the quality of the service and to obtain feedback from the people living there, their representatives and other stakeholders. People told us the manager was approachable and welcomed any feedback about the service.

People could move freely around the building and it was adapted to meet the needs of people whose mobility was restricted.

There were five people living at the Willows and we met with all of them during the course of our visit.

The people using this service had complex needs which meant they were unable to share direct views about their care. We therefore used observations and looked at care records to help us understand their experiences. We also looked at various records around the way the home was being run. We met with the deputy manager, four members of staff and a visiting professional.

We saw good interactions between staff and people who use the service. Staff were alert to changes in people's mood, behaviour and general wellbeing and knew how to respond to individual communication styles and body language.

A relative told us, “the home is fantastic, I have no concerns.” A visiting professional said, “The staff treat people well and are respectful.”

People's care records were person centred and up to date so that staff understood what people's needs were and how to support them. The staff showed understanding and insight into people's different needs and knew how to keep people safe. There were sufficient numbers of staff to meet people’s needs and provide individual support. Staff we spoke to told us that they liked working at the Willows and that they could discuss any problems with the manager.

The care provider had effective systems for assessing and monitoring the service they provided. There were appropriate arrangements in place to manage medicines.

There were three people living at the Willows and we met with all of them during the course of our visit.

Due to their needs, the people that we met were unable to share direct views about the standards of care. In order to make judgements about the care that individuals received, we observed care practices; interactions with staff and tracked three people's records of care. Case tracking means we looked in detail at the care people receive. We also looked at various records in relation to the staff and the way the home was being run.

People living in the home have both learning and physical disabilities, some of whom have complex needs and limited communication abilities. During our visit people were offered choices, spoken to respectfully, made to feel involved and showed signs of well being when interacting with both the staff and other people using the service. Staff were attentive to individuals and were able to identify with the gestures and reactions that people gave, what these were likely to indicate and respond appropriately.

Plans of care were person centred, well created and closely reflected the specific needs of the person. This meant that staff had clear information on how to support their needs and lifestyles.

Before the Willows opened in June 2011, the staff team were given lots of training to enable them to meet people's needs and understand the way the service should be run. Staff told us that they were happy working at the home and felt well supported by the manager. They said there was good teamwork and a supportive atmosphere. Comments included, “the training is good and appropriate to our work.”

We saw that people were provided with a range of personalised and meaningful activities to meet both their specific physical needs and social interests. This extended to within both the home and local community.

The home was clean, safely maintained and furnished to comfortable standards. People had the right specialist equipment to promote their independence and meet both their physical and sensory needs.