Willersley House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Willersley House provides accommodation and support for up to a maximum of 34 people in one adapted building.

The service had a registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

At our previous inspection on 4 December 2015 we found that people were receiving high quality care which was extremely responsive to people’s individual needs. At this inspection, we found that these standards had been maintained and improved further. People received an outstanding level of care. Skilled and extremely caring staff supported people in the way they chose and end of life care was exceptional.

The environment at Willersley House was calm and inviting. The registered manager, the staff team and the people who used the service were all very keen to share their thoughts and views of the service.

Without exception people and their relatives were extremely complimentary about the service. They were full of praise for the management and care staff and told us that they were exceptionally kind, caring and compassionate towards them. All of the people we spoke with told us they felt that Willersley House was an excellent place to live and that they felt safe. People consistently referred to the service as being ‘one big family’ and considered it their home. Relatives also confirmed that people living and working at the home had become an extended family.

The provider was creative in seeking people’s feedback and people were actively involved in making decisions about the care that they received. Their opinions were respected and listened to. The service was run very much around the needs of those living there.

Medicines were managed safely and staff had an exceptional knowledge of the medicine systems and procedures in place to support this. The support people received with their medicines was person centred and responsive to their needs. Staff worked closely with people to provide the right level of support they required.

Staff were highly trained in safeguarding people from abuse and put this training into practice. The home used creative ways to support people to maintain relationships and safeguard them when needed. Positive relations with staff were encouraged and staff had time to spend with people. The service was staffed above their minimum required staffing levels and staff retention was high.

People’s care plans showed that there was a strong commitment to person centred care and that risks were assessed and managed. People were supported to make their own decisions regarding their own safety and positive risk taking is encouraged.

People were supported to access a comprehensive programme of activities both within the home and in the wider community. This was person centred and supported by a team of dedicated and creative volunteers. People’s spiritual well-being was promoted and extremely well looked after and their religious beliefs encouraged and supported.

People’s nutrition and hydration needs were extremely well catered for. A highly motivated nutrition champion was in place who constantly considered ways to improve people’s nutritional and fluid intake. We saw that this had had a very positive impact on people’s health and well-being.

Staff were highly skilled and competent to meet the needs of people. Training was tailored to meet the needs of the residents and this demonstrated an enhanced knowledge and understanding of people in their care. People w

The inspection of Willersley House took place on 4 December 2015 and was unannounced. At the last inspection on 22 January 2014 the service was meeting the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These were amended in April 2015 to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Willersley House is a residential care home that provides accommodation and support to a maximum of 34 older people, some of whom may have physical dependence because of age, but not people living with dementia. The service is situated on the main road in Willerby, a suburb of Hull and is within the East Riding of Yorkshire boundary. It is run by Methodist Homes Ltd. All accommodation is in single en-suite bedrooms, there are several lounge and dining areas, ample gardens and a passenger lift to upper floors. Car parking is available for approximately nine vehicles.

The registered provider was required to have a registered manager in post and on the day of the inspection there was a registered manager employed and on duty. 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.

People that used the service received an extremely high level of responsive care from the service. This was in relation to all aspects of their care needs, and care was delivered according to a strong person-centred approach. People’s care needs were very well documented in their care assessments and care plans and were exceptionally well met on an individual basis so that people had an outstanding sense of wellbeing and purpose.

Staff were extremely responsive to people’s individual needs for personal care, social interaction, maintaining their relationships with family and having a sense of worth and purpose. Staff consistently looked for different ways of helping people to achieve their potential and so people lived as fulfilling a life as they were able to.

We found that people who used the service were protected from the risks of harm or abuse because the registered provider had ensured staff were appropriately trained in safeguarding adults from abuse. All staff we spoke with fully understood their responsibility to ensure people were protected using the systems in place and staff we spoke with demonstrated knowledge of the types of abuse and their signs and symptoms. The registered provider had systems in place to ensure safeguarding referrals were made to the appropriate department and were notified to us as required.

People were safe in the service because the risks to them individually and collectively were reduced by the implementation of risk assessments. The premises were safely maintained according to the requirements of relevant legislation that related to the building, utilities and equipment in use. All service maintenance contracts and certification was up to date.

We saw that staffing was in sufficient numbers to meet people’s needs and this was confirmed by people and staff we spoke with. We found that staff recruitment followed safe policies and practices so that staff employed by the service were suitable to work with vulnerable people.

Medication management systems were appropriately used and so people were not at risk of receiving the wrong medication. We saw that infection control practices were safely followed by staff that were aware of and understood the procedures in place to protect the people they supported.

We found that people were supported by staff that had been inducted into their roles and were trained and qualified. All staff received regular supervision and took part in an annual staff appraisal system. We saw that people benefited from good communications within the service and their legal rights were upheld and protected by the service that followed the Mental Capacity Act legislation.

We saw that people’s nutritional and health care needs were well managed because the service carefully monitored people’s general health.

We found that the premises were suitably maintained and decorated to meet the requirements and taste of the people that used the service. The premises were clean and comfortable and provided an elegant environment in which to live.

People were supported by caring and compassionate staff who knew their needs, wishes and aspirations. People had good relationships with staff and were involved in the running of the service where possible.

We saw that people received the information they required to keep them informed about the service and about their own personal development and progress. Staff were informative. People enjoyed a high level of privacy and dignity so that they felt relaxed and well cared for. Staff exercised discretion and maintained confidentiality.

We found that people had systems in place to use should they need to complain and while they were well aware of their right to be able to complain they told us they had not needed to. These systems were carefully managed so that any learning was used effectively to ensure improvements were always made.

People had the benefit of a service where the culture was extremely positive, inclusive and encouraging. The consistency of the same registered manager in post and staff meant that people felt comfortable with the team that supported them and were able to build up trusting relationships.

We found that people had the benefit of a service that operated a robust external quality monitoring system and a responsive internal auditing system so that service delivery was always being improved upon. The service had consistently achieved high scores year after year in its organisational quality assurance assessments.

Best practice was consistently sought and the records held in the service were accurate, up-to-date and confidentially maintained and stored.

We spoke with people about living at Willersley House and we discussed the care offered to them with staff. We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We saw that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were encouraged to maintain their independence, but their privacy and dignity were respected and their rights were upheld whenever they required support from the staff. People were well cared for. They said, "It is very good here. I can find no fault with Willersley. There are no rules ", "The staff are very nice and courteous" and "I am pretty satisfied living here. The staff get on very well together and that makes for a pleasant atmosphere all round. Our cleaning and laundry is done for us if we want it doing".

From speaking with people and observing food provision we found that people were protected from the risks of inadequate nutrition and dehydration. They said they were satisfied with the meals they received and enjoyed variety and choice.

We found that peoples' health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in cooperation with others.

People were protected from the risk of infection because appropriate guidance had been followed. People were cared for in a clean, hygienic environment. People told us they were satisfied with the levels of cleanliness and infection control at Willersley house.

We found that from the information we were given, the observation we made and the testimony of the people that used the service, people were given their medicines in a safe way at the time they needed them. There were checks on systems to ensure they were safe and so people were protected from the risk of harm associated with medicines.

We found that the premises was well maintained and people were satisfied with the facilities they had available to them. All of this meant that people experienced a living environment that was safe, accessible and promoted their wellbeing.

We found that people were protected from the risk of inappropriate use of equipment and from the risk of an accident if equipment was broken and so people were assisted safely with their mobility needs.

People were cared for or supported by suitably qualified, skilled and experienced staff that were supported to deliver care and treatment safely and to an appropriate standard.

We found that people were asked for their views and they were listened to in order to implement improvements in the care and support they received. Satisfaction was assessed by the service and audits were effective. There was an effective complaints system available.

We found people that used the service were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

People told us they were included in planning for and meeting their care and health care needs. We saw evidence in case files that people had signed their documentation where they wished to. During our observations of interaction between people and staff we saw that staff respected peoples' privacy, dignity and independence.

People told us they were satisfied with the care and support they received and that their needs were met. People told us they thought the staff were very helpful and that they supported them in a way they wanted.

People told us they felt safe in the home and that their finances were handled in a satisfactory way and according to their preferences.

We saw that the service of care and support people received was of a good standard. Staff were thoughtful, caring and efficient and respected peoples' rights. We saw evidence that the manager ran the home well and valued the staff team.