We inspected Willoughby House on 20 September 2016. We gave the registered persons a short period of notice before we called to the service. This was because the people who lived in the service had complex needs for care and benefited from knowing that we would be calling. The inspection team consisted of a single inspector. The service provides care and support for up to 8 people. When we undertook our inspection there were 7 people living at the home.

People living at the home were of mixed ages. Some people required more assistance either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks.

There was a registered manager in post. 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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect them. At the time of our inspection there were three people subject to such an authorisation.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.

People were treated with kindness and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

Staff had taken care in finding out what people wanted from their lives and had supported them in their choices. They had used family and friends as guides to obtain information whenever possible.

People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to help prepare the meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.

People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements.

People who used the service told us they were happy living at the home and all their needs were being met, They told us staff treated them with respect and dignity. One person said, "Staff know what I like to do each day and I get to do it." There were ample opportunities available for people who used the service to take part in local events and to go on holiday. Some people enjoyed the garden and some to stay within the confines of the home.

The people we spoke with told us they knew staff kept notes on them and had taken part in reviews of those notes. They described the different sections of the notes and what they had given staff permission to help them with. One person told us, "I like help crossing the road and staff are always about to help me."

Each person who lived at the home had been assessed for their capabilities to administer their own medicines. No one could do this at the time of our visit. One person told us, "I like my medicines to be given to me."

Everyone we spoke with told us there were sufficient staff around at all times to fulfill their needs. They told us, when an escort was required or a car drive,r a staff member was always found. One person said, "I like regular trips out and someone always comes with me."

People who used the service described how they would make a complaint should the need arise. They told us their views were valued. A person told us, "I never have any fear about making a complaint, but I haven't had to do it."