The Willow Centre is a care home which provides respite support for up to 6 people with dementia. The home is located in Maghull, Sefton, and provided by Parkhaven Trust, a registered charity. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection, there were two people using the respite service. This service also provided domiciliary support to people living in their own houses and flats in the community. At the time of our inspection, one person was receiving domiciliary support.

At our last inspection on 16 September 2015 we rated the service Good. At this inspection we found the evidence continued to support the overall 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.

A registered manager was in post at the time of our inspection. The registered manager of the Willow Centre is also the Chief Executive of the Trust. 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. Day to day responsibility for the service was delegated to the Scheme Leader who oversees the day to day running of the centre. The Scheme leader is supported by a deputy manager.

Risk assessments were detailed and contained sufficient information to guide staff on how to mitigate risks. Procedures were in place to analyse accidents and incidents, such as medication errors and falls, with a focus on reflection for future learning and prevention.

People were supported to live in a clean and well-maintained environment. A range of health and safety checks were completed to ensure the equipment and premises were safe for people to live.

Staff had received training in the safe administration of medicines and medication was stored securely.

Safe recruitment procedures were in place to ensure that staff were suitable to work with vulnerable people. There were appropriate numbers of staff deployed to meet people’s needs and to ensure people received support when they needed it. Staff had received training in safeguarding and knew how to recognise and report abuse to local partner agencies.

Staff received an induction and suitable training to complete their job role effectively. All staff were regularly supervised in their role and received an annual appraisal. Staff spoken with told us that they were supported with their learning and development and felt they could raise any issues both formally and informally.

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 at the service supported this practice. The service was working in accordance with the Mental Capacity Act and DoLS (Deprivation of Liberty Safeguards) and associated principles. Mental capacity assessments were completed and best interest decisions were made on behalf of those who lacked capacity.

People’s overall health and well-being needs were being safely and effectively supported. Staff maintained effective communication within the team and with outside partner agencies to ensure people’s outcomes were met. People were offered a varied diet and the chef catered to people’s individual dietary preferences.

The two people who used the respite service were unavailable on the day of our inspection and therefore we were unable to speak to them directly however t

This inspection took place on 16 December 2015 and was unannounced.

The Willow Centre provides respite care for people with dementia and is located in Maghull, Sefton. The service is provided by Parkhaven Trust, a registered charity, which provides a wide range of services to support people with dementia, older people and people with learning and physical disabilities

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.

Everyone we spoke with told us that they felt safe at the service. All of the family members we spoke with told us they felt their family member was well looked after while they were at the service.

Staff were able to clearly explain to us what course of action they would take if they felt someone was being abused. Staff were able to explain the organisation’s whistleblowing policy and this was available for us to look at.

People received their medications safely.

Staff had been recruited appropriately to ensure they were suitable to work with vulnerable adults. People who used the service, families and staff told us there were sufficient numbers of staff on duty at all times.

Staff told us they were well supported through the induction process, and had regular supervision and appraisal. They said they were up-to-date with all of the training they were required by the organisation to undertake for the job. Staff told us management provided good quality training.

Various risk assessments had been completed depending on people’s individual needs. Care plans were in place and complete and they reflected people’s current needs, with particular reference to health needs where appropriate. The risk assessments and care plans were reviewed on a six monthly basis or more frequently if needed.

There were safeguards in place to ensure medicines were managed in a safe way. The premises were appropriate for their use and were well maintained. Sufficient living space, bedrooms, a sensory room and secure garden were available for people to use.

People’s care was personalised and diverse, and it was evident during our inspection staff knew the people they were supporting very well, and we saw them interacting with them with kindness and compassion.

People told us they were satisfied with the meals. The food was well flavoured and nutritious. We observed people had plenty of encouragement and support at meal times.

People and their families described management and staff as caring, respectful and approachable. The families we spoke with had regular contact with the registered manager and the owner.

Families said the service was well managed and a family member told us they had recommended the service to other people.

A full and varied programme of recreational activities was available for people to participate in and this was displayed in pictorial format in the hallway. Staff sought people’s consent before providing support or care. The home adhered to the principles of the Mental Capacity Act (2005). Applications to deprive people of their liberty under the Mental Capacity Act (2005) had been submitted to the Local Authority.

There were quality assurance systems’ and processes in place to monitor the delivery of care and quality of support.

We were able to speak to one relative of a person who received care at the respite centre. They told us "I cannot fault this place. The food - everything - is fantastic. [Person's name] gets as much help as she needs. The staff are excellent - I couldn't ask for more."

We were able to speak with four people who used the day centre, attached to the respite centre. The day centre was accessed by people who stay at the respite centre, which was contained within the same building. Comments from people using the centre included: "It really is a lovely place", "A really nice place, staff are so kind", and "I love getting my hair done".

The manager showed us around the respite centre. We found all six bedrooms were well appointed, clean and comfortable. At the time of our inspection, only two people were using respite care. We found these people were enjoying the company of staff at the home, chatting and watching television. The manager showed us other areas of the centre, and explained the facilities in the day centre were available to those on respite care. These services included organised activities and a hairdressing salon.

We found meals offered were well balanced and menus we reviewed provided choice and variety. We noted from care records that any special dietary requirements were accommodated and followed by staff. The building is a well maintained, modern purpose built centre for the provision of day care and respite facilities. The gardens were also accessible to people using the centre.

The manager was able to demonstrate that complaints were handled effectively and was also able to show us the many compliments people had made about staff and the service provided.

We used a number of different methods to help us understand the experiences of people accessing the service. This was because all of the people using the service had dementia care needs which meant they were not able to tell us their experiences. We observed during our inspection that the people appeared happy and content during their stay at the Willow Centre. We found people were treated respectfully and given support to have their say in how they wanted to be helped and were supported to do the things they wanted to do.

We spoke with a relative of a person using the service and reviewed recent feedback from a number of relatives. Comments included:

“I’m delighted with the care”.

“A lovely place”.

“Always at the end of the phone”.

People who used the service were cared for by staff who were appropriately recruited, trained and experienced to support them.