This inspection of Willow View took place on 9 March 2017 and was unannounced. This meant they did not know we were coming. The service was last inspected on 8 and 10 July 2015. At that time the service was not meeting the regulations related to safe care and treatment and safe recruitment of staff.

The registered provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this inspection we checked to see if improvements had been made.

Willow View is a care home providing accommodation and personal care for up to six people who have a learning disability and who may have behaviour that challenges others. There were five people using the service at the time of our visit. The business is owned by Action for Care Limited and they are a registered charity.

The service had a registered manager. 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 who used the service told us they felt very safe and happy at Willow View. Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence. Positive risk taking was encouraged and supported.

Effective recruitment and selection processes were in place and medicines were managed in a safe way for people.

There were enough staff to provide a good level of interaction. Staff had received a thorough induction, supervision, appraisal and role specific training. This ensured they had the knowledge and skills to support the people who used the service.

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 supported this practice. People’s capacity was always considered when decisions needed to be made. This helped ensure people’s rights were protected in line with legislation and guidance.

People were supported to eat a balanced diet and meals were planned on an individual basis.

The home had a warm homely atmosphere and was tailored to meet each person’s individual preferences.

Staff were very caring and supported people in a way that maintained their dignity, privacy and human rights. People were supported to be as independent as possible throughout their daily lives and were provided with emotional support and guidance to meet their personal goals.

The service was led by each individual’s goals, life style choices and aspirations. Individual needs were assessed and met through the development of detailed personalised care plans and risk assessments. People’s care plans detailed the care and support people required and included detailed information about people’s likes and dislikes, enabling person centred care to be delivered.

People and their representatives were always involved in care planning and reviews. People’s needs were reviewed as soon as their situation changed and the service used innovatively methods to anticipate people’s needs and promote their well-being.

People were encouraged and supported to engage in social, educational and leisure activities in line with their goals and aspirations. People were supported to take an active part in their community and care plans illustrated measures to protect people from social isolation and exploitation.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time and people told us staff were always approachable.

People, relatives and staff told us the registered manager was great and they could not wish for a better manager. Relatives and people could not thi

Willow View provides accommodation and personal care for six people with learning disabilities who live at the home. The service had a registered manager in place.

People told us they were happy living in the home, were safe and were provided with opportunities to undertake a range of activities. A relative and social care professional also told us this was the case

We saw people were involved in choices in relation to their daily lives for example choosing activities that they wanted to be involved in. More could have been done to involve people in their care plan review to ensure people were involved in the evaluation of their care package including their goals and objectives.

We found documentation required improvement in a number of areas. One person’s care records did not contain the latest information on their needs as it had not been updated following a diagnosis of autism. Completion of other care records including those concerning people’s health plans was also inconsistent with some documents missing. The overall records showing completion of staff supervision and appraisal were not clear so it was difficult to establish when staff had a supervision or appraisal. The problems we found breached Regulation 20, of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

Staff were aware of how to meet people’s individual needs. Completion of training was mixed with some areas requiring improvement such as Mental Capacity Act (MCA) and manual handling to ensure staff we up-to-date with the latest available guidance and best practice. Completion rates with other topics such a safeguarding and non-violent crisis intervention was better. The service had a workforce development plan in place to address shortfalls in specialist training such as autism. This meant that the service had plans in place develop staff skills in order to better meet people’s individual needs over time.

We found staff had a good understanding of how to support people, their individual needs and how to keep them safe. We saw that staff had the time to forge meaningful relationships with people who used the service. Most people had one to one support, which allowed staff to develop close relationships with people. We saw staff provided kindness, compassion and companionship to people using a range of verbal and non-verbal communication techniques

Staff told us tht the management were open, supportive and fair and addressed concerns raised by staff and people who used the service. We saw that there was an established set of values and objectives which staff understood. An improvement plan was in place to ensure the organisation continuously improved the quality of its service and management were provided with support and resources to drive improvement. This meant that provider was able to continuously improve the quality of its services.

An incident reporting system was in place, but the lessons learnt from incidents were not always robustly documented which meant there was no record of learning from incidents which had occurred. The service’s quality assurance systems had not identified and acted on deficiencies we found in care and staffing records.

At the time of our inspection there were 5 people who used the service who were available to speak with us.

The comments from people included;

"I love it here and enjoy the activities on offer."

"Friendly staff."

"They look after me, and the food is good.”

"It’s my home and I like it here."

We spoke with three of the five people who live at Willow View. They told us that they were happy living at the service and that they received the care and support that they need.

These are some of the things people who use the service told us: “The manager is very open.", “I am impressed with the building”. “I feel listened to”.

People we spoke with told us they received care that was appropriate to their needs. One person told us “The care here is really good.”

Visitors told us they were involved in making decisions about their relatives care and treatment. They also said they were kept informed of any changes in their relatives needs. One person told us "There is a good team here.”

People told us they were happy with the care and support they received. One person told us that they and their relative agreed that every staff member was very good.

People told us their room was always kept clean. One person told us “I like my room”.

Staff we spoke with told us they felt supported and had the knowledge and skills to appropriately support people who lived at the home. One staff member said “Care is really good here”.

The inspection of Willow View Care Home took place on 8 and 10 July 2015. The visit on 8 July was unannounced and the visit on 10 July was announced. We previously inspected the service on 3 April 2014 and at that time we found the provider was not meeting the regulations relating to maintaining an accurate record in respect of each service user which included appropriate information and documents in relation to the care provided.

We asked the registered provider to make improvements. The registered provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this visit we checked to see if improvements had been made.

Willow View is a care home providing accommodation and personal care for six people who have a learning disability and who may have severe challenging behaviours. There were six people using the service at the time of our visit. The business is owned by Action for Care Limited and they are a registered charity.

The service is required to have a registered manager. 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. In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. The current manager had submitted their application to commence registration with CQC. At the time of our inspection this was not finalised.

People who lived at Willow View told us they felt safe. Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse.

Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

Effective recruitment and selection processes were not in place. This was a breach of regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

There were not robust enough systems in place to store and administer medicines safely. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

There were enough staff to provide a good level of interaction. Staff had received an induction, supervision, appraisal and role specific training. This ensured they had the knowledge and skills to support the people who lived there.

People’s capacity was considered when decisions needed to be made and advocacy support provided when necessary to support and enable people to air their views. This helped ensure people’s rights were protected when decisions needed to be made.

People were supported to eat a good balanced diet and people enjoyed the food served

Staff were caring and supported people in a way that maintained their dignity and privacy.

People were supported to be as independent as possible throughout their daily lives. Individual needs were assessed and met through the development of personalised care plans and risk assessments. People and their representatives were involved in care planning and reviews. People’s needs were reviewed as soon as their situation and needs changed.

Care plans considered people’s social life which included measures to protect people from social isolation.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time. There had been no recent complaints received by the service, but our discussions with people who used the service, staff and community professionals gave us assurance they would be dealt with appropriately

The culture of the organisation was open and transparent. The manager was visible in the service and knew the needs of the people in the home

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard, however this system had not picked up the problems we found with safe storage and administration of medicines and also safe staff recruitment procedures. You can see what action we told the provider to take in relation to the breeches in the regulations at the back of the full version of the report.