About the service: Willowbeck Health Care Limited is a nursing home, providing nursing care to up to 80 people with mental health or physical health support needs. It comprises seven discrete units each with their own focus, as well as communal facilities. At the time of the inspection one of the units was not in use, and 62 people were using the service. The home is located in a suburb of Sheffield, not far from the city centre, with good public transport links.

People’s experience of using this service:

People told us they experienced very good outcomes and Willowbeck Health Care Limited. People we spoke with were positive about the care they received. One person told us: “The care is exceptional, staff know me well and know what I want to be doing; they help me to achieve what I want to.” A staff member said: “The whole point is to try to get people to be as independent as they can and make their own choices. That’s what motivates us all as a team, when we see people developing new skills.”

The provider had implemented imaginative and creative methods to enable people to be involved in their care and in the running of the home. People living at the home had been nominated as resident ambassadors, who coordinated meetings with other people using the service and gave feedback to senior staff, including the provider’s board of directors, about people’s views. People using the service were involved in recruitment and held various responsibilities around the home, including managing the post and operating a snack shop.

People received care which was highly tailored to their needs. People were involved in planning their care, and people we spoke with told us they understood their care plans and felt they had control over them. People told us they felt there were enough staff on duty at all times. One person said: “Whenever I need help, there’s always someone around

People experienced care which was delivered safely. Staff had received training in safeguarding and staff we spoke with demonstrated a good understanding of their responsibilities in this area. One person said: “I know I’m safe here because they look out for me and check on me so that I don’t come to any harm.” Managers had a good oversight of risks within the service and these were regularly reviewed to ensure they were managed appropriately.

People gave us positive feedback about food within the home. We spoke with a member of the catering team who had a good knowledge of people’s special diets and what steps they needed to take to meet such needs. People told us they enjoyed the food available. One person said: “I like the food, it’s always good.”

Managers were highly visible within the service and accessible to people using the service. People told us they knew the management team well and could speak with them whenever they wanted to. We saw that managers conducted a daily visit to every unit within the home which meant they had a good oversight of the service and regular contact with people using it. Staff told us they felt very supported by the management team, describing the home’s manager as “fantastic.”

People were supported in maintaining good health, and staff liaised with external healthcare providers where appropriate to ensure that care was provided in a way that met people’s needs.

Rating at last inspection: Good. The report was published in October 2016

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: ongoing monitoring.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 11 October 2016 and was unannounced, which meant no one working at the home knew we would be inspecting the service. The care home was last inspected in January 2014 when it was found to be meeting the Regulations we assessed.

Willowbeck provides nursing and personal care for to 82 younger adults. The beds are divided into five individual units, catering for the needs of younger adults between the ages of 18-65 years old. Two units support people with complex physical disabilities, including critical care needs, and two units care for people with mental health problems, whose behaviours may challenge. At the time of our inspection the fifth unit was not operational. All bedrooms are single with ensuite toilets and are located across two floors. Lounge and dining areas are situated within each unit. The home has a garden area, a car park and is close to a bus stop.

The service did not have a registered manager in post at the time of our inspection. However, the deputy manager, with support from senior managers, was overseeing the day to day operation of the home. 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 and associated Regulations about how the service is run.

People who used the service, and the relative we spoke with, told us they were happy with how care and support was provided at the home. They spoke positively about the staff and the way the home was managed. Everyone we spoke with told us the staff were very good and they felt safe living at Willowbeck.

We saw there were systems in place to protect people from the risk of harm. Staff we spoke with were knowledgeable about safeguarding people and were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified risks to people and management plans to reduce the risks were in place to ensure people’s safety.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this topic. People who used the service had been assessed to determine if a DoLS application was required.

Systems were in place to ensure people received their medications in a safe and timely way from staff who were appropriately trained. We found the majority of the time staff had followed the correct procedures. However, we identified some minor concerns in respect to recording and reviewing medication. These were resolved at the time of the inspection.

There was enough skilled and experienced staff on duty to meet people’s needs. Recruitment systems were robust, so helped the employer make safer recruitment decisions when employing new staff. New staff had received a comprehensive induction into how the home operated and their job role. This was followed by regular refresher and specialist training to meet the needs of the people using the service.

People were supported to eat and drink sufficient to maintain a balanced diet and adequate hydration.

People’s needs had been assessed before they moved to the home and we found they, and if required their relatives had been involved in the planning care. Care files checked reflected people’s care and support needs, choices and preferences. However, we found the care files on one unit were difficult to follow, due to the way they were organised and the amount of out of date information stored in the files.

People had access to a varied programme of activities which provided regular in-house stimulation, as well as trips out into the community. People said they enjoyed the activities they took part in.

A complaints policy was available to peopl

During our inspection we spoke with eight people who lived at the home. We spoke with the registered manager, the training manager, a nurse, four care workers and a doctor who had attended the home. We reviewed five care files and a number of other records relevant to our inspection.

Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. Where required, decisions were made in people’s best interests in line with relevant legislation and evidenced in their care plans.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Comments included, “I’m happy, it’s my life now”, “They’re good to me…spend time with me, know if I’m down, they ask me. They’re great” and “I wouldn’t change anything, they look after me.”

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. The home had effective recruitment procedures in place to safeguard people who lived there.

Comments and complaints people made were responded to appropriately. People had opportunities to make their views known and said they knew how to complain.

There are two managers listed on this report however Rachel Lister was the sole manager of the home at the time of our inspection.

We spoke with eight people about how the service respected and involved them. People told us that their opinions were sought so they were involved in any decisions and they had choice. Examples given included choosing when to get up and go to bed, whether to join in activities, what to wear and what to eat. People’s comments included, “staff are helpful and I exercise every morning” and “I can choose when I get up and go to bed”.

People told us that they enjoyed the activities at Willowbeck, these included the exercise class, pottery, painting and going on trips. We saw that pictures and pottery completed by people living at Willowbeck were displayed throughout the home. At the time of our inspection some people were looking forward to a visit to Blackpool the following day.

We spoke with two relatives about how the service respected and involved their family members. One relative told us that the staff knew the food preferences and favourite activities of their family member. The other relative told us that their family member was now able to be involved as a result of staff at Willowbeck being proactive and arranging a communication aid for their family member. They told us that this had "given [their family member] a voice.”

We spoke with eight people from different units within the home about the care, treatment and support they received. People told us that they liked living at Willowbeck and received the care they needed. People’s comments included, “Its nice living here,” and “the staff listen and get you what you need.”

We spoke with two relatives about the care their family received at the home. Each relative told us that they were confident in the way in which their relative was cared for. One relative described the care provided to their family member as “excellent” and stated “I wouldn’t have [my relative] anywhere else.” The other relative stated “I can’t fault staff for what they’ve done and what they continue to do.”