Willowbrook is a residential care home for six people with an acquired brain injury or associated needs and rehabilitation. The service is a modern purpose built accommodation with level access throughout and adapted to promote people’s rehabilitation. At the time of our inspection there were five people in residence.

At the last inspection in March 2015, the service was rated good.

At this inspection we found the service remained good.

People told us they felt safe using the service and with the staff. Staff understood their role in protecting people to stay safe. People received support that was tailored to their needs and rehabilitation in order to achieve their aspirations and goal to live independently as possible.

People received their medicines at the right times. People were provided with a choice of meals that met their dietary needs to maintain their health. People had access to a range of specialist health care support. The registered manager and staff worked closely with relevant health care professionals to ensure people’s ongoing health needs and goals to live independently were met.

Staff were safely recruited. Staff received comprehensive ongoing essential training which included training in an acquired brain injury. Staff worked closely with health care professionals to support people with complex needs. Staff received support and guidance through supervision and meetings in order to meet people’s needs effectively.

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. Support plans provided staff with clear guidance and information about the support people required. People took part in activities that were important to them both at home and in the community, including their faith, which promoted their quality of life.

Staff were kind and caring. Staff had developed positive trusting relationships with people who were skilful in their interactions with people and focussed on their rehabilitation and promoting their independence. Staff treated people with dignity and respect. The design of the environment helped to ensure people’s privacy was promoted.

People’s relatives were confident to raise concerns. Relatives had regular contact with the registered manager and staff which meant any issues could be discussed and ideas shared for the benefit of those using the service.

Staff spoke positively about the registered manager in relation to the support provided and their leadership. They told us that there were effective systems which enabled them to communicate well with their colleagues to ensure that people received the support they needed. Staff were confident to raise any issues with the registered manager and their views were sought in how to improve the service and the lives of people who used the service.

The registered manager was committed to providing quality care and showed an awareness of their legal responsibilities. They promoted a culture of openness and promoted staff’s learning and professional development. The provider’s governance system to monitor and assess the quality of the service was in place. Information gathered as part of the quality audits was used to continually develop the service and look for ways in which people using the service could achieve greater autonomy.

This inspection took place on 4 March 2015 and was unannounced.

Willowbrook is a purpose built care home that provides residential care for up to six people with an acquired brain injury or associated needs and specialises in rehabilitation. The service is a modern purpose built accommodation with level access throughout. At the time of our inspection there were five people in residence.

A registered manager was 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.

People told us that they felt safe. People were well cared for, felt safe with the staff that looked after them and protected them from harm and abuse. People’s needs had been risk assessed to promote their safety and independence. People were actively involved in the development of their plan of care along with the staff and relevant health and social care professionals. People told us they were satisfied with the care provided.

Safe staff recruitment procedures were followed that ensured staff were qualified and suitable to work at the home. We saw there were sufficient numbers of staff to support people to meet their individual needs including developing their daily living skills and accessing community services.

Staff were knowledgeable about their responsibilities and were confident that if they had any concerns about people’s safety, health or welfare then they would know what action to take.

Staff were recruited in accordance with the provider’s recruitment procedures that ensured staff were qualified and suitable to work at the home. We observed there to be sufficient staff available to meet people’s needs and that they worked in a co-ordinated manner.

People received their medication as prescribed and their medication was stored safely. Staff were appropriately trained in medicines management and their competency assessed to ensure people’s medicines were managed properly to maintain their health and wellbeing.

Staff received an appropriate induction and training which reflected the needs of people who used the service which enabled them to provide care in a safe manner. They had access to people’s care records and were knowledgeable about people’s needs and things that were important to them.

People were protected under the Mental Capacity Act and Deprivation of Liberty Safeguards. The registered manager and staff understood their role in supporting people to maintain control and make decisions which affected their daily lives. We found that appropriate referrals had been made to supervisory bodies where there was a risk people did not have capacity to make decisions.

The design and layout of the service took account of people’s needs and promoted people’s freedom and safety. The environment was used to encourage people to learn skills to live independently.

People were provided with a choice of meals that met their cultural and dietary needs. People at risk of poor nutrition had assessments and plans of care in place for the promotion of their health. People gave their views about the meal choices and staff supported those with meal planning and budgeting as part of their rehabilitation plan to live independently.

People had choice and control over their lives and were supported to take part in activities both at the service and outside in the community. This included supporting people to maintain their identity, observe and practice their faith.

People had access to health care support to meet their needs in a timely manner. Health care professionals with expertise to rehabilitate people with an acquired brain injury were involved in the development of people’s rehabilitation plans of care and supported staff in using appropriate strategies in promoting people’s safety, health and wellbeing.

Information gathered from a health care professional and our observations showed there to be a positive working relationship between professionals and the service, which impacted on the quality of care people received.

People spoke positively about the staff’s attitude and approach. They felt staff were kind and caring. Their privacy and dignity was respected in the delivery of care and their choice of lifestyle. People were comfortable and relaxed in the company of staff. We observed people being encouraged to make decisions about their day and records showed people’s comments and views were documented in their care records.

People’s care and support was person centred, which took account of their individual needs along with their goals and aspirations. People were supported by staff who were responsive to their needs and requests for support, which included accessing community facilities independently or with support from staff. People were involved in the development of their plans of care with support from the staff and the relevant health care professionals. Staff including their provider’s internal health care professionals working with external health care professionals and developed with innovative ways of supporting people to meet their individual needs and goals. Staff were aware of the strategies developed to support people in their rehabilitation, which were monitored and reviewed regularly.

People were confident to raise any issues, concerns or to make complaints, which would be listened to and acted on appropriately. Records showed complaints received had been documented and included the outcome and response to the complainant.

Staff told us they had access to information about people’s care and support needs and what was important to people. Staff knew they could make comments or raise concerns with the management team about the way the service was run and knew it would be acted on.

The registered manager understood their responsibilities and demonstrated a commitment to provide quality care. They had an ‘open door’ policy to encourage feedback from people who used the service, relatives, health and social care professionals and staff.

The provider’s quality assurance systems and processes monitored the performance of the service and the quality of care provided. There were effective systems in place for the maintenance of the building and equipment which ensured people lived in an environment, which was well maintained and safe. Audits and checks were effectively used to ensure people’s safety and their needs were being met.

The registered manager worked with health and social care professionals and the local authority commissioner that monitor the service for people they funded to ensure people received care that was appropriate and safe.