Willowbeck Health Care Limited

Updated 9 June 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection visit was carried out by two inspectors and a Specialist Advisor. An Expert by Experience undertook telephone calls to people and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Willowbeck Health Care Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection the registered manager was not at the home and was no longer involved in the running of the service. The home had a manager who intended to make an application to be the registered manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service including Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and four relatives about their experience of the care provided. We spoke with fifteen members of staff including the registered manager, deputy manager, senior support workers, support workers, the cook and domestic staff.

We reviewed a range of records. This included five people’s support records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the home manager to validate evidence found and we spoke with staff during telephone calls.

Updated 9 June 2021

About the service

Willowbeck Health Care Limited is a nursing home providing personal and nursing care to up to 80 people with mental health or physical support needs. It comprises seven discrete units each with their own focus with communal facilities in each. At the time of the inspection one of the units was not in use and was being refurbished. There were 66 people living at the service.

People’s experience of using this service and what we found

Some environmental risks had not been identified which could have had an adverse affect on people’s safety. Staff were not given enough information about some risks to support them to keep people safe. Best practice guidance was not fully followed during the administration of people’s medicines. Lessons learnt were identified and shared, however these had not always been effective. People told us they felt safe and enjoyed living at the home. Staffing levels were sufficient to meet people’s needs.

People’s needs were assessed and support to meet those needs was planned however some people's support plans did not always contain enough information to support them safely. Staff were engaged with and received training. Compliance with this was high and well-monitored. People had a good choice of food and drink, which supported people’s preferences and cultural requirements. Regular handovers took place and systems were in place to make referrals to other professionals. People received and were encouraged to access ongoing healthcare support. People’s rooms were personalised. Staff were knowledgeable about people’s capacity and choices. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was a structured and detailed governance framework, however these systems had not identified the issues found during inspection nor some of the previous incidents which had occurred. There was a focus on continuous learning, however the effectiveness of this was not always evident. People and staff spoke highly about the home manager. Staff told us they were well-supported. People and their families were engaged with the home.

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

Rating at last inspection

The last rating for this service was good (published 10 May 2019).

Why we inspected

Prior to the inspection we received concerns in relation to the safety of people at the home and the management of medicines. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Willowbeck Health Care Limited on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to the effectiveness of governance and management oversight at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.