Archived: Willowhurst

Willowhurst provides personal care and accommodation for up to five young people with mental health support needs. The service aims to provide an alternative to hospital. There is a central hub where mental health professionals are based. Young people access their services by visiting the hub in a nearby town and also receive some home visits. The service promotes independence and responsibility for young people who are actively involved in their plans for the future. At the time of the inspection there were two young people living in the service.

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

Young people living in the home were positive about their experiences at Willowhurst. Their comments included; 'I feel safe at all times, staff are always there to help me or reassure me they are here' and 'I enjoy the support I get from staff. I have always got on with people I live with. Willowhurst is the best place for me.'

Young people had been supported to manage risks. The provider had reviewed and updated risk management plans to minimise the potential for harm. Staff said the new plans were helpful and provided clear guidance.

Young people were supported by trained staff. There were enough staff to support young people safely. Staff had received diagnostic training which help provide them with an introduction to specific mental health conditions. Staff were supported by the providers supervision and support policies and praised the support from the registered manager.

The provider and registered manager were clear with staff about the values of the organisation. Staff were positive about the clear example set by the registered manager who they found to be knowledgeable and approachable.

The registered manager had effective oversight of the service which helped ensure the quality of care, records and premises were maintained. The registered manager had established consistent communication with partner agencies and commissioners who confirmed they were kept up to date regularly.

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

Rating at the last inspection

The last rating for this service was Requires Improvement (published 1 September 2021). There was breach of the regulations in relation to good governance. We had also made recommendations in relation to safe staffing levels, staff training and risk mitigation.

Why we inspected

We carried out an announced comprehensive inspection of this service on 1 September 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance, staffing, training and risk mitigation.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-Led, which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

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.

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.

Willowhurst provides personal care and accommodation for up to five young people with mental health support needs. The service aims to provide an alternative to hospital. There is a central hub where mental health professionals are based. Young people access their services by visiting the hub in a nearby town and also receive some home visits. The service promotes independence and responsibility for young people who are actively involved in their plans for the future. At the time of the inspection there were three people living in the service.

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

People were not always safe. Staff did not have the training and qualifications the provider had identified to commissioners. No staff had completed either Level 2 or 3 in health and social care. Although staff said they understood the therapeutic model based on Safewards for Safehomes, some staff reported they had not had any introductory training in relation to mental health conditions and would have valued this.

Staff told us effective management and oversight had not always been maintained. There was an acting manager in post, who planned to register with CQC. Staff told us they felt there had been an inconsistency in support from the provider which had impacted on the experience of young people living in the home. On call facilities were available as a contingency from managers and mental health professionals, however, staff had mixed views about how useful they had found this.

We have identified a breach in relation to Governance because we found there had not been effective oversight by the registered manager and provider. We have made recommendations in relation to staffing, training and responding to risks.

Young people we spoke with were positive about their experiences living in Willowhurst. Staff we spoke with reported enjoying working there and were committed to supporting young people.

Young people were fully involved in developing their care plans which were highly person centred. Young people were encouraged to develop their independence and have ownership of their decisions. We saw young people achieved positive outcomes and had moved on from the service.

Young people were supported by caring and compassionate staff. Staff actively promoted young people's equality, diversity and human rights.

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.

Rating at the last inspection

This service was registered with us on 25 September 2020 and this is the first inspection. Prior to this date the service had been registered with the hospitals inspectorate.

Why we inspected

The inspection was prompted in part due to concerns received about risk management and staffing levels. A decision was made for us to inspect and examine those risks.

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.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.