The Willows Care Home

At the last inspection carried out on 22 March 2016 the service was rated Outstanding. At this inspection we found the evidence continued to support the rating of Outstanding. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place. 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 lived at the home continued to receive personalised care which was very responsive to their individual needs. Staff had an excellent understanding of the care and support people required and provided this with great care and patience.

The Willows had achieved the highest award possible for end of life care. A healthcare professional we spoke with told us this was explementary as standards required to achieve this were extremely high. We saw relatives had praised end of life care provision for their loved ones at the home.

The owner and registered manager continued to support staff to provide extremely high standards of care for the benefit of people who lived at The Willows Care Home. This was demonstrated by the outstanding awards in caring for people the service had achieved.

Without exception everyone we spoke with including people who lived at the home, their visitors and healthcare professionals couldn't praise the home high enough. People who lived at the home told us how happy and well cared for they were.

People's care and support had been planned proactively and in partnership with them. People felt consulted and listened to about how their care would be delivered.

Links with health and social care professionals were excellent. Health professionals we spoke with repeatedly praised the high standards of care provided and described the service as exceptional. Health

care professionals told us staff were very responsive and acted quickly if people had healthcare issues.

The home had a vibrant and welcoming atmosphere where visitors were welcomed and encouraged. People we spoke with told us it was a pleasure to visit their relatives at the home.

People who lived at the home, their visitors, staff and healthcare professionals told us without exception the registered manager 'led by example'. This was underpinned by a clear set of values which included promoting each person's individuality, privacy, dignity, choice and rights. During our visit we observed staff acted according to these values when providing support to people in their care.

People who lived at the home and relatives repeatedly praised the quality and choices of food provided. Healthy eating was promoted. Meal times were relaxed and organised around people's individual daily routines. We saw the dining experience was enjoyed by people who were supported by caring, attentive and patient staff. Healthcare professionals told us nutritional support provided at the home was excellent.

The service continued to provide interesting and stimulating activities for people to participate in. People who lived at the home told us they felt engaged and spoke with great enthusiasm about the activities organised for them.

Systems, processes and practices were embedded to safeguard people from abuse and risk of harm. Good practice guidance had been followed to keep people safe. Staffing levels were continuously reviewed to ensure there were enough staff on duty to provide flexible care.

Recruitment procedures were safe with appropriate checks undertaken. Careful consideration had been given to ensure staff offered employment shared the same care values of the registered provider to deliver high quality care alongside the existing staff team.

Staff and their mix of skills were used innovatively to give them the time to develop positive and meaningful relationships with people to keep them safe and meet their needs. There was a strong emphasis on promoting independence and empowering people wherever possible.

Staff retention was good and people told us they were supported by staff who knew and consistently met their needs.

The service used innovative and creative ways to train and develop their staff and ensured they put their learning into practice to provide an outstanding service.

People who lived at the home, their relatives and healthcare professionals praised the way in which safety and risk was managed. We were repeatedly told that people remained safe whilst living at the home.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People received their medicines as prescribed and when needed and appropriate records had been completed.

The service had safe infection control procedures in place and staff had received infection control training.

People who lived at the home and relatives repeatedly praised the quality and choices of food provided. Healthy eating was promoted. Meal times were relaxed and organised around people's individual daily routines. We saw the dining experience was enjoyed by people who were supported by caring, attentive and

patient staff. A healthcare professional told us nutritional support provided at the home was excellent.

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.

The service used a variety of methods to assess and monitor the quality of the service. These included regular audits and satisfaction surveys to seek people's views about the service provided.

Further information is in the detailed findings below

The five questions we ask about services and what we found