Willowbrook Homecare

This service is a domiciliary care agency. It provides personal care to people living in their own houses. The agency also provides care and support to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant's own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service. At the time of the inspection, a total of 261 people were receiving a service from the agency.

At the last inspection, in April 2016, the service was rated as overall good, however, we identified one breach of the regulations. This was because the provider had failed to operate a robust recruitment procedure. Following the inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve the key question of 'Safe' to at least good. At this inspection, we found the provider had made the necessary improvements to the recruitment procedure. However, we found some improvements were needed to the management of medicines and the risk assessment process. We have therefore retained the rating of requires improvement in the key question of 'Safe', but as we have identified no breaches of the regulations the overall rating remains 'Good'.

People using the service told us they felt safe and staff treated them well. Safeguarding adults' procedures were in place and staff understood their responsibilities to safeguard people from abuse. Individual risks had been assessed; however, risks associated with choking and skin integrity had not been fully assessed and documented. There were systems in place to support people with their medicines, however, there were some shortfalls found in the records and the care planning for medicines. We were assured by the registered manager the necessary improvements would be made.

People told us the staff arrived on time and stayed for the agreed amount of time. None of the people spoken with had experienced a missed visit. The registered manager closely monitored any missed visits and there was evidence of investigations following missed visits. According to the central register, there had been eight missed visits in 2018. An electronic call monitoring system was in place to monitor visits.

Staff members told us they received effective training to meet people's needs. An induction and training programme was in place for all staff.

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. However, the principles of the Mental Capacity Act were not always evidenced as part of the care planning process. People were supported with their healthcare and nutritional needs as appropriate.

People told us the staff were caring and they respected their rights to privacy, dignity and independence. All people spoken with told us the staff were kind and caring. People told us they were involved in the development and review of their care plans. This meant people were able to influence the delivery of their care and staff had up to date information about people's needs and wishes. People told us they usually received care from a consistent group of staff. People were aware of the complaints procedure and processes and were confident they would be listened to.

Systems were in place to monitor the quality of the service, which included seeking and responding to feedback from people and their relatives in relation to the standard of care.

The five questions we ask about services and what we found