Green Willows is registered to provide support and accommodation for up to 30 people. It provides a service to people which includes older people, people living with a physical disability, sensory impairment and some people living with dementia. It also provides respite care. On the day of our visit there were 29 people who used the service.

There was a registered manager 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 and relatives said they felt safe and secure and had no concerns about safety at the home. Staff understood local safeguarding procedures. They knew what action to take if they were concerned that someone was at risk of abuse. Risks to people’s safety were assessed and reviewed. People received their medicines safely.

Thorough recruitment processes were in place for newly appointed staff to check they were suitable to work with people. Staffing numbers were maintained at a level to meet people’s needs safely.

Staff received regular training and there were opportunities for them to study for additional qualifications. Staff were supported by the management through supervision and appraisal.

Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). We found the registered manager understood when an application should be made and how to submit one.

People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated in line with their personal preferences.

People were supported by kind and caring staff who understood their job role. Staff took time to engage with people, providing reassurance and support. People had developed very good relationships with staff and told us that staff were kind, caring and that they treated them respectfully. Staff understood how to care for people in a sensitive way. People were supported at the end of their life to have a private, comfortable, dignified and pain-free death.

Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.

People were involved as much as possible in planning their care. Care plans provided information about people in a person-centred way and identified the support people needed and how support should be given. The registered manager and staff were flexible and responsive to people's individual preferences and ensured people were supported to live the life they wanted, in accordance with their needs and abilities.

Care plans were regularly reviewed. We saw that when a person’s needs had changed the care plan was updated to reflect this. People were encouraged to maintain their independence and to participate in activities that interested them. People were supported to express their religious beliefs and to maintain their cultural or religious needs. There was a clear complaints policy and people knew how to make a complaint if necessary.

The service was well led. The registered manager operated an open door policy and welcomed feedback on any aspect of the service. There was strong leadership within the home and the registered manager, deputy managers and senior staff monitored the delivery of care. The Service had a clear vision and values which were enforced by an open and positive culture. A system of audits were in place to measure and monitor the quality of the service provided and this helped to ensure care was delivered consistently. Suggestions on improvements to the service we

This visit took place to follow up a compliance action made at our last inspection in August 2014 when we found non-compliance regarding the infection control procedures at the home. We judged this to have a minor impact on people. The provider sent us an action plan to say the home would have taken the necessary actions to be compliant with this regulation by mid- September 2014.

One inspector carried out this inspection and spoke with the registered manager and three members of staff. We toured the home and reviewed the cleanliness of the premises. We also looked at policies and procedures in place to support the management of infection control.

At this inspection we found that the provider had completed the works necessary to ensure people were protected from the risk of infection and appropriate action had been taken to ensure people were cared for in a clean, hygienic environment.

Green Willow Care Home provided support and accommodation to a maximum of 30 people. At the time of our inspection there were 29 people living at the home.

During our visit we spoke with eight people who lived at the home. We also spoke with one visitor, the registered manager, the deputy manager, a senior carer and four members of staff.

The inspection was conducted by one inspector who was assisted by an expert by experience. We used this inspection to answer our five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.

Is the service safe?

None of the people we spoke with had any concerns about the support they received. All the people we spoke with told us they felt safe at Green Willow Care Home

We saw care and treatment was planned and delivered in a way that ensured people's safety and welfare. All of the care plans we looked at had risk assessments in place to help minimise any risk that had been identified.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Although we found the home was clean the systems in place with regard to the control of infections needed improvement.

Is the service effective?

Each person had a plan of care and support. We saw support plans explained what the person could do themselves and what support they needed from staff. Staff told us the care and support plans gave them the information they needed to provide the level of support people required.

We observed staff supporting people and care staff we spoke with were aware of people's needs and how people wanted care to be delivered. We saw staff offered advice and support and people were enabled to make their own choices and decisions.

Is the service caring?

Without exception, people said they were very happy with the way the staff interacted with them and felt they were both skilful and knowledgeable, but most importantly that they were kind and caring.

We observed staff speaking to people appropriately and they used people’s preferred form of address; We saw people and staff got on well together.

Is the service responsive?

We saw people had regular reviews of the care and support they received. People were able to participate in a range of activities both in the home and in the local community. Staff told us that they encouraged and supported people to participate in activities to promote and maintain their well-being.

People who used the service and their relatives were asked for their views about how the home was meeting people’s needs and any concerns or ways to improve the service were acted on.

Is the service well led?

Green Willow Care Home had a policy and procedure for quality assurance and one of the providers visited the service on a regular basis.

The manager told us they carried out a range of weekly and monthly audits to ensure that the home was maintaining a good standard of care and support. The provider checked that these audits were undertaken. The provider compiled a report after each visit and a copy of these reports were kept on file at the home.

Staff meetings took place every four to six weeks and minutes of these meetings were kept. The home also had regular meetings with people who used the service to obtain their views on how the home was performing.

The manager told us systems were in place for all staff to received regular one to one supervision where staff performance issues were discussed and additional staff training was identified.

In this report the name of a registered manager appears who was not in post and not managing the regulated activities at this location at the time of the inspection. Their name appears because they were still the registered manager on our register at the time.

We spoke with eight people who have been accommodated at Green Willow Care Home. We also spoke with two relatives who were visiting. They told us about the care and support they had received and confirmed they were very satisfied with the way it had been delivered.

They told us they had discussed their needs with the manager of the home and had given consent to the care they received. They also confirmed that the food provided was of a good standard and their nutrition needs had been met.

One person told us, "I get very good care. If I want anything I can get someone to help me." Another person said, "The staff are very good." A relative told us, “I know the staff are unable to improve my relative’s health, but they can make my relative comfortable and happy.”

We noted the atmosphere throughout the visit was good. It was calm, friendly and homely. We observed staff on duty had a good relationship with the people living at Green Willow Care Home. When talking with people, staff were friendly and professional. They spoke clearly to ensure they were understood and listened carefully to make sure they knew what was expected of them.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

We spoke with four people who have been accommodated at Green Willow Care Home. We also spoke with two relatives who were visiting. They told us about the care and support they had received and confirmed they were very satisfied. They also confirmed that they found staff were competent and skilled when providing for their needs.

One person told us, "The staff are pretty good. I am very comfortable. I always get the care provided when I need it." Another person said, "The staff are very loving towards us all!"

We spoke with three members of staff who were on duty. They informed us that they had received training that provided them with the necessary skills to deliver the care and support to people that was required. They also said they felt well supported by the manager in their work.

The atmosphere throughout the visit was good. It was calm, friendly and homely. We observed staff on duty had a good relationship with the people living there. When talking to people, staff were friendly and professional. They spoke clearly to ensure they were understood and listened carefully to make sure they knew what was expected of them.

We spoke to 4 people living at the home and a relative of someone living at the home. People said that they are satisfied with the service they receive. We were told that people had a look round the home before making a decision about moving in and that they were given written information about the home.

People said that the home meets their care and support needs. The following comments were made: ‘I can’t fault it. It was very satisfactory how they greeted me and what they have done for me. They don’t begrudge you anything you ask for. You are treated with kindness.’ Another person said that the staff ‘don’t hesitate to help you and they ask you what you want.’ A relative commented that everyone is treated ‘very respectfully and with dignity.’ Staff were said to be responsive to requests for support when they use the call point in their rooms. One person said, ‘The staff are here like a shot when I press the buzzer for help.’ People said that they are aware they have a care plan and have agreed to the care they receive.

People said that they are able to exercise choice in how they spend their time and that there is a choice of food at each meal. We were also told that frequent drinks are available including regular cups of tea and soft drinks.

People commented that there is an activities programme, and three people said that they make regular trips out from the home to events and attractions.

People said that they feel safe at the home. One person commented that night staff make regular checks on people. Comment was also made by people that they considered that the home has sufficient staff to meet their needs. Staff were said to be helpful, obliging and good at reassuring people.

People told us that they are asked to give their views on the service provided by the home by the use of a questionnaire, and that they feel comfortable raising any concerns or suggestions for improvement they have.