The inspection took place on the 27 September 2018 and was unannounced. The service first became registered in September 2017. It was previously registered under another provider. This was the first inspection of the service with the new provider.

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

Three Willows Residential Care Home provides accommodation and care to up to 21 people. At the time of our inspection 21 people were living in the home. Care is provided across two floors with their own communal area on the ground floor. The service specialises in providing care to older people who are living with dementia.

There was a registered manager at this service. 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 their relatives told us they felt safe with staff and there were enough staff to meet their needs. Staff were trained in safeguarding and knew how to safeguard people against harm and abuse. People’s risk assessments were completed, regularly reviewed and gave sufficient information to staff on how to provide safe care. Staff kept detailed records of people’s accidents and incidents. Staff wore appropriate protective equipment to prevent the risk of spread of infection. Thorough recruitment checks were completed to assess the suitability of the staff employed. Medicines were stored and administered safely. The home environment was clean.

Staff knew people’s individual needs and were provided training to meet those needs. Staff told us they felt supported by the registered manager and received regular supervision. People were supported to meet their dietary needs and told us they liked the food. Staff assisted and supported people to access ongoing healthcare services to maintain healthier lives. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. Staff understood people’s right to choices and asked their permission before providing care.

Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS is law protecting people who are unable to make decisions for themselves or whom the state has decided their liberty needs to be deprived in their own best interests.

People’s needs were assessed and met in a personalised manner. Care plans were in place which included information about how to meet a person’s individual and assessed needs. People’s cultural and religious needs were respected when planning and delivering care. Staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.

The service had a complaints procedure in place and we found that complaints were investigated and where possible resolved to the satisfaction of the complainant.

The service had an end of life policy for people who used the service. The service explored end of life wishes during the initial needs assessment and care planning.

People, relatives, and staff told us the registered manager was supportive and available in the service. The service had various quality assurance and monitoring mechanisms in place.