The inspection took place on 27 March 2018, and was unannounced

Willett Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home can provide accommodation and nursing care for 20 people in one detached building that is adapted for the current use. The home provides support for people living with a range of healthcare, mobility and sensory needs, including people living with dementia. There were 17 people living at the home at the time of our inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered managers, 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.

At the last inspection on 14 March 2017, the service was rated Good. At this inspection we found the service remained Good

People and relatives told us they felt the service was safe. People remained protected from the risk of abuse because staff understood how to identify and report it. A social care professional told us, “Based on recent reviews of people’s placements, I can confirm that resident’s safety whilst living at Willett’s Lodge is one of the most important areas for the care team.”

The registered manager completed risk assessments and a programme of regular health and safety checks to ensure quality was measured and maintained. We observed audit activity for areas including, medicines, and fire safety and infection control.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to have their medicine safely when they needed it. People were supported to maintain good health and had access to health care services.

People and their relatives felt staff were skilled to meet the needs of people living with dementia and provide effective care. One relative told us, “It’s not posh but it’s good care”. Staff told us they received training that the importance of understanding people’s life experiences and supported them to work empathically when delivering person centred care.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. 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 provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

Staff supported people to eat and drink and their nutritional needs were met. One person told us, “The food is always lovely here.” Where special dietary needs were required in relation to people being at risk of malnutrition or choking staff followed guidance given by care plans and the health professionals.

People’s relatives told us and we saw that the staff were caring and respectful. One person told us, “They care about people, they care about us”. Care and support provided was personalised and met peoples’ diverse needs. People and their relatives were included in the assessment of their needs and development of care plans.

People when needed received ‘end of life care’ that was responsive to their health care needs and respected their wishes and diverse cultural needs.

Feedback received showed relatives were satisfied overall, and felt staff genuinely cared. People and relatives felt listened to and any concerns or issues they raised were addressed suitably and dealt with in a timely way.

Quality assurance audits completed by the registered manager and provider were embedded to ensure a good le

This focused inspection took place on 14 March 2017 and was unannounced. At the last comprehensive inspection on 26 January 2016, the service was rated as Good overall. This focused inspection was undertaken in response to information of concern we received which included allegations that people were not always provided with safe care and treatment. Therefore this report only covers our findings in relation to the ‘Safe’ domain and the overall rating for Willett Lodge remains unchanged. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Willett Lodge on our website at www.cqc.org.uk.

Willett Lodge is registered to provide accommodation and nursing care for up to 20 people with a range of healthcare needs, including people living with dementia. At the time of our inspection, 20 people were accommodated at the home. Willett Lodge is situated in a residential area of Worthing close to the town centre and seafront, with easy access to public transport. The home has a large sitting room, dining room, hall area and sun lounge. Bathrooms are accessible and equipped for people with limited mobility. Some bedrooms have en-suite facilities. There is a garden to the rear of the property and a decking area so that people can sit outside.

A registered manager was 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 felt safe living at Willett Lodge and their relatives spoke positively about the care delivered by staff. People were protected from harm and staff had been trained in safeguarding adults at risk. Risks to people were identified, assessed and managed appropriately. Guidance for staff was contained within people’s care plans in a range of areas, such as moving and handling, nutrition and risks associated with specific health conditions. People at risk of malnourishment were monitored appropriately. Safe moving and handling techniques were observed. Various parts of the home were in need of repair or refurbishment and the provider had plans in place to address these. Some refurbishment was in progress at the time of this inspection. Staffing levels were sufficient to meet people’s needs. Safe recruitment practices were in place. Medicines were managed safely and people received their medicines as prescribed.

The inspection took place on 26 January 2016 and was unannounced. Willett Lodge is a nursing home that is registered to provide care and support for up to 20 people with a range of health needs, including dementia. At the time of our inspection, 18 people were living at the home. Willett Lodge is situated in a residential area of Worthing close to the town centre and seafront, with easy access to public transport. The home has a large sitting room, dining room, hall area and sun lounge. Bathrooms are accessible and equipped for people with limited mobility. Some bedrooms have en-suite facilities. There is a garden to the rear of the property and a decking area so that people can sit outside.

A registered manager was 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 were supported to be safe by staff who had been trained to recognise the signs of potential abuse and knew what action to take if they suspected abuse was taking place. Risks to people were identified, assessed and managed appropriately. Accidents and incidents were recorded and monitored and, where needed, risk assessments and care plans were updated. Premises and equipment were managed to keep people safe. Environmental risks had been identified and assessed and safety checks undertaken as needed. There were sufficient numbers of staff on duty and when new staff commenced employment, checks were undertaken on their suitability to work in the care profession. People’s medicines were managed so they received them safely by trained staff. The home was clean and hygienic and staff wore personal protective equipment when delivering personal care and serving meals.

Staff were trained in a wide range of areas so people received effective care. New staff undertook an induction programme and followed the Care Certificate, a universally recognised qualification. Staff received regular supervision and had annual appraisals. The requirements of the Mental Capacity Act 2005 and associated legislation under the Deprivation of Liberty Safeguards were understood by the registered manager and staff. Where required, decisions were taken in line with this legislation and best interest meetings held. People were supported to have sufficient to eat and drink and to maintain a healthy lifestyle. They had access to a range of healthcare professionals and services. People were encouraged to personalise their rooms with photos and ornaments that were important to them. The provider was in the process of redecorating the home.

People were looked after by kind and caring staff who knew them well. Staff cared for and supported people in a warm, friendly and reassuring way. One relative said, “They do over and above what they have to do, but they do it because they care”. People were treated with dignity and respect and were encouraged to be involved in decisions about their care. Care plans were reviewed monthly and relatives were consulted and involved in care planning. Staff were trained to support people as they reached the end of their lives to enable people to have a comfortable and pain-free death.

Care plans contained comprehensive information about people and provided guidance to staff on how they wished to be cared for. Some care plans did not contain personal histories about people and the registered manager was in the process of completing these, in conjunction with people’s relatives. A range of activities was on offer, with group activities or staff spending 1:1 time with people to engage in their hobbies or games. People were encouraged and supported by staff to go out into the community. Complaints were managed appropriately and, where neces

There was no registered manager for the service at the time of the inspection. However, there was a manager in post who was in the process of applying to be registered.

We looked at respecting and involving people who use services, care and welfare of people, safeguarding, supporting staff and the assessment and monitoring of service provision. We spoke with one person who uses the service, five relatives, and the manager.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found

Is the service safe?

The relatives of people living at Willett lodge told us they thought their family members were safe at Willett Lodge. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. Relatives told us they were able to report any safeguarding concerns they had. Systems were in place to support the manager and staff to learn from events such as accidents and incidents, complaints and concerns.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. One person living at Willett Lodge was subject to this safeguard and the appropriate process had been followed. Staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People we spoke with and their relatives told us they were happy with the care that was provided. From what we observed and from speaking with the staff it was clear that they understood people’s care and support needs. Staff had received training and development to meet the needs of the people living at the home. Risks were assessed and care plans written to reflect the support provided.

Is the service caring?

We saw that staff were attentive and kind to the people who needed support. Staff told us they encouraged people to maintain their independence. People’s preferences, interests and diverse needs had been recorded in the care plans we reviewed. One relative told us they were 'Very impressed with the level of care and interest' that staff provided.

Is the service responsive?

People’s needs had been assessed before they moved into the home. Information had been recorded on detailed care plans. People and their relatives knew how to make a complaint if they were unhappy. We saw that a copy of the complaints procedure was given to everyone when they moved to Willett lodge. People living at the home participated in a range of activities that were tailored to their individual needs.

Is the service well-led?

The service worked with other agencies and services to make sure people received their care in a joined up way. A quality assurance system was in place and where issues had been identified these had been rectified by the manager. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurances that were in place. People using the service and their relatives were offered a questionnaire to complete. Where shortfalls or concerns were raised they had been addressed and discussed with the person.

On the day of our inspection there were 18 people living at the service. Due to their complex needs, people who used the service were not able to speak with us in detail about how their care was provided. We talked with one person who used the service, one relative in person and two relatives on the telephone. We also spoke with four members of staff and the manager.

One person told us it was “Very nice indeed” at the service. Relatives we spoke with told us that people received good care. One relative said “They look after him really well. He’s very happy there.” Another relative told us that their family member “Receives very good care. The staff answer my questions honestly. Staff are kind, caring and patient.”

People told us that staff understood the needs of the people who used the service and that they provided appropriate care and support. One relative said “Staff know what they’re doing, we’re very impressed with them.” We observed that staff were responsive when people asked for assistance and offered people choices about how their care was provided.

Sufficient numbers of staff with the relevant training, skills and experience were employed to meet peoples’ needs. Records showed that the service took account of peoples’ views. A relative told us “I feel free to mention things to the manager if there’s anything I’m not happy about”. The service monitored the quality and safety of the service provided and took action where needed.

Due to people’s complex needs, many people were not able to tell us about their experiences. We used a number of different methods such as observation of care and reviewing of records to help us understand the experiences of people using the service.

One person we spoke said “they take good care of me, no doubt about it.” Relatives and visitors we spoke to said the level of care was good, and a relative said to us that staff were “very caring and committed to all the residents.”

The provider had addressed the concerns we found at our previous inspection. We found that the provider had monitored that people were receiving safe care and improvements were made where needed. We observed that safe care was provided to people, and that activities people wanted to participate in took place.

We spoke with five of the 15 people who lived Willett Lodge. They told us they were very happy with the care afforded to them. One person told us, “I think this home is very well run.”

Conversation with people was limited due to their disabilities. However, we also spent time with them and observed the care they received from staff in order to understand what it was like to live at this care home

We spoke to the relatives of one person who were visiting the service. They confirmed they were satisfied with the standard of care provided. They told us, “The staff are always kind and caring.”

We spoke with the nurse in charge of the shift and two members of care staff who were on duty. They demonstrated they knew about the level of care that each person required. They told us that they felt well supported by the manager.