Willow Brook is a registered care home that provides care and support for up to five people who may have mental health needs, a learning difficulty or physical support needs. We conducted our inspection on 16 and 17 October 2018. At the time of our inspection there were five people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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 and associated Regulations about how the service is run.

We previously inspected Willow Brook on 23 August 2017 and found the provider had not ensured staff were always appropriate trained. We also identified governance systems were not robust in recognising areas for improvement. We rated the service ‘Requires Improvement’. At this inspection we found improvements had been made so we rated the provider as ‘Good’.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

People were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector.

Risks associated with the environment and equipment had been identified and managed.

Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.

Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place. Staff had a good understanding of equality, diversity and human rights.

People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future.

Staff had received essential training and there were opportunities for additional training specific to the needs of the service, including challenging behaviour and epilepsy.

Staff had received both supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place.

People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people could give feedback and have choice in what they ate and drank. Health care was accessible for people and appointments were made for regular check-ups as needed.

People felt well looked after and supported. We observed friendly relationships had developed between people and staff. Care plans described people's preferences and needs in relevant areas, including communication, and they were encouraged to be as independent as possible.

People chose how to spend their day and they took part in meaningful activities.

People were encouraged to express their views and had completed surveys. They also said they felt listened to and any concerns or issues they raised were addressed.

People's individual needs were met by the adaptation of the premises.

Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an 'open door' management approach, whe

We carried out an announced inspection of this service on 24 August 2017. Willow Brook provides personal care and support for adults with a learning disability, autism or mental illness.

Willow Brook is a supported living service where people reside in self-contained flats on the first floor of a purpose built building and have designated key workers to support them with activities of daily living and personal care. The service operates from an office within the building. At the time of our inspection one person was being supported at Willow Brook.

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.

The provider supported staff with mandatory training which enabled them to care for people effectively. However, not all staff had completed training to assist them in managing behaviours that challenge which could impact on their skills in being able to deal with these behaviours in every day practice and audits had not identified this lack of training. However, there were other quality auditing and management systems in place to ensure that areas of improvement were identified and acted upon and to maintain best practice throughout the service.

Staff knew about the risks of abuse and avoidable harm and there were suitable processes

in place if they needed to report concerns. The provider had procedures in place to identify, assess, manage and reduce other risks to people's health and wellbeing which were tailored to their individual needs.

There were enough staff employed by the service to keep people safe and in accordance with their needs. Safe recruitment practices were followed to ensure that those employed were suitable to work in a care setting.

Medicines were stored securely in individual people's flats and administered by appropriately trained staff. Medicine administration records (MAR) were kept up to date and medicines that were no longer required were disposed of appropriately.

Staff demonstrated a good understanding of the Mental Capacity Act 2005 and provided good

examples of seeking consent when providing personal care and support. Deprivation of Liberty Safeguards (DoLS) applications were all completed thoroughly with a robust system in place to renew applications when required. There were good examples of best interest decisions having been made for a person when they lacked capacity to make decisions for themselves.

Staff were supported by regular supervision, well-being checks, group work and annual appraisal.

Staff were able to develop caring and warm relationships with people. They respected their independence, privacy and dignity when supporting people with their personal care and other activities of daily living. People were encouraged and supported to engage in meaningful activities according to their individual preferences.

People were supported and encouraged to maintain a healthy balanced diet and access health and social care professionals when required.

The provider's assessment, care planning and reporting systems were designed to make sure people received care and support that met their needs and was delivered according to their preferences and wishes. People were actively encouraged to contribute to decisions regarding their care and support. Support plans were personalised and holistic.

People knew how to make a complaint if they had concerns and complaints were logged, investigated and followed up in accordance with the provider policy. The complaints procedure was available in an easy read format.

The registered manager sought feedback from people, staff and external professionals to ensure the continual improvement of service provision. Feedback was very