Willow Brook is a registered domiciliary service that provides care and support for people who may have mental health needs, a learning difficulty or physical support needs. This service provides care and support to people living in ‘supported living’ settings so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of our inspection eight people received care and support from Willow Brook.

We conducted our inspection on 16, 17 and 26 October 2018. At the time of our inspection there were eight people using the service.

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 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.

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 received supervision and annual appraisal to support development.

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 said they felt listened to and any concerns or issues they raised were addressed.

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, where managers were always available to discuss suggestions and address problems or concerns.

The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.

We carried out an unannounced inspection of this service on the 23 August 2017.

Willow Brook provides personal care and support for adults with a learning disability, a mental illness and/or other health conditions. The home is a purpose built building on one level with each person having their own room with ensuite shower facilities. There is a communal lounge and kitchen/dining area for people to use and a bathroom for people who choose to have a bath rather than shower. At the time of our inspection there were five people living 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.

Although the registered manager sought feedback from people, staff and external professionals to ensure the continual improvement of service provision, the registered manager did not always follow up on the actions with regards to staff training in a timely manner.

People were kept safe from potential abuse and avoidable harm by staff who knew them well. Staff were able to demonstrate a good knowledge of how to recognise the signs of abuse and how to report this appropriately. The provider supported staff to keep people safe by providing mandatory safeguarding training.

The provider followed safe recruitment practices to ensure that those working in a care setting were suitable. There were enough staff employed to keep people safe.

Medicines were stored managed, disposed of and stored securely.

Detailed risk assessments were in place and tailored to each person to mitigate any potential risk of harm to people and staff.

Staff were mostly up-to-date with mandatory training updates which enabled them to care for people effectively.

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

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

The service supported people to maintain a healthy and balanced diet. People actively contributed towards their meal choices and were supported to engage in cooking meals if they wished. People were encouraged and supported to access health and social care professionals when required.

People developed warm relationships with their support workers who knew people well. Staff spoke in a caring and positive manner about people living at Willow Brook and demonstrated pride in the outcomes achieved by people living at the home.

Support plans were detailed and personalised. Each care plan was available in easy read format to support people in being able to contribute towards decisions about their care and treatment. There was evidence of support plans having been reviewed regularly.

People’s privacy and dignity was supported at all times with an emphasis on ensuring that people maintained their independence and had choice in relation to their care, environment and the activities they engaged in.

There was a complaints policy in place which was also available in easy read format for people living at the home and kept in the communal lounge. Evidence showed complaints were dealt with in accordance with policy.

The culture of the home was very caring and supportive which had been introduced and maintained by the registered manager. Staff spoke positively of the management team. The registered manager promoted staff well-being by introducing a number of processes to ensure staff felt valued. Meetings were held to encourage people and staff to discuss any issues they may ha