About the service

Willow Lodge Nursing Home is in a residential area of Ormskirk, close to the town centre and all local amenities. The home provides accommodation for up to 22 people who need support with personal and nursing care needs, including those who are living with dementia. Both single and shared facilities are available on two floors, served by a passenger lift and stairs. There are communal areas available, including lounges and a dining area. There is a car park to the front of the property and a garden area to the rear of the home. At the time of our inspection there were 17 people living at the home.

People’s experience of using this service

Everyone we spoke with provided us with positive comments about the quality of service delivered. The provider had systems to act on allegations of abuse. People who lived at the home were not able to tell us what it was like living at Willow Lodge. However, family members told us they felt their relatives were safe. A system was in place for the reporting and recording of accidents and incidents and staff were recruited safely.

However, the provider lacked oversight of the service, as they failed to carry out robust checks and to address areas of significant risk. The premises needed upgrading and modernising. Some areas needed a thorough clean and fire safety was a concern in some parts of the home.

The management of medicines was satisfactory. However, the organisation of creams and PRN (as and when required) medicines could have been better. We made a recommendation about this.

Plans of care were detailed and person-centred. They reflected people's assessed needs well and had been consistently reviewed. Any changes in need had been recorded. Activities were not being regularly provided, to prevent isolation and boredom. We made a recommendation about this.

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. However, people were not involved in the planning of their own care, or that of their loved one. We made a recommendation about this.

People's needs and choices were assessed before they moved into the home. We saw some lovely interactions between staff and those who lived at Willow Lodge. However, people’s privacy and dignity were not consistently respected, and the meal service was not always person-centred. We made recommendations in these areas.

The provider did not calculate the staffing levels in accordance with the assessed needs of those who lived at the home, so that an appropriate number and skill mix of staff were deployed on each shift. We made a recommendation about this. New staff received an in-depth induction programme and a broad range of training had been completed by staff, who were regularly supervised and observed at work. However, appraisals had not been introduced at the time of our inspection. We made a recommendation about this.

The provider had policies for the management of complaints and systems for recording complaints had been introduced. Feedback had been obtained from those who used the service and their relatives. Team meetings had been held and staff members felt able to approach the managers with any concerns, should they need to do so. Meetings were not held for those who lived at the home and their relatives. The registered manager told us these meetings were arranged and advertised, but no-one attended. However, she operated an open-door policy, to encourage people to discuss any concerns or areas of good practice.

Rating at the last inspection

This was the first inspection of Willow Lodge since the change of ownership on 3 April 2018.

Why we inspected

This was a scheduled inspection.

Enforcement

We have identified breaches in relation to safe care and treatment, premises and equipment and good governance at this inspection.

Please see the action we have to