Willows Edge is a residential care home for up to 39 people living with dementia. Accommodation is provided over three floors each served by a lift.

At the last inspection, the service was rated Good overall with a rating of Requires improvement for Safe, due to insufficient staffing provision.

At this inspection we found the service remained rated Good overall. Action had been taken to address the previous staffing issues through an increase in the service’s staff complement per shift. However, we found that further improvements were needed in “Effective” which was rated Requires Improvement. Further work was required to the general environment and to making the building and garden more dementia-friendly. Work had begun to address this but was still under way. Staff training and supervision had also fallen behind the provider’s own expectations but this too was being addressed since the appointment of a new registered manager in January 2017.

Previous issues with the food provided by the external caterers had been addressed and feedback said the food was improving.

The service had systems in place to ensure people were as safe as possible. Identified risks were assessed and action taken to mitigate them. Safety checks and servicing took place regularly and the staff recruitment process was robust.

The service met people’s needs effectively and responsively. People’s health and care needs were met. They were provided with a variety of activities and entertainment including some one to one time with staff. People’s and relative’s views about the service were sought and acted upon.

Care plans were sufficiently detailed for staff to be able to deliver personalised care. People were treated with respect and their dignity, privacy and rights were upheld. They were involved as much as possible in their care and making daily choices about their lives.

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 registered manager had effective systems to monitor the service and sought to develop and upskill the staff team. Staff felt supported and positive and understood the ethos of the service. Feedback from the local authority was positive. “Improvements have been noted around their documentation, recording/reporting and activities and [The registered manager] is currently addressing the environment.

Further information is in the detailed findings in the full report.

We found that people’s consent was obtained wherever possible. They were given choices and helped to make as many decisions for themselves as they could. Relatives of people who used the service told us that staff were always willing to listen and respect people’s choices.

We found that people’s health and care needs were met. We saw staff responding to people’s requests for assistance promptly and in a patient and professional way. People indicated by nodding and smiling or told us that they liked living in the home.

People were given a choice of freshly prepared food. People told us the food was, ''very nice indeed''.

The home was clean, hygienic and well maintained and a major refurbishment programme was underway.

We found that there were enough staff who were trained and supported to give good care to the people who lived in the home. People described staff as ''lovely girls''. Relatives told us that ''staff were patient and professional''.

The home had ways of making sure that they checked the quality of care being given to people. They listened to the views of the people who lived in the home.

People who lived in the home told us that they were ‘’always treated with respect’’. We found that staff communicated respectfully and sensitively with people who used the service, at all times. People told us that they could make choices about day to day activities for themselves and gave us some examples. We saw that staff respected people’s individuality and diversity.

We noted that the home was being refurbished in several areas. Staff were working hard to support the people who lived in the home through the disruption. The laundry refurbishment had been completed and the home had new windows. Staff members knew the individuals current needs and were observed meeting people's needs effectively. People told us that ‘’staff were always there to help you and always listened to what you told them’’. Staff were supported to do their jobs by being provided with appropriate training and regular supervision. People described staff as ‘’very good’ and relatives said they were ‘’very kind and caring’’. We found that medication was being administered safely and any medication errors were dealt with appropriately.

The records kept in the home were accurate and up-to-date. They were kept securely and could be accessed by the appropriate staff members.

People told us that it was ‘quite nice’ living in the home. They said there was very good food. People told us that ‘you could choose to do whatever you liked, for as long as you were still able to’.

A relative of someone who lived in the home described it as ‘brilliant’. They told us that staff were always alert to their relatives’ needs. They said that when they left them they were confident that they would be well looked after.

The inspection took place on 28 and 29 April 2015 and was unannounced. The service is registered to provide personal care support for up to 39 older people. At the time of the inspection care was being provided to 37 people all of whom were living with varying degrees of dementia. The home provided care over three floors, each with communal facilities available.

The service was required to have a registered manager. A manager was in place who had applied for registration. 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 service had been through a period without a permanent manager and where staff turnover had been high. This had resulted in training and staff support having fallen behind and reduced levels of activities at a time when dependency levels had increased.

The new manager was acting to address these issues and had sought additional care and activities staffing to do so. At the time of inspection staff levels were not sufficient to meet people’s needs at all times, which potentially placed them at risk of harm. Following the inspection plans were made to address this pending the recruitment of additional permanent staff.

People were supported with food and fluid intake and received their medicines correctly. Appropriate support was sought from external health professionals and others to support individuals and the development of the service.

Staff supported people in a caring way, involving them where possible and took account of their wishes. People’s rights and dignity were respected by the staff in the way their worked.

The operation of the service was monitored effectively by the manager and provider. Actions taken to address any issues were monitored.