Altrincham: Care home for children criticised by watchdog

Care Quality Commission (CQC) inspectors have raised concerns about systems at The Willow in Altrincham.

The home has been given an overall rating of "requires improvement".

An inspection was carried out in February.

Run by Oakfield Psychological Services, the facility provides "therapeutic psychological support" for children and young people with mental health illnesses and additional needs. 

A CQC report reads: “At the time of the inspection, systems had not been fully established to safeguard service users from abuse and improper treatment as safeguarding incidents had not always been effectively managed.

“Effective safeguarding policies and procedures in place to manage allegations of abuse when made against members of the senior management team were not in place.

“The provider did not have an effective policy and procedure for safeguarding vulnerable adults and staff had not received appropriate levels of training in safeguarding vulnerable adults.”

In two out of five of the assessment categories – "caring" and "responsiveness" – The Willow was said to be "good".

For "safety", "effectiveness" and "leadership" it was deemed to be in the "requires improvement" category. 

The report said there was enough staff to keep young people at The Willow safe.

“Staff who we spoke with were committed to treating young people with compassion, kindness and respect,” it said.

“They were passionate about making sure that young people were cared for as best as possible.”

It said the "use of restraint" had been kept to a minimum and "verbal de-escalation strategies" had been used successfully on several occasions.

The inspection team said the previous rating for The Willow, published in January 2022, was "requires improvement" and the service had had previous breaches of regulations.

“At this inspection we found the provider remained in breach of regulations,” they said.

Inspectors have made the following recommendations to the provider:

• Better cleaning of living quarters of young people who live at The Willow.

• Support for young people living at The Willow to maintain a balanced diet.

• Making sure all important documents such as health plans are available.

• Ensuring staff have an understanding of "Gillick Competence" (where children under the age of 16 consent to their own treatment if they’re believed to have enough intelligence, competence and understanding to fully appreciate what’s involved in their treatment).

• Young people living at The Willow should have access to an "independent mental capacity advocate".

The CQC found that The Willow was in breach of three regulations in the Health and Social Care Act 2014. 

Systems had not been established to assess, monitor and mitigate risks to health, safety and welfare of people using the service as the provider had not always taken reasonable steps to make sure that risk management plans had been updated when needed.

The Willow has been asked to send the CQC a report saying what action they will take on this.

But the CQC has taken enforcement action in the form a warning notice over its findings that systems had not been established to safeguard users from abuse and improper treatment as safeguarding incidents had not always been effectively managed; and that the provider had not operated an effective system to make sure the most up-to-date policies at The Willow reflected up-to-date legislation and guidance and that policies did not always reflect current practice or provide enough information to support staff.

The Willow was given notice that it must be compliant no later than April 7, 2023. 

A spokesperson for The Willow said: “We have taken immediate steps to further improve the quality of care and therapeutic support of our young person and very much look forward to inviting CQC back to support such actions.

“We endeavour to ensure that our young people receive the best specialist care and support and most importantly their voice and wishes are heard.”