The Willows

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect. These shortfalls are a repeat breach of legal regulation 9: Person centred care, people were not supported in a person-centred way.

This service scored 45 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.



We received mixed views from people and relatives about whether the staff treated them with kindness and compassion. One person said, “Some [staff] are better than others.” This was reflected in our observations, we saw some very caring interactions from staff, whilst we also saw some which were not as caring. For example, a staff member was standing over a person completing their notes on the handheld device, whilst not interacting with them. A staff member rushed over to a person and made a fuss of them, which made the person smile, however, this level of positive interaction was not consistent with other people sitting in the room. Some staff did not speak with people when supporting them, but others did. There was an inconsistent approach of staff relating to caring interactions, which did not always demonstrate people were valued.

We observed people were provided with one biscuit on a paper plate, there was no choice given. When we pointed this out, people were then given a choice of their snack.

Since our last assessment, people’s continence pads were no longer on show in their bedrooms, which respected their privacy and dignity. We saw staff knock on people’s bedroom doors before entering.

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s care records did not include their hopes and aspirations. Some people’s records held their life history and how staff could speak with people about their previous work or interests, others did not. Where people’s preferences were documented, staff were not always respecting these. For example, one person’s records stated they preferred a bath in the evening, their daily notes did not evidence baths were being offered in the evening. Another person’s records were contradictory regarding their preferences, their care plan stated they did not eat meat or fish, but also stated they ate fish. Their daily notes showed, at times they were offered the meat dishes as well as the vegetarian option. This did not demonstrate and understanding and respect for individual preferences.

We received feedback from a relative regarding their family member wearing clothes which did not belong to them. We also observed a relative speak with a staff member about their family member wearing someone else’s clothing and how their new underwear was missing. This did not respect people’s dignity. We did see a relative meeting minutes where relatives were advised of labelling and a lost clothing rail which was available to check.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

Whilst people’s independence was identified in care plans. We were not assured this was always promoted and respected. A person’s care records said they needed prompting but could independently move position when in bed. However, daily notes identified they were being supported to move position by staff ‘by hand.’ This demonstrated the care plan was not being followed and independence was not always being promoted and respected. A member of the management team said they were in the process of addressing this.

The manager told us the activity staff had left the previous month. There were limited activities provided apart from visiting entertainers. The activity board showed 2 visiting entertainers for that week. During our visits, we only saw a visiting entertainer on 1 day and a staff member walking round the corridors with a person. There was no other social engagement. There were missed opportunities when staff could have spent time with people, such as before lunch when they were waiting for the food trolley. A person told us they were bored and they were not always told when the entertainers were due to visit. We saw people were not engaged and stared ahead or slept. People’s daily notes did not show people had access to meaningful activity to reduce the risks of boredom and isolation. Where records stated staff had a ‘chat’ with a person, this was only when they were being supported with their personal care needs. There were items which were dementia friendly available, but these were in a cupboard.

People’s relatives told us they could visit their family members when they chose to. One person’s relative told us as well as visiting, they also telephoned their family member and this was supported. We saw a staff member take the telephone to a person to speak with their relative.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We were not assured staff understood how to support people with their distress reactions. People’s care plans did not always include triggers for people’s distress and guide staff how to support people. For example, a person’s care plan stated they took medicines for depression, this was not explored fully in the care plan. Another person’s care plan lacked guidance for staff in how staff were to respond when they chose to speak about their deceased spouse. Daily notes for two people showed they had been distressed when being supported with their personal care needs, there was no evidence to show staff had withdrawn and returned later.

People told us and we saw staff were available when they were needed. We observed a staff member act quickly when a person was showing signs of discomfort, they ensured the person was comfortable and gave verbal and physical reassurance.



Feedback from people’s relatives varied regarding if they were consulted about their family member’s care. Whilst there was access provided to people’s care records to relatives, there was no evidence of discussion with people and their relatives about the person’s plan of care and if it was current or any changes were needed.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Since our last assessment, improvements had been made in the completion of e-learning training by staff and the provision of face-to-face training, including dementia. At our previous assessment, the previous management team assured us that they were considering providing training to staff who had been sponsored on dialects and British culture to ensure people’s cultural needs were being met and understood. At this assessment, this had not been delivered, the manager told us they were researching what was available in the community. This did not show a commitment to ensuring staff were provided with guidance and support to provide person centred care at all times.

Two staff told us there was a staff divide and a culture of bullying. We saw staff meeting minutes from November 2024 where staff were advised of the expectations of their role and to seek support of management should they need if for example, discrimination, or derogatory language happens. However, we were concerned that the minutes from these meetings stated staff were not to report concerns to CQC and told to raise within the service. Whilst it was positive to note staff were told their concerns would be listened to, there was a risk of the development of a closed culture where staff were told, “Care staff must not make a complaint directly to CQC.” The manager told us they were not aware of this message and would speak with the staff to reassure them of their right to raise concerns about the service externally if required.