Treelands Home Ltd Main Site and Treelands Atrium

Treelands Home Ltd Main Site and Treelands Atrium (thereafter known as Treelands) is a residential care home providing personal care for up to 60 people, some of whom are living with dementia. At the time of our inspection there were 56 people using the service. Treelands is situated in an easily accessible rural area and is purpose built. The main site can accommodate 36 people with the Atrium building across the drive for 20 people. There were wide ranging country views and large, safe open spaces for people to use.

People's experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People felt safe living at Treelands. People received safe care and were protected from the risk of abuse. Staff were aware of their responsibilities for keeping people safe and received safeguarding training. Peoples’ comments included, “It’s lovely here, I’m absolutely fine and I have everything I need. I’m getting a sun lounger so I can sit on my patio in the summer". Relatives were happy and felt safe leaving their loved ones at Treelands. They said, “We thank all the lovely staff. Dad had a lovely respite week and made some very nice friends. He is hoping for another holiday there soon”, “[Staff] truly care for the residents and make each one feel part of the family” and “Mum has made genuine friends with so many of the care staff and maintenance crew that I can relax.”

People were supported by enough suitably experienced and trained staff who were safely recruited. Staff worked with health and social care professionals to help people maintain their health and wellbeing.

Medicines were safely managed by trained staff.

Risks associated with people's care had been regularly reviewed and were well managed.

Visitors were welcomed into the service and their views were sought, considered and respected.

There were robust systems and processes in place to monitor the quality of the service. When required actions were taken, and the necessary improvement made. The registered manager was supported by the provider to identify concerns and learn lessons when things went wrong.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 14 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service and length of time since the last inspection. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Treelands Home Ltd Main Site and Treelands Atrium on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Treelands is a residential home registered to provide accommodation with personal care for up to 40 older people, some living with dementia. The service had a registered manager.

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.

People living at the service, their relatives and health and social care professionals gave us positive feedback about the service. One person said, “If all homes were like this one, there wouldn’t be anything to worry about.”

People said they felt safe living at the home. Staff knew how to identify signs of potential abuse, where and how to raise concerns and that these would be acted upon. Environmental risk assessments were undertaken but regular checks were not always undertaken. This left some people at risk of avoidable harm. Individual risk assessments were undertaken and records showed that appropriate measures had been put in place to minimise risks to people. Medicines were administered and stored safely.

An effective recruitment process made sure only suitable staff were employed to care for people.

There were sufficient numbers of staff on duty to support people. Staff received a thorough induction, training and ongoing supervision to enable them to carry out their roles. Staff felt well supported by management.

People were treated as individuals with dignity and respect and their consent was sought for care and treatment. Where people lacked capacity, the Mental Capacity Act 2005 and its code of practice was followed. Relatives, health care professionals and others were consulted and involved in best interest decision making. People received a varied diet in accordance with their own choices. People’s health needs were met by a range of external professionals. Healthcare professionals felt confident that the service delivered good quality service.

People and their relatives praised the staff for delivering high quality care. Staff were described as friendly, kind and caring.

People had individual risk assessments and care plans and had been consulted along with their families. There was a programme of activities on offer. Family and friends were able to visit freely and visitors were made welcome.

There was a variety of systems in place to monitor the quality of the service. Prompt action was taken to remedy any shortcomings. External organisations provided support to improve systems.

We found that there had not been leadership or clear responsibilities on some shifts. Some staff said that their views were not listened to and minutes of staff meetings did not provide evidence of any discussions or actions. We found that some incidents had not been analysed to identify learning and possible improvements.

We inspected Treelands again on 6 March 2014 to check that specific improvements had been made. We found that the provider had taken effective steps to improve the quality assurance systems at the home.

We found that there was a clear understanding of responsibilities and leadership. We saw evidence which showed that care workers' views about issues which could have an impact on quality were more clearly recorded and had been responded to.

Care workers told us about recent changes and new processes which had been introduced. Although some care workers felt that the pace of change was too quick, most staff we spoke with felt that the changes had improved the service.

We found that there had been proper analysis of incidents to support learning and improvement, especially in relation to medication.

Overall we found that quality assurance systems were more robust.

We spoke with nine members of staff, five people who used the service, and four relatives of people who used the service. People told us that care workers were "fine, no problem" and "fairly polite".

We found that Treelands had a clean environment which supported the delivery of safe care. We found that consistency in infection control was being monitored by the manager.

We looked at four people's care plans and found that they contained up to date needs assessments. Daily care records showed that people had been supported with their personal hygiene and individual health needs. Treelands had appropriate arrangements for protecting people from the risks of unsafe use or management of medications.

There were sufficient numbers of suitably qualified and experienced staff to meet people's needs at the time of our inspection visits. Plans to improve leadership on shifts had been made but not yet implemented.

We found that care workers were not always able to influence the service and that analysis of incidents did not always occur. This meant that the provider might not have had an informed view of the quality of the service.

An inspection in March 2012 had identified the need for improvements relating to the updating of policies, maintenance records and training. During this inspection we found that those improvements had been made.

People we spoke with told us that their care needs were well met. Comments included, "They help me as much as I want and do just what I need". We observed during our visit that call bells were answered promptly. People told us that food at the home was good and that there was enough of it. They told us that they felt safe. The home provided activities and people told us they were free to choose whether they took part in them. We observed that people were treated respectfully. People told us they were involved in decisions about their care.

Records showed that people's care needs were assessed and had been reviewed on a regular basis. Daily care records showed that care had been delivered in line with care plans. A district nurse who visited the home regularly told us that staff raised health concerns promptly. The home had measures in place to deal with emergencies.

Effective recruitment processes were in place and staff were supported with training and through regular supervisions.

The home had effective systems of quality monitoring in place and responded to feedback from people and their families.