Archived: Treetops

Updated 21 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was carried out by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We reviewed information we had about the service including statutory notifications. Notifications are information about specific events that the service is legally required to send us. A Provider Information Return (PIR) had not been requested for this inspection.

Some people at the service were living with dementia. This meant they were not always able to tell us about their experiences. We used a number of different methods such as undertaking observations to help us understand people’s experiences of the home. As part of our observations we used the Short Observational Tool for Inspection (SOFI). SOFI is a way of observing care to help us understand the needs of people who could not talk with us

During the inspection we spoke with five people living at the service, 11 relatives and 13 staff members. This included the registered manager, the newly appointed manager and other senior staff members. We received feedback from two health and social care professionals. We looked at eight people’s care and support records and four staff files. We also looked at records relating to the management of the service such as incident and accident records, meeting minutes, recruitment and training records, policies, audits and complaints.

Updated 21 June 2018

We undertook an unannounced inspection on 15 and 17 May 2018. The last comprehensive inspection of the service took place in September 2017. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this last inspection the service had failed to comply with a warning notice that had been issued after a comprehensive inspection in January 2017. The service was rated as requires improvement. The domain of well-led was rated inadequate for a second consecutive time therefore, the service was placed in special measures.

During this inspection we checked that the provider was meeting the legal requirements of the regulations they had previously breached. You can read the report from our last inspections, by selecting the 'All reports' link for, Treetops on our website at www.cqc.org.uk

Treetops is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Treetops can provide care and support for up to 24 older people, some whom are living with dementia. At the time of our inspection there were 15 people living at the service.

The service provides accommodation in purpose built premises. The service is on ground floor level and has three separate areas. Maple, Holly and Ash. Each area has a lounge and kitchen area. There was a communal activity room and two garden areas.

There was a registered manager in post. 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. Each manager was responsible for a number of services.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements had been made and is no longer rated inadequate in any of the key questions. Therefore, this service is now out of Special Measures.

Since our last inspection the service had made improvements and was now meeting the regulations previously breached. Consent to care and treatment was sought in accordance with the Mental Capacity Act (MCA) 2005. Systems to monitor and review the quality of care had been improved so that records were accurate and issues were identified promptly so appropriate actions could be taken.

Staffing numbers were at a consistently safe level. However, the service continued to use a high proportion of agency staff, both for nursing and care staff. This impacted on people as they were often supported by staff who were unfamiliar to them. It also affected the staff team morale and teamwork.

Risk assessments identified potential risks to people. Guidance was clear for staff on how to support people safely and reduce risks. People’s independence was promoted through positive risk assessments and care planning.

Staff received an induction, training and regular supervision to support them in their roles. Staff spoke positively about the training offered by the service and the support they received.

People were supported by staff who were kind and caring. The atmosphere was calm and relaxed. Visitors were welcomed at the service and encouraged to engage and provide feedback about the care and support provided.

Care plans had improved to provide consistent information about people’s backgrounds, preferences and routines. Strategies were in place to guide staff on how to support people effectively.

People were supported with their nutrition, hydration and healthcare needs. Applications were made when appropriate in relation to the Deprivation of Liberty Safeguards (DoLS). DoLS is a framework to approve the deprivation of liberty for a person when they lack the capacity to consent to treatment or care or need protecting from harm.

There were activities available for people. People and relatives felt comfortable in raising any concerns or complaints. Actions were taken as a result promptly.

Improvements were being made in the internal decoration and external areas of the service. The service was clean and tidy and infection control policies and procedures were adhered to. Regular checks of the environment, equipment and fire safety were undertaken.