15 May 2018
During a routine inspection
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.