Box Tree Cottage Residential Home provides accommodation and personal care for up to 14 adults requiring support with their mental health needs. At the time of our inspection there were three people living at the service who received the regulated activity of personal care. The service is situated in a village location outside of the city of Cambridge. The service did not have a registered manager in post. There was both a home manager and care manager in post to deal with the day to day running of the service. 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.
This inspection was carried out on 15 June 2017 and was an unannounced inspection. At the last inspection on 18 March 2015, the service was rated as ‘good.’ At this inspection we found the service remained ‘good.’
Staff were knowledgeable of how to report incidents of harm and poor care. Staff helped people in a manner that supported their safety and people were looked after by staff in a caring and patient way. Staff encouraged people to make their own choices and live as independently as possible. People’s privacy and dignity were promoted by staff and people were treated with respect.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People’s care arrangements took account of people’s wishes including their likes and dislikes. People’s care plans recorded their individual needs, choices and any assistance they required. Risks to people who lived at the service were identified, and plans were put into place by staff to monitor and minimise these risks such as for those people who required support with their mental health needs.
People were looked after by enough, suitably qualified staff to support them safely with their individual needs. Where needed, staff were flexible around when they needed to work to support any short notice absences.
Staff enjoyed their work and were supported and managed to look after people. Staff understood their roles and responsibilities in meeting people’s needs and they were trained to provide effective and safe care. Staff were supported to maintain their skills by way of supervision and appraisals. Pre-employment checks were completed on new staff members before they were assessed to be suitable to look after people.
People were supported to take their medicines as prescribed and medicines were safely managed by staff who were trained, and whose competency had been assessed. Where there had been any errors in the administration of people’s medicines, these had been identified and dealt with to reduce the risk of recurrence.
The service was flexible and responsive to people’s needs. People were encouraged to maintain contact with their relatives and friends when they wished to do so. Staff assisted people to maintain their links with the local community.
People were supported to eat and drink sufficient amounts of food and fluids. People’s choice about what they wished to eat and drink was promoted and supported. Staff monitored people’s health and well-being needs and acted upon issues identified by assisting people to access a range of external health care services.
There was a process in place so that people’s concerns and complaints were listened to and acted upon and where possible resolved to the complainants satisfaction.
Arrangements were in place to ensure the quality of the service provided for people was regularly monitored. People who lived at the service and staff were encouraged to share their views and feedback about the quality of the care and support provided. Actions were taken as a result to drive forward any improvements required.
Further information is in the detailed findings below.