The Service Tree Limited

Updated 17 January 2019

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 registered persons continued to meet 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.

Before the inspection we examined the information we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about. We also invited feedback from the commissioning bodies who contributed to purchasing some of the care provided by the service. We did this so that they could tell us their views about how well the service was meeting people’s needs and wishes.

As part of the inspection we used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

The inspection team consisted of an adult social care inspector.

This comprehensive inspection visit took place on 28 November 2018 and was announced. The provider was given 48 hours' notice because the location provided a domiciliary care service to people who lived in the community. We gave the registered persons a short period of notice because they are sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that they would be available to contribute to the inspection.

At the registered office we spoke with one person using the service, four care staff and both registered managers. In addition, we looked at the care plans of three people who used the service and any associated daily records such as the daily log and medicine administration records (MARs). We looked at three staff files as well as a range of records relating to the running of the service such as duration of care calls, staffing, quality audits and training records.

On 5 December 2018 we spoke by telephone with two people who used the service, two relatives and one friend. This helped us find out what it was like to receive care from the service.

Updated 17 January 2019

The Service Tree Limited is a domiciliary care agency. This service supports people in their own home and people receive care and/or support in order to promote their independence and well-being. At the time of our inspection 29 people were using the service. The service can support people who are living with dementia, have a learning disability, special sensory needs and/or a physical disability. It can also assist people who have mental health needs. The service provided support to people living in Nottinghamshire.

This was the first inspection of the service since it was registered at its new address. We last completed an inspection of the service in March 2016. At that inspection we said that the overall quality rating for the service was, ‘Good’. At the previous inspection the safe rating was requires improvement. At this inspection this rating had improved and was now ‘Good’.

At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were very satisfied with all aspects of the service provided and spoke highly of staff and the registered managers. People who used the service told us they were treated with compassion and kindness and that their privacy and dignity were respected.

People who used the service and relatives we spoke with told us they felt staff provided safe and effective care. Staff turnover was low which people and relatives valued. People were supported by a small team of staff that understood their needs.

We found that there were systems, processes and practices to safeguard people from situations in which they may experience abuse including physical harm. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected.

People told us they received their medicines as prescribed. Medicines Administration Records (MARs) reviewed had been completed by staff and were regularly audited by management.

Background checks had been completed before new care staff had been appointed. People were protected by there being arrangements to prevent and control infection and lessons had been learnt when things had gone wrong.

Staff had received all the training required to support people safely. Staff received regular supervision and annual appraisals and were able to reflect on the care and support they delivered. Staff were able to identify further training in addition to their mandatory training.

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

People had their rights protected under the Mental Capacity Act 2005. People were supported to eat and drink sufficient amounts to meet their nutritional needs when required. People had been supported to live healthier lives by being supported to have suitable access to healthcare services so that they received on-going healthcare support. Suitable arrangements had been made to obtain consent to care and treatment in line with legislation and guidance.

People received personalised care that was responsive to their needs. Care staff recognised the importance of promoting equality and diversity by supporting people to make choices about their lives. Confidential information was kept private.

There was strong sense of leadership in the service that was open and inclusive. The registered persons focused on achieving positive outcomes for people and their staff. People benefited from there being a robust professional management framework that helped care staff to understand their responsibilities so that risks and regulatory requirements were met.

The service encouraged feedback from people who used the service, relatives and care staff. Views were gathered through questionnaires, telephone conversations, regular face-to-face meetings at their home or in the office.

No complaints had been received in the last 12 months. People were introduced to lay advocates if necessary.

Quality checks had been completed to ensure people benefited from the service being able to quickly put problems right and to innovate so that people could consistently receive safe care.

The registered managers who were also the owners of the service had a clear vision of delivering high-quality person-centred care. Staff understood and were committed to realising this vision. There was a positive and open team culture, the registered managers were visible and supportive of staff. Staff and people's views about how to develop and improve the service were encouraged and acted on.

Staff and management worked in an open way with external agencies, such as the local authority and community healthcare services, to share information about people's support. This helped identify and agree how best to work in partnership, so people could receive consistently effective and person-centred support.

Further information is in the detailed findings below.