Twelve Trees Residential Care Home

We found the following examples of good practice.

The service had signage displayed on all external doors to alert visitors to restrictions on entering the building and the infection control measures they would need to take.

Staff had completed training in infection control, COVID-19 and donning and doffing personal protective equipment (PPE). The service had an adequate supply of PPE to meet current and future demand. Staff were using and disposing of PPE correctly.

The home had arrangements in place to test both people and staff for COVID-19, in line with the current guidelines on testing. People and most staff had received a first dose of the vaccine.

The registered manager was open and pro-active in sharing information with friends and family, so they understood decisions around visiting and restrictions.

People were supported to maintain links with friends and family via telephone and video calls. Links with families were maintained through regular communication and relatives' meetings held online which allowed many relatives including families in other countries to take part.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The home had a manager in place who had applied for registration with The Care Quality Commission (CQC). 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.

Staff knew how to protect people from the risk of abuse or harm. They followed appropriate guidance to minimise identified risks to people's health, safety and wellbeing. There were enough staff to keep people safe. The provider had appropriate arrangements in place to check their suitability and fitness to support people.

We saw people were supported to have sufficient to eat and drink to maintain a balanced diet. People told us they liked the food and lunchtime was a social event.

The environment was clean and staff followed good practice for minimising risks to people that could arise from poor hygiene and cleanliness. They also ensured the environment was clear of slip and trip hazards to support people to move freely around. The premises and equipment were regularly maintained and serviced to ensure these were safe. Medicines were managed safely and people received them as prescribed.

People's rights were also protected because management and staff understood the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). We saw staff had received refresher training in the last two years. In addition, we also found staff had received formal supervision and appraisal.

The manager and staff ensured access to healthcare services were readily available to people and worked with a range of health professionals, such as social workers, community nurses and GPs to implement care and support plans.

People were involved in the assessment and care planning process and their care plans were regularly updated to reflect their changing needs. People were encouraged and supported to participate in a range of activities to suit their individual interests. There was a complaints system in place and people felt able to raise any complaints or concerns.

Staff were respectful and compassionate towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks.

Systems were in place to make sure people's views were gathered. These included regular meetings, direct interactions with people and questionnaires being distributed to people, relatives and healthcare professionals. The service was assisted to run effectively by the use of quality monitoring audits carried out by the manager and registered provider, which identified any improvements needed and actions were taken.

There was a calm and relaxed atmosphere during our inspection. We observed staff treating people in a kind and gentle manner, offering assistance where required and sitting with people engaging in eye-to-eye contact.

We heard examples from people and their relatives about how staff at Twelve Trees offered choice and respected people's dignity and privacy. For example, one person told us, 'I have my meals in my room as I don't like going to the dining room all the time."

During our inspection, we were able to speak to one relative. They told us that they were confident in the way in which their relative was cared for, and that they were informed straight away of any issues about their relative's care.

We noted dedicated members of staff were seen carrying out cleaning duties throughout the home during our inspection. There were effective systems in place to reduce the risk and spread of infection.

We spoke to four members of care staff. Comments included "Brilliant, this is a lovely place to work." "I really like it here." and "the staff are wonderful to work with and it's a joy to work here."

We looked at Twelve Trees training matrix and saw that this detailed a range of mandatory and other training sessions. The four members of care staff we spoke to confirmed that they had received a variety of training.

We spoke to four people who told us that if they had a complaint about their care they would talk to their key worker or the manager. They told us all staff were approachable and people would have no hesitation in talking to them.