Treetops

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

People were treated with dignity and respect. Staff were aware of peoples likes and dislikes and supported people in a way they wanted. People who lived at the service were central to all support provided. We observed staff were responsive and kind when interacting with individuals. Interactions varied between different people for example, the use of touch and eye contact was more appropriate for some people. Family members were encouraged and supported to visit and were involved in all aspects of people’s care. People’s needs and choices were assessed effectively, care plans were personalised and included involvement from specialist services. This included support required in relation to their culture, religion, lifestyle choices and diet preferences. There was a wide range of activities available for people which could be changed on a daily basis to meet the needs of people. Multi-agency meetings took place frequently, this ensured the appropriate advice was taken to mitigate any risks identified and ensure support was person centred.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We observed family members being involved in the support being provided. Feedback provided was positive, family members were encouraged to be involved in the support provided. Family members told us they felt staff knew their loved one well and understood their needs. People were happy with the staff team and felt they were treated with respect.

Staff spoke about how they treat all people with respect and support them to maintain their dignity. They told us how this could also differ between people depending on their needs and communication skills. Staff used examples such as knocking on doors before entering, giving privacy when bathing or using the toilet and supporting some individuals to get dressed when this was appropriate. Staff understood people really well and were able to discuss the likes/dislikes of people without hesitation. They told us how these are also documented in the folders of people and care plans and staff were encouraged to spend time reading these. Staff also told us that by talking to people and spending time with them, it becomes easier to understand their needs and get to know them. The manager discussed the recruitment process and how the service ensures they are recruiting people who are right for the role. This included a pre-screen, discuss attitudes and values during interview, DBS, references, and health questionnaires.

Partners felt staff were caring and kind. The registered manager had a positive influence within the home and was actively involved when a challenging situation arose.

People were well treated and supported. We saw throughout our visit that staff were responsive and kind when interacting with individuals. We observed how interactions varied between different for example the use of touch and eye contact was more appropriate for some people. We observed staff laughing with people and playing board games in the garden. Dignity was considered by staff when showing us around the building for example, not entering bedrooms without consent or when people were sleeping. Staff knocked on doors and awaited a response before entering

From feedback received people were able to see their family when they wanted. People said they were treated with dignity and respect and were provided with a choice of support they wanted and when they wanted it. Support was tailored around meetings people needs.

Staff understood people’s individual needs and preferences. Staff understood the different communication needs of people and adapted these to fit each individual. For example, one staff member told us that pecs were kept around their neck to ensure they were always accessible for communication with individuals who require them.

We observed visitors attending on the day who confirmed that they are able to visit at any time with no restrictions. We observed the bedrooms of people living in the service, they were personalised. One person told us about their plans to paint their bedroom with the support of the manager and hang up photographs of their family.

People’s individual needs and preferences were understood and reflected in their care, treatment and support plans. For example, care records included PBS plans, PEN profiles which outlined likes/dislikes/how the person communications and support required. Communication and choice are supported. Daily diaries allow people to choose a picture to explain how their day has been and how they are feeling. One person’s care record included a stress scale using pictures which would allow staff to recognise triggers of stress and solutions. There are communication and person centred care policies in place.

People were able to access the community when they wanted, either independently or with the support from staff. People told us independence was encouraged. There were no restrictions on when family members could visit. Family members told us they were supported with visiting arrangements.

Staff told us about the different activities that people engaged in which included local walks, swimming, going for dinner. Staff had good knowledge of people’s individual abilities, needs and preferences. Staff told us that people have activity planners, however this can sometimes change and will adapt if the person does not wish to do a certain activity on that day. Staff told us that people are supported to maintain relationships with family and people could have visitors whenever they wished. One staff member told us they carried out an activity for future planning with one person last week. ‘This allowed the person to choose some big days out for the future’. She believed that more planning in advance would allow the people more choice and options. The manager told us that staff preference forms are used for people at the service to ensure their wishes are responded to e.g. gender of staff, or time they get up. This also includes families preferences.

We observed, and records showed activities that were meaningful for the person were provided. During the assessment we saw staff being polite and offering choices to people, always making sure their needs were met, and using different communication methods. People’s input was valued by staff.

Care records were person centred. The service had processes to ensure care plans reflected people’s independence and their individual choice and control. Records showed the service promoting and maintaining relationships with those who are important to people. People’s choices, likes and preferences were recorded in care records. Families and relatives were involved in the care planning process. This meant people could be assured that staff considered the things that were important to them. People were supported to be as independent as possible for example, where possible, people had access to their own vehicles and risk assessments were in place for this.

Family members told us they were kept up to date in relation to their relative’s needs. Feedback identified people and their families were involved in care plan reviews. People told us their needs were responded too.

Staff were able to explain how they would know if a person was becoming unwell and how this could vary between people for example, whilst one person would be able to tell you they were unwell, another person may change their behaviours or make different noises and facial expressions. If people were unwell, staff told us how in some cases, they would ask a person if they would like to see a GP, however this may differ if it is an emergency or a person who does not have capacity. The manager told us that to ensure staff are capable in identifying people’s needs and knowing what action to take, staff are required to complete person specific training, read support plans, health action plans and specific risk assessments. The manager also told us ‘We use monitoring forms, food, fluids, bowel, glucose levels. With detailed plans around what a person's good day looks like’. There is also a 3 tier on call system in place in case of any emergencies on site.

We observed positive interactions between staff and people living at the service. One person requested support from the registered manager due to their mental health, the manager reacted immediately and support was provided.

Staff told us they felt valued and supported in their role due to feedback from managers and people. Staff feel listened to and able to raise concerns. Staff told us they can take regular breaks; these are not allocated a specific time but the team on shift will work it out between them and ensure there is enough cover. Staff told us there is a room upstairs where they can take their breaks properly. They are given protected time and space to complete and learning and training. The manager told us that the service offers incentives and reward schemes on the Achieve Together App. Yearly hero awards are also held where staff, people and their families can be nominated. Staff also have access to EAP services and mental health champions.

Supervisions did not happen in line with the companies policies. Some staff had not received supervision for over 3months, however the registered manager was in the process of ensuring all staff had received supervision. Staff were provided with surveys to ensure feedback could be captured. Feedback evidenced staff were happy with the support they received. We saw evidence team meetings were being held and staff were encouraged to share their views.