Archived: Treetops Residential Home

Updated 29 November 2016

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 provider is meeting 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.

This inspection took place on 27 October and 1 November 2016 and was unannounced.

The inspection team consisted of two inspectors. Before the inspection we reviewed the Provider Information Record (PIR). The PIR is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make. We reviewed notifications we had received from the service. Notifications are information we receive from the service when significant events happen, like a serious injury. We spoke to a visiting health care professional.

During our inspection we spoke to five people, one person’s relatives, the providers and five staff. We looked at four people’s care and support records and associated risk assessments. We looked at people’s medicine records and management records including staff recruitment, training and support records and staff meeting minutes. We observed people spending time with staff.

We last inspected Treetop in September 2014. At that time we found that the registered provider was complying with the regulations.

Updated 29 November 2016

This inspection was carried out on 27 October and 1 November 2016 and was unannounced.

Treetops Residential Home provides accommodation and personal care for up to 24 older people. The service is a large converted property. Accommodation is arranged over three floors and a lift is available to assist people to get to the upper floors. There were 18 people living at the service at the time of our inspection.

A registered manager had not been working at the service since April 2016 and the providers were leading the service. The provider had a condition on their registration that required a registered manager to be in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run. One of the providers planned to apply to CQC to become the registered manager until a suitable manager was appointed and had completed their employment probation to the provider’s satisfaction.

Detailed plans and equipment were not in place to keep people safe in an emergency. The providers requested the local Fire and Rescue Service visit the service to give them advice and guidance following our inspection.

Detailed information was not available for staff to refer to about people’s care and how to manage risks to them. The provider had identified this before our inspection and had put plans in place to address these shortfalls. This did not impact on the care and support people received as staff knew people well and people were able to tell staff what they wanted. People’s care was planned with them, to keep them safe and help them be as independent as possible. Possible risks to people had been identified and were managed to keep them as safe as possible, while supporting them to be independent.

Some people wanted more to do during the day. The provider was recruiting an activities coordinator to offer people a wider variety of activities.

People received the medicines they needed to keep them safe and well. Changes in people’s health were identified quickly and staff contacted people’s health care professionals for support. People were encouraged to eat a balanced diet.

Staff were kind and caring to people and treated them with dignity and respect at all times. Staff knew the signs of abuse and were confident to raise any concerns they had with the providers. Complaints were investigated and responded to.

The providers had oversight of the service. Staff felt supported and were motivated. They shared the provider’s vision of a good quality service.

There were enough staff, who knew people well, to provide the support people wanted. People’s needs had been considered when deciding how many staff were required to support them at different times of the day. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.

Checks had been completed to make sure staff were honest, trustworthy and reliable. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

Staff had completed the training and development they needed to provide safe and effective care to people and held recognised qualifications in care. The providers met regularly with staff to discuss their role and practice. They supported staff to provide good quality care.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). People were not restricted and went out when they wanted to. Some people went out without staff support. Applications had been made to the supervisory body for a DoLS authorisation when necessary.

The requirements of the Mental Capacity Act 2005 (MCA) had been met. Staff supported people to make decisions and respected the decisions they made. When people lacked capacity to make a specific decision, decisions were made in people’s best interests with people who knew them well.

The providers worked alongside staff and checked that the quality of the service was to the required standard. Any shortfalls found were addressed quickly to prevent them from happening again. People, their relatives and staff were asked about their experiences of the care and their feedback was acted on.