Background to this inspection
Updated
24 September 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
Yew Tree House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Yew Tree House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service. This included notifications about important events at the service and feedback shared directly with CQC. We used all this information to plan our inspection.
During the inspection
We observed staff interacting with people and looked at the premises. We spoke with seven members of staff including the regional operation director, registered manager, service manager and four care staff. We observed the people who use the service. We also spoke to one healthcare professional who was visiting the service. We reviewed a range of records including medicines records. We looked at three people’s care records and two staff files in relation to recruitment. A variety of records relating to the management of the service, including audits and checks were reviewed.
After the inspection
We spoke with four people's relatives. We received feedback from one professional who works closely with the service. We reviewed the extensive evidence sent by the provider electronically. This included the service's staff training data, records related to medicines, care documentation and other information related to the service and provider oversight. We also considered a report by a local advocacy group who had visited the home.
Updated
24 September 2022
About the service
Yew Tree House is a residential care home for up to nine adults with complex needs including learning and physical disabilities and mental health needs. The service is provided in adapted building in a residential area in a small rural village. At the time of our inspection there were nine people living at the service.
People’s experience of using this service and what we found
People were supported to live safely in their home within the community. People appeared to be relaxed and happy in their home environment and while interacting with staff.
We observed the lunchtime support at the service. The atmosphere was busy and friendly. During the morning people had been supported to access the community for activities and to attend appointments. People who remained at home were supported to engage in activities such as bingo and story reading. We met everyone living at the home, spoke with some people and observed the support offered by staff during lunch.
Staff understood people's needs and how to assist them to protect them from avoidable harm. Care plans and risk assessments were in place, which provided staff with guidance on how to meet people's needs and manage identified risks.
People were supported to receive their medicines safely and as prescribed.
The service had infection control processes and systems in place to reduce the risk of people contracting COVID-19. The home was clean and decorated in a homely style.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Based on our review of safe and well-led, this service was able to demonstrate how they were currently meeting the underpinning principles of ‘Right support, right care, right culture’.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The provider had developed a model of care and an environment that maximised people's choice, control and independence. People's care was planned and delivered with their individualised needs in plans.
People were supported to access facilities in their local community such as carriage horse riding, trampolining and swinging.
The managers at the service and staff described their priority as delivering person centred care that met people's individual needs. Staff received autism and learning disabilities training.
We received very positive feedback from staff, relatives and professionals regarding the service and leadership in the home.
There was a robust quality assurance system in place to ensure people received the best possible service. The registered manager worked closely with the provider and partner agencies and services to promote best practice within the service and make a positive impact to people's lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was good (published 12 October 2017).
Why we inspected
We received concerns in relation to people’s safety and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service remains the same based on the findings of this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.