Background to this inspection
Updated
17 May 2018
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 was an unannounced inspection which took place on 27 and 28 March 2018. The first day of the inspection was carried out by an adult social care inspector, an assistant inspector and two experts by experience. An expert by experience is a person who has personal experience of using this type of service or caring for someone who uses this type of care service. On the second day one adult social care inspector returned to the service to complete the inspection.
Before the inspection we reviewed information we held about the service, including the Provider Information Return (PIR). A PIR is a document that asks the provider to give us some key information about the service, what the service does well and any improvements they are planning to make. We also reviewed the statutory notifications the CQC had received from the provider. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay.
Prior to the inspection we contacted the local authority, the NHS clinical commissioning group and Healthwatch Oldham, to ask if they had any concerns about the service, which they did not. Healthwatch is the national independent champion for consumers and users of health and social care in England.
During our visit we spoke with the home owner, registered manager, deputy manager, six care assistants, a registered mental nurse, an activities coordinator, ten people who used the service and three relatives. We also spoke with five relatives on the telephone the day after our inspection. We looked around the home, checking on the condition of the communal areas, toilets and bathrooms, kitchen and laundry. We looked in several bedrooms after we had received permission to enter them. We spent time observing the lunchtime meal on Sycamore and Oak units.
As part of the inspection we reviewed in detail the electronic care records of three people living at the home. The records included their care plans and risk assessments. We reviewed other information about the service, including training and supervision records, three staff personnel files, medicine administration records, audits, meeting minutes and maintenance and servicing records.
Updated
17 May 2018
Treelands is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection
Treelands Care Home is registered to provide accommodation and care, including nursing care, for up to 80 people. At the time of our inspection there were 70 people living at the home. The accommodation is provided over two floors and is divided into four units: Sycamore unit provides care and support to people requiring residential care; Beech unit provides care and support for people with complex needs, such as mental health needs; Oak unit provides general nursing care and Elm unit provides care and support for people living with varying levels of dementia. The home is set within a large garden and there is a car park available for visitors.
The home had a registered manager. 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.
This was an unannounced inspection which took place on 27 and 28 March, 2018. We last inspected the service in January 2017. At that inspection we rated the service ‘Requires Improvement’ overall. We identified four regulatory breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014. These were in relation to cleanliness, risk assessments, training, supervision, staff induction, weight monitoring, Deprivation of Liberty Safeguards, care plans and governance. At this inspection we found that improvements had been made and the service was no longer in breach of any of the regulations of the Health and Social Care Act (2008) Regulated Activities 2014.
We have made one recommendation about the provision of activities on Oak and Elm units.
There were systems in place to help safeguard people from abuse. Staff understood what action they should take to protect vulnerable people in their care. Recruitment checks had been carried out to ensure staff were suitable to work in a care setting with vulnerable people. At the time of our inspection there were sufficient staff to respond to the needs of people promptly.
The home was well-maintained, clean and decorated to a high standard. Adaptations, such as the addition of clear picture signage, had been made so that it was suitable to people living with a dementia. Procedures were in place to prevent and control the spread of infection. There were systems in place to protect staff and people who used the service from the risk of fire. Maintenance checks on services and equipment were up-to-date.
The management of medicines was carried out safely.
Staff had undertaken a variety of training which enabled them to carry out their roles effectively. They received regular supervision which provided them with opportunity to voice any concerns and plan their professional development.
Staff encouraged people to make choices and remain independent where they were able. The service was working within the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).
People who used the service were complimentary about the home and staff. We observed kind and caring interactions between staff and people who used the service. The service had introduced an electronic care documentation system. We found that care plans and risk assessments were detailed and reflected the needs of each person.
A range of activities were provided throughout the home. However, people commented that there was a lack of stimulation and things to occupy people in a meaningful way on Oak and Elm units.
There was strong leadership from the home owner, registered manager and deputy manager. This had ensured that improvements required following our January 2017 inspection had been carried out. The management team was forward thinking and committed to finding new ways to develop the service and improve the quality of care and support provided at Treelands. Audits and quality checks were undertaken on a regular basis and any issues or concerns addressed with appropriate actions.