3 Trees Community Support

Updated 17 November 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 inspection took place on 4 and 8 October 2018 and was an announced inspection. We gave short notice of this inspection because the service provides care to people in their own homes and we needed to be sure there was someone available in the office to support our inspection.

The inspection was carried out by one Inspector. Prior to the inspection we reviewed all information available to us, including the Provider Information Return (PIR). The PIR is a form completed by the provider setting out what the service is currently doing well and any areas they plan to improve. We also reviewed any notifications made by the service. Notifications are information about specific events that the provider is required by law to tell us about.

As part of our inspection we met three people using the service, at their supported living flats. We spoke with four team leaders and two support workers. The registered manager was present on the second day of inspection and we also spoke with the company directors. We reviewed care files for four people, as well as other documentation relating to the running of the service such as quality surveys and medicines records.

Updated 17 November 2018

The inspection took place over two days, 4 and 8 October 2018. The first day was spent in the office of the organisation and on the second day we visited people using the service in a block of supported living flats. People using the service have learning difficulties.

This service is a domiciliary care agency. Some people using the service live in a ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. Other people using the service lived at home with their family.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in place. 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.

The service was Outstanding in its responsiveness to people’s individual needs and preferences. Staff had in depth knowledge of the people they supported, enabling them to deliver a highly person centred service. Working with people’s particular communication needs and with understanding of their particular behaviours, staff supported people to manage their anxieties and related behaviours.

Staff were kind and caring and proud of the achievements of the people they supported. People were treated with dignity and respect and given privacy when they wanted it.

People using the service were safe. There were sufficient staff to meet people’s needs. Where there were gaps in rotas, these were covered by existing staff so that no agency staff were used. There was a positive approach to risk taking, which meant people didn’t experience necessary restrictions in their lives. For one person, staff had worked with the police and local shopkeeper to help make the local environment safe for them to go out independently. Support was given for those people who were prescribed medicines. When these were administered, it was recorded on a Medicine Administration Record (MAR) chart.

The service effectively met people’s health needs, working with healthcare professionals when necessary. People were supported nutritionally to maintain a healthy diet and weight. For some people this involved working with the community dietician. People’s rights were met in line with the Mental Capacity Act 2005 (MCA). We viewed records of Mental Capacity Assessments and Best Interests decisions.

Staff were well supported in their work, attending supervision regularly. They told us they felt able to raise issues and concerns and that senior staff were approachable. Staff were also positive about the training they received. They told us the training enabled them to meet the complex needs of people they supported. The provider demonstrated the importance they placed on training by sending staff on ‘train the trainer’ training for certain topics that were difficult to find courses for.

The service was well led. The registered manager and directors were involved at all levels of the organisation. There was a culture of continual improvement within the service and the provider had clear ideas about how they wanted to improve. There were systems in place to monitor the quality of the service provided.