Tall Trees

Updated 15 December 2021

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 Care Act 2014.

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 team consisted of two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Tall Trees is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. There was no registered manager in post. A registered manager is a person who has registered with the CQC 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 means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. The service was led by an interim manager who had been in post since the last inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We looked at notifications received from the provider. A notification is information about important events which the provider is required to tell us about by law. This ensured we were addressing any areas of concern. We looked at the service's last inspection report and reviewed the action plan the provider had submitted. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service as well as three relatives. Most people living in the home could not verbally give us feedback. As such we looked around the home and observed the way staff interacted with people. We looked at six people's care records and four medicine administration records (MAR). We spoke with 10 members of staff including the interim manager, new manager, deputy manager, area operations manager, quality assurance manager, nurses, carers and domestic staff.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We received feedback from one healthcare professional. We received further feedback from three relatives.

Updated 15 December 2021

About the service

Tall Trees is a residential care home providing personal and nursing care to 24 people aged 65 and over at the time of the inspection. The service can support up to 61 people in one adapted building. The service supports older people and includes support for people living with dementia.

People’s experience of using this service and what we found

People living at Tall Trees received safe care from skilled and knowledgeable staff. Staff knew how to identify and report any concerns. The provider had safe recruitment and selection processes in place which incorporated their values. Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely, and people received their medicines as prescribed. The provider had made significant changes and ensured there were clear processes and procedures to manage all aspects of medicines safely.

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.

The home was well-led by an interim manager who was committed to improving people's quality of life. We received positive feedback about the management of the home from people, relatives, staff and healthcare professionals. The provider and management team had made significant changes to improve people's care. They had developed a more effective quality assurance process. The manager had support from the provider which allowed them better oversight of the service. The service had a clear management and staffing structure in place and staff worked well as a team. Staff worked well with external social and health care professionals.

Rating at last inspection and update

The last rating for this service was requires improvement (Published 7 October 2021) and there were three breaches of regulations in relation to safety, safeguarding service users from abuse and improper treatment and quality assurance systems. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We carried out an unannounced focused inspection of this service on 26 May 2021. Three breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve their management of risks, management of medicines, systems and processes to prevent abuse of service users and quality assurance systems.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Tall Trees on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.