Archived: Treelands Care Home

Updated 17 November 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 an inspector, a medicines inspector 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

Treelands Care Home 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. Treelands is a care home with 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 not a registered manager in post. A manager who was currently registered for another of the provider’s homes had taken over the managers role at Treelands in September 2022. It was planned for them to register at Treelands moving forwards.

Notice of inspection

We gave a short period notice of the inspection due to the COVID -19 pandemic to ensure we had prior information to promote safety and to ensure the registered manager and/or a representative from the provider would be present to support the inspection. Inspection activity started on 26 September 2022 and ended on 11 October 2022, by which time we had received and reviewed evidence provided after our visits to the home. We visited Treelands Care Home on the 27 September and 03 October 2022.

What we did before the inspection

Prior to the inspection we reviewed information and evidence we already held about the home, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the home. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also asked for feedback from the local authority and professionals who work with the service. 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 used all of this information to plan our inspection.

During the inspection

We spoke with 9 people and 4 relatives about the home and the care provided. We also spoke with 21 members of staff, which included the manager, interim clinical lead, nurses, senior carers, carers, activities, maintenance and domestic staff.

We reviewed a range of records and other documentation. This included 6 people’s care records, risk assessments, safety records, supplementary charts, audit and governance information. We also looked at medicines and associated records for 12 people.

After the inspection

We requested and reviewed additional evidence from the provider. This included fire safety records, safety documents, staff rotas, training data, supplementary charts and an additional person’s care plan.

Updated 17 November 2022

About the service

Treelands Care Home is registered to provide accommodation and nursing care for up to 80 people. Accommodation is provided over 2 floors and within 4 units: Sycamore provides care and support to people requiring residential care; Beech provides care and support for people with complex needs, such as mental health needs; Oak provides general nursing care and Elm provides care and support for people living with dementia. At the time of our inspection, Elm unit was closed for refurbishment with the majority of people from this unit being supported on Oak. There were 54 people living at the home at the time of our inspection.

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

Improvements were required with medicines management, record keeping, staff training and supervision, engagement with people and relatives, reporting of incidents to CQC and the audit and governance process. Issues noted at the previous inspection had not been addressed. The new home manager was open and honest about the challenges they faced and where improvements were needed.

People told us they felt safe living at the home. Staff had completed safeguarding training and knew how to report concerns. People, relatives and staff provided mixed comments about staffing levels. We were told staffing was sufficient to meet needs and keep people safe, but care was task orientated, with limited time for staff to engage in conversations, activities or spend quality time with people. 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. Accidents, incidents and falls had been documented but reviews to look for trends and help prevent reoccurrences had not taken place. We found the home to be clean, with effective cleaning and infection control processes in place.

Due to the short time they had been in post, some people and relatives we spoke with were unsure who the current manager was. Staff spoke positively about the current management team, which included the home manager and an interim clinical lead provided via a consultancy firm, who they felt had started to make necessary changes and improvements in the home. Despite a lack of engagement through meetings and surveys, people and relatives told us they would recommend the home to others, as they had no concerns with the care being provided.

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 requires improvement (published 04 May 2022). The service remains requires improvement.

Why we inspected

We received concerns in relation to people not receiving safe care, safeguarding concerns not being reported correctly, staffing levels not being appropriate, post fall observations not being completed, the audit and governance process not being followed and action plans not being followed through.

As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Treelands Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the management of medicines and the audit and governance process at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.