Archived: Treehaven Rants

Updated 4 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

Day one consisted of two inspectors and one specialist medicine inspector. Day two consisted of two inspectors.

Service and service type

Treehaven Rants 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. Treehaven Rants 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

Both days of inspection were unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We sourced feedback from the local authority and reviewed information we held about the service on our systems, as part of the planning process.

During the inspection

We spoke with six members of care staff, including the registered manager across the course of our inspection. We reviewed a range of records, including three people’s care and six people's medication records. We looked at staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We attended the staff shift handover meeting and spoke with an activity volunteer on day one and spoke with a visiting social care professional on day two.

We provided written and verbal feedback at the end of each day of inspection. On the second day of inspection, feedback was given to the nominated individual and director of operations via video call. (The nominated individual is responsible for supervising the management of the service on behalf of the provider).

We spoke with five relatives by telephone to source their feedback on the care and support provided.

Updated 4 November 2022

About the service

Treehaven Rants is a residential care home providing personal care and support to up to seven people with learning disabilities and or autistic people. At the time of our inspection there were six people using the service. The service consisted of one main house, divided into two areas referred to as "Rants" and "Boomer". Some people had ensuite bathroom facilities, and their own living spaces, other people shared communal areas of the service.

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

The dynamics of the service had greatly changed since our last inspection, with an overall reduction in the number of people living at the service. This had resulted in a positive impact for the standards of care being provided, with people receiving more meaningful care and activities. There was a different registered manager in post, and staff morale had improved. Staff told us they felt more supported and able to meet the demands of their roles.

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.

Right support: The standards of care provided, gave people choice and control over their own care and lifestyles. This was supported by consistent levels of staff available to meet people’s assessed needs and risks to enable people to be active members of the local community. People lived in a clean and comfortable care environment. Whilst we identified some areas of improvement needed to the outside of the property, we were assured by the actions being taken by the registered manager in response to our feedback.

Right care: Care records reflected people and their relative’s involvement in their development with their individual wishes and preferences being consistently reflected. People’s dignity, privacy and human rights were being upheld. People were supported to have maximum choice and control of their lives, although a recommendation has been made to ensure key decisions are documented. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff training and competency checks ensured they had the necessary skills, knowledge and expertise to safely meet people’s needs.

Right culture: There was consistent leadership of the service, due to there being an experienced registered manager in place. The registered manager led the service by example, giving the staff clear expectations of the standards they were to uphold. People were empowered to lead meaningful lives and be part of their local community. The continued to be improvements needed in relation to aspects of provider level oversight of the service, and this was reflected in the ongoing breach of regulation identified.

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 inadequate (published 30 September 2021).

The service had breaches of regulation relating to provision of safe care and treatment, dignified and person-centred support, the condition and maintenance of the care environment, sourcing people’s consent, protecting people from the risk of harm or abuse, the governance and oversight of the service. We took urgent enforcement action as an outcome of the last inspection. 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 significant improvements had been made, however the provider remained in breach of the regulations for governance and oversight of the service.

This service has been in Special Measures since 30 September 2021. During this inspection the provider demonstrated improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

The inspection was prompted due to current rating, and breaches of the regulation identified at the last inspection impacting on the safe running of the service, and risks relating to people’s care. A decision was made for us to inspect and examine those risks.

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.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.