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Inspection carried out on 10 August 2017

During a routine inspection

Three Trees is a care home that provides support and accommodation for up to 21 people with a learning disability or autistic spectrum disorder. On the day of the inspection there were 18 people living at the home plus one person receiving respite care. Accommodation is on three floors and people who live on the first and second floors have to be able to use the stairs. There are some small living room and kitchen areas in the home were people are able to live more independently in groups of two, three or four.

At the last inspection in April 2015 the service was rated as Good. At this inspection we found that the service remained Good.

There continued to be sufficient numbers of staff employed to make sure people received the support they needed, and those staff had been safely recruited.

Staff continued to receive appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on the administration of medicines and on how to protect people from the risk of harm.

People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People led active lives; they attended day centres and took part in activities within the home and in the local community.

Staff were kind, caring and supportive and they respected people’s privacy and dignity.

Care planning described the person and the level of support they required. Care plans were reviewed regularly to ensure they remained an accurate record of the person and their day to day needs.

People told us they were aware of how to express concerns or make complaints. People were also given the opportunity to feedback their views of the service provided.

The manager carried out audits to ensure people were receiving the care and support that they required, and to monitor that staff were following the policies, procedures and systems in place.

The feedback we received and our observations on the day of the inspection demonstrated that the home was well-led.

Inspection carried out on 21 December 2015

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 22 April 2015 and found the registered provider was breaching Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 : safe care and treatment.

After the comprehensive inspection, the registered provider wrote to us to say what they would do to meet the legal requirement in relation to the breach. We undertook an unannounced focused inspection on the 21 December 2015 to check that the registered provider had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this one breach of legal requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Three Trees’ on our website at www.cqc.org.uk

Three Trees is a care service that is registered to provide accommodation and personal care for up to 21 people. People who live at the service have a learning disability or autistic spectrum condition.

At the time of the inspection there was a registered manager in post in the service. 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. In addition there was also a care manager in post. They were employed to assist with the day to day running of the service and are referred to in the report as the manager.

At our focused inspection on the 21December 2015, we found that the registered provider had followed their action plan in which they had told us they would be compliant by 18 September 2015. We found that sufficient improvements had been made to the way that staff administered medicines that we judged that the breach in regulation had been met. The registered provider had revised their medicine policy and procedure and ensured all staff responsible for medicine administration had seen and read the new policy and procedure. Changes to the way staff administered medicines had been made in line with best practice, and these changes were reflected in the new medicine policy and procedure.

Inspection carried out on 22 April 2015

During a routine inspection

Three Trees is a care home that provides support and accommodation for up to 21 people with a learning disability or autistic spectrum disorder. On the day of the inspection there were 18 people living at the home plus one person receiving respite care. Accommodation is on three floors and people who live on the first and second floors have to be able to use the stairs. There are some small living room and kitchen areas in the home were people are able to live more independently in groups of two, three or four.

At the last inspection in April 2015 the service was rated as Good. At this inspection we found that the service remained Good.

There continued to be sufficient numbers of staff employed to make sure people received the support they needed, and those staff had been safely recruited.

Staff continued to receive appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on the administration of medicines and on how to protect people from the risk of harm.

People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People led active lives; they attended day centres and took part in activities within the home and in the local community.

Staff were kind, caring and supportive and they respected people’s privacy and dignity.

Care planning described the person and the level of support they required. Care plans were reviewed regularly to ensure they remained an accurate record of the person and their day to day needs.

People told us they were aware of how to express concerns or make complaints. People were also given the opportunity to feedback their views of the service provided.

The manager carried out audits to ensure people were receiving the care and support that they required, and to monitor that staff were following the policies, procedures and systems in place.

The feedback we received and our observations on the day of the inspection demonstrated that the home was well-led.

Inspection carried out on 9 April 2013

During a routine inspection

During the inspection we spoke with three people who lived at the home and chatted to others. We also spoke with the providers, the manager and two members of staff to assist us in making a judgement regarding compliance.

We observed that people who lived at the home were supported to be independent and to make their own decisions about their day to day lives. Efforts were made to ensure that people consented to the care and support they received from staff.

People who lived at the home were encouraged to take part in activities, both within the home and external to the home. Care plans recorded a person's capabilities and how they wished to follow their chosen lifestyle. We saw that risk assessments supported responsible risk taking and recorded how any identified risks would be managed. We observed good rapport between people who lived at the home and staff and that a homely atmosphere was promoted.

We saw that staff were recruited safely although we noted that the policies and procedures in place could be more robust. There were sufficient numbers of staff employed to provide safe levels of care and enable people who lived at the home to take part in their chosen activities.

There was a quality assurance system in place that included obtaining the views of people who lived at the home and staff. Regular audits were undertaken to monitor the quality of the service provided and to check that systems introduced to promote safe practices were being adhered to.

Inspection carried out on 9 May 2012

During a routine inspection

People told us that their experience was a positive one. They were involved in the decisions about coming into the service and staff discussed their care and treatment with them. They were able to make choices and decisions about their daily lives, and the staff respected their wishes and supported their independence.

People told us that they had a good choice of social activities to take part in and the meals provided at the service offered them lots of choice and variety. People said they enjoyed living in the home and the staff were friendly and supportive.

People said that they had good access to outside healthcare professionals and they were satisfied with the level of medical support given to them. They said staff were good at giving them their medicine on time and when they needed it.

Reports under our old system of regulation (including those from before CQC was created)