The Banyan Tree is a residential care home for up to four younger adults who may have learning disabilities, mental health needs, or emotional difficulties. At the last inspection in December 2015, the service was rated Outstanding. At this inspection we found the service remained Outstanding. People with challenging and complex care needs were supported to be as independent as possible with a personalised amount of staff support. Staff supported people to make safe decisions, and when they were struggling they were supported to seek the help they required to maintain their own safety. Staff were exceptionally caring and compassionate and took great pride in their work and the relationships they had built with people to achieve great progress and positive outcomes for people.
People were supported to understand their own risks and comprehensive systems were in place to help people and staff maintain people’s safety. People were empowered to make their own decisions about their known risks and staff were aware when people needed additional support to enable them to do this.
Staffing requirements were flexible to meet the needs of people to help keep them safe, particularly during difficult times if people were in a period of distress or anxiety. The provider prioritised people’s welfare and arranged staffing to ensure people’s needs could be met. Staff were suitably recruited and appropriate checks were made on staff backgrounds.
People’s medication was handled sensitively and people were encouraged to manage their own medicines if they were able to. Staff tailored the support each person needed to manage their own medicines and staff ensured the medicines were safely stored.
People were supported to learn about infection prevention, cleanliness and the risks associated with poor hygiene practices. Staff ensured there were systems in place to maintain adequate standards and supported safe infection control practices.
Comprehensive assessments were in place to ensure that staff had all the information they needed to deliver the care and support people required. Staff training was personalised to meet the needs of people living at the home and staff were keen to learn and understand about people’s needs. People were fully supported to provide their consent to the care they received. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People's care needs were carefully monitored and staff worked proactively with external services to support people to have access to the support they required. The provider worked to identify and act on best practice and people received excellent support to have their health care needs met. Staff received personalised supervision which identified their strengths and areas for improvement and staff commented that this was effective and helped them to improve.
People were empowered, encouraged, and inspired to make their own decisions about their care. People were fully involved in making decisions which affected them and they were given honest and open information to understand their options. People were treated with compassion and were given opportunities to learn skills of independence when they were ready. Staff understood people’s needs well and had built relationships with people to help them get the best out of themselves.
People had comprehensive and unique care plans in place which provided information and guidance about how people preferred their care. The care plans were updated as people’s needs changed and staff were aware of people’s recent changes. People were encouraged to follow their goals and to make achievements when they were able. The staff worked with external agencies to help support people maintain employment or education if this was their wish and staff celebrated with people when they had done well or achieved a goal.
Staff had a great understanding of people’s likes and preferences and ensured people’s support was tailored to accommodate this. People were supported to pursue activities and interests they enjoyed and staff supported people to ensure these were achieved.
The home was well led and people and relatives had great respect for the registered manager and provider. There was clear leadership which helped to encourage people receive the care they needed when they needed it. People were consulted, involved, and encouraged to provide feedback which could help improve the service and the care they received. Governance systems helped to review the quality of the service and the registered manager was keen to receive feedback and listen to people and staff.
Further information is in the detailed findings below.