Twelve Trees Residential Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were safeguarded from abuse and avoidable harm. Staff told us they were well supported by the management team and felt confident to raise any concerns. Staff were able to recognise possible signs of abuse and knew how to report such concerns promptly. 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. Risk assessments about care were person-centred, proportionate, and regularly reviewed with the person, where possible. Safe staffing levels were in place. We shared some feedback about the recruitment procedures at the service. The registered manager took immediate action in response to the feedback. The provider had identified some staff refresher training and supervisions were overdue, an action plan was in place and the provider was making progress to complete it.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were safeguarded from abuse and possible harm. Staff received safeguarding training and demonstrated a clear understanding about how to recognise and report abuse and poor care. One staff member said, “I would report up to senior or line manager. If it wasn’t successful (know it would be) would report to HR or higher. Lots of people to go to.” The registered manager understood their responsibility to refer any safeguarding matters to the appropriate agencies. The registered manager told us, “We ensure staff know what to look for and how to let us know.”

During our site visit we saw kind and respectful interactions between people and staff. Staff were seen to offer people choices and seek consent before supporting. The atmosphere in the home felt warm and inviting.

There were effective systems, processes and practices to make sure people were protected from abuse and neglect. There was a commitment to taking immediate action to keep people safe from abuse and neglect. This included working with partners in a collaborative way. People’s care records showed the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place or being sought to deprive a person of their liberty. Any conditions related to Deprivation of Liberty Safeguards DoLS authorisations were being met. Renewals of authorisations for DoLS were not always completed within the required timescales. This was actioned following the site visit and evidence provided.

People told us they felt safe and had no worries or concerns. People felt confident they could raise concerns if they needed to. One person said, “I feel safe there is a lot of supervisors and I am not afraid to ask if I need to.” Relatives spoken with felt their family member was safe. Comments included, “Yes she [family member] is safe and she is well looked after” and “Mum is safe and gone from been on her own and now a huge weight has been lifted.”

When people communicated their needs, emotions or distress, staff could manage this in a positive way that protected their rights and dignity and maximised learning for the future about the causes of their distress. For example, staff explained one person was known to show behaviour of distress which could impact on other people. The person was found to be calmer when they had an item to carry. It was noted throughout our visit staff supported the person to have their item and they appeared content and calm.

People and/or their relatives told us they were involved in assessing and managing risks. People’s comments included, "They [staff] will always talk with you” and “They [staff] discuss my care plan with my daughter and son.”

Staff told us people had individual risk assessments in place so staff could manage any risks appropriately. One staff member said, “Everything in care plan and have a handset with all the information and have sensors on the floor and any updates overnight the manager or deputy manager tells us.” Staff told us handovers enabled information about people’s individual risks to be shared effectively. One staff member said, “Comes with training and always have handover and if anyone's had a fall (lady with quite a few falls so making sure she's safe all the time and not on her own) sometimes its mobility.”

Individual risk assessments were completed for people so that identifiable risks were managed effectively. The risk assessments seen covered all aspects of a person’s activity and were specific to reflect the person’s individual needs. We found risk assessments were relevant to the individual and promoted their safety and independence.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The registered manager used a dependency tool to assess how many staff were needed. This was regularly reviewed to ensure there were enough staff to meet people’s needs. Some staff refresher training was overdue such as First Aid and pressure area care. This had already been identified by the provider and an action plan was in place to bring all staff up to date. Following our visit the provider sent us information to show progress was being made. Although staff told us they felt supported, records showed the frequency of staff supervision and appraisal meetings were not compliant with the providers policy. This had already been identified by the provider and an action plan was in place. Recruitment procedures were in place so people were cared for by suitably qualified staff who had been assessed as safe to work with people. However, it was noted that some areas of the process needed closer scrutiny. For example, to ensure there were no gaps in a staff member's work history. We shared this information with the registered manager who took immediate action. Supporting information was received following our site visit to confirm action had been taken.

There were appropriate staffing levels and skills mix to make sure people received consistently safe, good quality care that met their needs. People did not have to wait long for support from staff when they needed this. Staff were vigilant when people were moving around or undertaking activities and made sure people remained safe. Staff regularly checked in on people who chose to spend time in their rooms or in quieter spaces around the service to make sure people were well and ask if they needed anything.

Staff told us they were well supported by the management team and felt confident to raise any concerns. They told us there were enough staff to meet people’s needs. They told us they received appropriate training and supervision. One staff member said, "I do feel supported - very much so.”

People told us staff were always available when they needed help or support. One person said, “I have a buzzer by my bed and in my bathroom. They come quickly depending on which I press (urgent and non-urgent) and if I press any they come quickly.” Relatives told us there was enough staff and they were well trained. Comments included, “The carers [staff] are excellent. I think the staff are well trained” and “I think any situation where you need care there is always a need for more staff but I think the staff level here is better than most places and the consistency of the same staff and they like it here.”

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.