Livability Treetops

Updated 20 February 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by an inspector and a professional advisor who was a nurse.

Service and service type

Livability Treetops is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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. The registered manager was present during the inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Prior to our inspection we reviewed information we held about the service. This included any safeguarding referrals and statutory notification that had been sent to us. A notification is information about important events which the service is required to send us by law.

The provider had completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with the registered manager and seven members of staff. We spoke with four residents and observed care practice throughout the day of our visit. We reviewed five care and support plans, medicine administration records, three recruitment files, staffing rotas and records relating to the quality and safety monitoring of the service. On the second day of the inspection we telephoned relatives to talk with them about their observations of care. In total we spoke to four relatives.

After the inspection

We continued to seek clarification from the provider to validate the evidence found.

Updated 20 February 2020

Livability Treetops is registered for accommodation for persons who require nursing or personal care, diagnostics and screening and treatment of disease disorder or injury. Livability Treetops provides a high dependency service and nursing care for up to 21 people who have a physical disability and may have a learning disability or an acquired brain injury. There were 20 people living in Livability Treetops on the day of our inspection. The building has been adapted for the people who use the service and was all on one level.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them. The service was a large home, bigger than most domestic style properties. This is larger than current best practice guidance however this was mitigated by the building design fitting into the residential area.

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

People and relatives spoke highly of the service and the quality of the support provided.

At our last inspection we identified issues with the management of medicines and levels of oversight by the provider. At this inspection we found that improvements had been made, the management of medicines had been strengthened and governance was more robust overall.

There were systems in place to assess and mitigate risks and care was delivered in a way that was intended to ensure peoples safety and welfare. The environment was accessible, clean and comfortable. There were systems in place to reduce the risk of infection and to learn lessons from accidents and incidents.

There was enough staff available to meet peoples needs, and while there were some staffing vacancies, interim arrangements were in place. There were clear processes in place to recruit staff to ensure they were suitable for the role. New staff received induction and ongoing training to provide them with the skills and knowledge they needed to support the people living in the service.

Mealtimes were a sociable experience and the staff worked with a range of health care professionals to support people’s health and wellbeing.

Staff were motivated and supported. They were clear about their responsibilities and there was a strong person-centred culture. There was a clear emphasis on helping people to communicate effectively and people told us they were consulted and had a say in how they were supported.

Peoples care was underpinned by detailed and informative care plans which were regularly updated to reflect changes in people’s needs. There were systems in place to hand over information about peoples needs which ensured that staff had the information they needed to support people effectively.

People were supported to follow their interests and had access to a range of social opportunities both within the service and in the local community.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

Regular audits were undertaken to identify learning and drive improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 24 January 2019.) At this inspection we found improvements and been made.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.