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Inspection Summary


Overall summary & rating

Good

Updated 15 December 2017

This unannounced comprehensive inspection took place on 25 October and 2 November 2017. We last inspected the service in November 2015 when we rated the service as Good overall, with two breaches of the Health and Social Care Act 2008 and Associated Regulations. The breaches related to staff practice not being in accordance with the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards. This was because some people who lacked capacity did not have their rights fully protected and had been subject to restrictions on their liberty for their safety and well-being without the proper processes being put in place. At this inspection we found that improvements had been made to staff training and understanding. The service now met the relevant requirements.

Treelands is a residential home registered to provide accommodation with personal care for up to 40 older people, some living with dementia. The service had a registered manager.

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.

People living at the service, their relatives and health and social care professionals gave us positive feedback about the service. One person said, “If all homes were like this one, there wouldn’t be anything to worry about.”

People said they felt safe living at the home. Staff knew how to identify signs of potential abuse, where and how to raise concerns and that these would be acted upon. Environmental risk assessments were undertaken but regular checks were not always undertaken. This left some people at risk of avoidable harm. Individual risk assessments were undertaken and records showed that appropriate measures had been put in place to minimise risks to people. Medicines were administered and stored safely.

An effective recruitment process made sure only suitable staff were employed to care for people.

There were sufficient numbers of staff on duty to support people. Staff received a thorough induction, training and ongoing supervision to enable them to carry out their roles. Staff felt well supported by management.

People were treated as individuals with dignity and respect and their consent was sought for care and treatment. Where people lacked capacity, the Mental Capacity Act 2005 and its code of practice was followed. Relatives, health care professionals and others were consulted and involved in best interest decision making. People received a varied diet in accordance with their own choices. People’s health needs were met by a range of external professionals. Healthcare professionals felt confident that the service delivered good quality service.

People and their relatives praised the staff for delivering high quality care. Staff were described as friendly, kind and caring.

People had individual risk assessments and care plans and had been consulted along with their families. There was a programme of activities on offer. Family and friends were able to visit freely and visitors were made welcome.

There was a variety of systems in place to monitor the quality of the service. Prompt action was taken to remedy any shortcomings. External organisations provided support to improve systems.

Inspection areas

Safe

Requires improvement

Updated 15 December 2017

The service was not always safe.

Some aspects of the environment were not routinely checked for safety.

People's individual risks were assessed and actions taken to reduce them as much as possible, whilst minimising restrictions on people�s freedom.

Staff knew about their responsibilities to safeguard people and how to report suspected abuse.

People were supported by sufficient staff to enable them to receive care at a suitable time and manner.

People received their medicines on time and in a safe way.

An effective recruitment process was in place to ensure people were cared for by suitable staff.

Effective

Good

Updated 15 December 2017

The service was effective.

People were well cared for by staff that had the knowledge and skills to carry out their roles.

Consent was sought from people for care and treatment decisions. Staff demonstrated a good knowledge and understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, and acted in accordance with them.

People were supported to access healthcare services. Staff recognised changes in people's health, sought professional advice and acted on it.

Caring

Good

Updated 15 December 2017

The service was caring.

People had developed good relationships with staff who knew them well and staff were kind towards people.

People were treated with dignity, respect and compassion. Staff protected people's privacy and supported them sensitively with their personal care needs.

People and their relatives were consulted and involved in decision making about care and treatment

Responsive

Good

Updated 15 December 2017

The service was responsive.

People received personalised care which matched their individual needs.

People were offered a range of activities.

People knew how to raise concerns and complaints, which were dealt with promptly and effectively.

Well-led

Good

Updated 15 December 2017

The service was well led.

The service had an open person centred culture with staff working well as a team.

People had confidence in the registered manager. People were consulted and their views taken into account in running the service.

The service had a range of systems in place to monitor the quality of care.

Systems were continually being improved to deliver better service.