New Treetops

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Records demonstrated incidents and accidents were being dealt with and there was evidence of lessons learned taking place. Lessons learnt were shared with the staff team and discussed as an ongoing item during team meetings.

Relatives were happy their loved ones were safe at the service and felt staff knew people well. All staff knew what to do as a result of accidents or incidents. One person had just had an accidental fall during our visit. This was managed well ensuring the person received prompt treatment. The incident record was detailed showing how it happened and actions taken. This was fed back to the relative who was reassured.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Relatives talked about the detailed assessment and transition process undertaken with people prior to them staying at the service. People’s care was reviewed regularly prior to each planned stay at New Treetops, any changing need was discussed with relatives. People and relatives could ring and book in easily if there were vacancies. People and relatives were able to look around and have short visits to trial the service until they felt confident to stay for a respite period. Relatives had been involved in discussions regarding people’s care needs and choices. One relative said, “We are having our first 2 night respite soon. We have no concerns, our son will love the break from us and all the attention he will get.” Another relative said, “We are very happy with the service, and it has given us all good respite over the last year. Staff deserve lots of positive feedback and praise for their good work.”

The service linked in with professionals to tailor support to people during their respite stay at New Treetops. Comments included, “Management and staff are responsive and engaging. Handled in a calm and empathetic way when understanding the reassurance, the person and families need.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Safeguarding records included details of the concerns, investigations undertaken and a summary log to monitor these. Up to date policy and guidance was available to support investigations. Staff had undertaken relevant training and knew what to do if abuse was suspected. All relatives told us they felt their loved ones were safe at the service. They said, “I feel my son is safe at New Treetops. There are always staff to talk to when I drop him off and I can contact the [acting manager] with any concerns” and “We feel entirely confident our daughter is safe. The staff have all been trained and are on top of it all.” People indicated to us they were happy at New Treetops, and positive and engaging interactions were observed.

We discussed with the management team about how they ensured people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty safeguards (DoLS). They told us they were linking in with relevant professionals to ensure DoLS applications were undertaken and in place where these were required for people accessing respite care. Staff told us and records confirmed training in MCA and DoLS had been undertaken. Policies and guidance were available to the staff team in relation to MCA and consent.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Individual risk assessments had been developed to support people in managing safe risks. Staff linked in with relatives prior to the stay to check if people’s needs had changed and if other risks needed to be considered. Staff understood people’s needs and how to keep them safe. They told us, “We make sure we always re-read risk assessments as they can change from one visit to another.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Fire safety checks were ongoing, and a fire risk assessment had been completed. Personal emergency evacuation plans were updated when people visited for respite care. The acting manager was adding these plans to the initial assessments to ensure all known registered users of New Treetops were kept in the emergency ‘grab bag’ for easy and up to date access. The property was purpose built and accessible to all people regardless of their mobility needs. Each room had an en-suite, some with access to the outside.

Environmental risk assessments were in place and up to date to ensure actions were taken to manage risks safely. We saw all areas of the environment were safe, equipment was stored safely and access to outside space was accessible to people. Staff ensured people’s safety was maintained.

A range of servicing and checks had been completed on the environment and equipment; these were ongoing and being done regularly. Some checks had lapsed during staffing changes, but this had been identified and rectified. Servicing and checks had been undertaken such as gas safety, fire safety and legionella. All relatives were happy with the environment and people’s safety. They told us, “It is clean and well maintained and in summer [people] can sit out in the garden”. Staff were responsible for daily garden maintenance with contracted gardeners visiting during the year. This sometimes meant the garden could not be prioritised. This resulted in weeds growing and the issue of non-shaded hot areasnot being addressed. This meant some garden areas were inaccessible for people.We fed this back to the provider who said they would speak with staff and seek a solution.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff were recruited safely. Relevant checks and inductions had been undertaken with new staff commencing in post. Supervision and observed competency checks on staff were undertaken.

A wide range of training had been completed by the staff team. None of the people, relatives or professionals raised any concerns about the knowledge and skills of the staff team. They said, “We feel staff are very sympathetic and are happy to support any treatment our daughter is receiving” and “We see total communication in use, they understand complex needs and have an awareness of what families go through.”

We saw enough staff undertaking duties during our visits. Sometimes staff were busy if the service was full or if people using the service all had complex needs at the same time. Staff still managed to consistently ensure peoples’ needs were met, meals prepared and the service was kept clean. At times, priority was not given to enabling people to access the community. One person, a relative and the staff told us this did sometimes happen but not all the time. A staff member said, “Staffing levels are good. Sometimes a full team isn’t needed but other times one more pair of hands would be helpful due to more complex needs.” We fed this back to the provider who was already looking at staffing levels alongside peoples’ needs and occupancy.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

All areas were clean and tidy and regular cleaning was ongoing. There was a high turnover of regular cleaning as people came and went from the service due to its respite function. Further deep cleaning was then fitted into lower occupancy times. Records were being completed which demonstrated cleaning checks and audits were taking place. Whilst these demonstrated checks were undertaken, they would benefit from more detail about what was being reviewed and what was expected by staff to ensure all staff were doing the same task content.

Staff knew how to protect people from infection; they had completed training and there were up to date policies and guidance available to support good Infection Prevention and Control (IPC) practices. Staff told us outbreaks were managed safely and there were enough supplies of personal protective equipment (PPE), We saw PPE being used appropriately by staff during our visit. No concerns were raised by people or relatives in relation to the cleanliness in the service. One said, “I have no concerns, the place is always clean.”

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were being managed safely. Information policy and guidance was in place to support safe administration. Medicines records had been completed and contained relevant information to support their administration, and medicines were being stored safely with the relevant safety checks undertaken. Staff told us they linked in with relatives and the GP to ensure they had up to date information about people’s medication.

Staff understood STOMP (Stopping over medication of people with a learning disability and autistic people) is a national NHS England work programme to stop the inappropriate prescribing of psychotropic medications, and how this impacted on people. We discussed as the service supported people for short-term respite, they would only be invited to take part in medicines reviews and monitoring if invited by relevant professionals. Staff had undertaken relevant training, and competency checks were being undertaken. None of the relatives raised any safety concerns and felt happy with the medicines booking in system.