Plane Tree Court

Plane Tree Court is a residential home which provides nursing and personal care to up to 66 people, across 3 floors. The service provides support to people with dementia and physical disabilities. At the time of our inspection there were 56 people using the service.

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

Medicines were not always stored in line with guidance and some protocols for ‘when required’ medication were not up to date. We have made a recommendation around this.Staff were recruited safely. Safeguarding concerns were escalated and responded to appropriately. Appropriate safety checks were in place at the service. We received positive feedback about the staff at the service. The home appeared clean throughout and there was regular cleaning of ‘high touch’ areas.

People had appropriate risk assessments in place. People’s care plans were not always sufficiently personalised. Relatives told us that staff knew people well and how they liked to be supported. Complaints were responded to appropriately. People were supported to engage in a variety of activities which they appeared to enjoy. Relatives were encouraged to visit the service.

Staff were passionate about supporting people with end of life care and avoiding unnecessary hospital admissions.

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 registered manager addressed concerns with staff, during staff meetings to drive improvements at the service. The service engaged well with other professionals to support people using the service. Staff were encouraged to give feedback. Relatives felt able to talk to the staff and registered manager.

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 good (published 3 March 2020).

Why we inspected

We received concerns in relation to staffing and cleanliness. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The home appeared clean and uncluttered, rooms were being regularly cleaned and an increased cleaning schedule was in place for high touch areas, this was to minimise the chance of cross infection.

The home was allowing visitors in line with guidance. All visitors’ temperatures were taken to help screen people for COVID-19. Appropriate personal protective equipment (PPE) was being used, and staff, residents and visitors also took part in routine COVID-19 testing. People were also supported to maintain regular contact with loved ones through video calls and telephone calls.

Staff spoke positively about the service and management and had no concerns. One staff member told us, “If I had concerns I wouldn't continue to work here, I feel safe working here, I only work here, it’s the only place I work.”

Plane Tree Court is a residential care home providing nursing and personal care for up to 66 people. At the time of the inspection there were 52 people using the service.

We found the following examples of good practice.

National guidance was followed on the use of personal PPE and regular Covid 19 testing was taking place. There were supplies of PPE readily available to staff and visitors.

Staff had received training in handwashing, Infection Prevention and Control (IPC) and use of personal protective equipment (PPE).

There were procedures and risk assessments to manage and minimise the risks Covid 19 presented to people who used the service, staff and visitors. The systems in place allowed people to be admitted to the home safely.

National restrictions on visiting were in place at the time of the inspection and alternative measures such as video calls were being used. The home had also built a pod to support people with safe visits.

The home was clean and uncluttered. Communal areas had been reorganised to promote social distancing.

Further information is in the detailed findings below.

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

There were enough staff to support people. The provider used thorough recruitment procedures to check new staff were suitable to work in the service. All staff were trained in how to identify and report abuse. The provider identified and managed risks to people’s safety. The provider had systems to learn from incidents to further improve the safety of the service. The staff handled medicines safely and people received their medicines as their doctors had prescribed.

People were supported by competent staff. People received support to enjoy their meals and to maintain a healthy diet. The staff worked effectively with other services to ensure people received the care they needed to maintain good health. The staff and registered managers understood their responsibilities under the Mental Capacity Act 2005 and people’s rights were respected. 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 staff were kind to people and attentive to their needs. They supported people to be involved in decisions about their care and to express their views and wishes. The staff respected people’s privacy and dignity and promoted their independence.

People received very high-quality support as they reached the end of their lives and were asked for their wishes regarding their end of life care. The staff planned and delivered care to meet people’s needs and to take account of their wishes and preferences. People were able to receive visitors as they wished and were provided with a range of activities they could take part in. The provider had a procedure for receiving and responding to complaints and people knew how they could complain about the service.

People received person-centred care which focused on what was important to them and took account of their preferences. The provider and registered managers were committed to the continuous improvement of the service. People valued the service and said they would recommend it. The staff worked with other services to ensure people received appropriate care promptly as their needs changed.

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 good (published 12 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Plane Tree Court is registered to provide accommodation and nursing care for up to 66 people, which was split across three floors. People who used the service have physical health and/or mental health needs, such as dementia. At the time of the inspection there were 61 people using the service.

There was not a registered manager at the service. 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. There was a manager who had been in post for four months and we were told that they were in the process of applying to become the registered manager.

We found there were some improvements needed to ensure there were enough staff available across the service to provide support to people.

We found that people were consistently protected from the risk of harm and received their medicines safely. The provider had safe recruitment procedures in place to ensure that staff were of a good character and suitable to support people who used the service.

People continued to be supported to make decisions about their care and staff sought people’s consent before they carried out support. 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 nutritional needs were managed and monitored. Staff received training to enable them to support people effectively. People had access to health care services and advice sought was followed by staff to ensure people’s health and wellbeing was maintained.

People were treated with dignity and staff were caring and kind. People’s dignity was respected and their right to privacy was upheld. Staff promoted people’s choices by ensuring that individual methods of communication were used to gain people’s views.

People had the opportunity to be involved in hobbies and interests. People and their relatives were involved in the planning and review of their care. Staff knew people well and people were supported in line with their preferences. People understood how to complain if they needed to and complaints were managed in line with the provider’s policy.

Effective systems were in place to assess and monitor the quality of the service people received. People and staff were encouraged to provide feedback about the service and how improvements could be made. The manager was approachable to both people and staff.

During this inspection we looked at a sample of care plans and, we looked at the systems in place to evidence that people had given their consent to care and treatment. We found improvements had been made since the last inspection.

We looked at the systems in place to assess and monitor the quality of the service being delivered. We found that the action plan we had been sent following the last inspection had been implemented.

Also due to some concerns we had received since the last inspection we looked at the complaints procedure, which included the complaint log and investigation process. We found that it was clear and was available for people to access and complaints made had been appropriately investigated.

People we spoke with told us that they were happy and had no complaints. Some of the comments we received were: 'The food is good, well cooked, well presented and there is plenty of it,' 'The girls are very good,' 'We are well looked after no doubt about that,' 'I couldn't ask for more, I have everything I need,' 'They always ask before they do anything' and 'They do have activities I like the sing songs.'

We spoke with two visiting healthcare professionals who both said they did not have any concerns.

We had no concerns regarding the training and supervision provided to staff. Staff spoken with told us they thought training was very good and a good standard of care was provided to people.

We found some improvements were needed to ensure consistent and accurate recordings in peoples care records.

We found that formal systems were not in place to evidence that people had given their consent to care and treatment.

We spoke to five people who lived in the home and they were all positive about the way they were treated and the care they received. We were told that the home was 'smashing' and that staff were 'kind'.

We looked at the activities available for people who lived in the home. Whilst it was clear that activities needed improvement the provider was making significant progress with the appointment of an activity coordinator and the development of individual social plans.

We looked at how staff implemented the home's policies for infection prevention and control and saw that they carried out hand hygiene properly and used protective equipment such as aprons and gloves when needed. The home was clean and did not smell.

We found that although staff told us they were well supported by the management team and that morale had improved there were no systems in place to ensure everyone had supervision on a regular basis.

On another day, 27 December 2012, the home was visited by a specialist pharmacy inspector from CQC. They found areas of good practice but were also concerned about the way in which people were given their medicines as well as methods for accounting for medicines.

Since we last visited the home has appointed a new manager who is registered with CQC.