Tall Trees

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.This is the first assessment for this service, due to a change in registration. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

While basic care needs were recorded within daily care records, we identified that some records lacked sufficient detail regarding peoples’ holistic care and support. We raised this with the registered manager who took immediate action to address this telling us, “We have discussed in a meeting with the team, about the use of enabling language…we were all in agreement and shared a few examples about ourselves and how we would be described if it were us so I am sure this will be embedded quite quickly.”

The service cared for people who had a variety of complex needs both physical and cognitive. We observed members of staff engaged with people respectfully and personally and knew people well. People were offered the opportunity to take part in meaningful activities inside and outside of the service led by dedicated staff. This promoted people’s social, cognitive and physical wellbeing.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

The provider worked with other professionals and services to ensure continuity of care when people transitioned into the service.A healthcare professional told us, “[Staff] are transparent in their communication with us regarding patient needs so we can plan appropriate support to meet their demand.” However, another healthcare professional shared some reservations and concerns about a lack of action taken by staff and leaders when advice is provided and conflicting information from staff provided. Whilst we found that staff engaged with external professionals and made referrals for people, we could not be assured that people always consistently received timely support when concerns were raised by staff. We shared this with the registered manager during inspection feedback so they could take action to address this.

Staff communicated clearly and took time to explain things to people; however, some information was not always presented in accessible formats, which limited understanding for individuals with specific communication needs. The registered manager and provider recognised this and were working towards improving the accessibility of information especially for those living with dementia.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and their relatives told us they felt involved in their care and support. Many relatives we received feedback from said they felt comfortable communicating with staff and the registered manager. People and their relatives were aware of how to make a formal complaint if needed and expressed confidence that any concerns raised would be taken seriously by the management team. One relative told us, “I’ve not much to complain about – just Iook and see the interaction there those 2 [carers] and the lady, see how they are kind – most of the time there is a nice atmosphere here.” Another relative said, “We have not had any formal complaints or concerns to raise. Sometimes we have asked how they handle a particular situation, in theory or in practice, and we have always had a satisfactory reply.”

A formal complaints procedure was in place and response details maintained. This included who to speak with outside of the service to feedback on care.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. There were areas within the service which required reviewing to suit the needs of the people who lived there. There was limited dementia friendly signage to help people navigate round the service. Toilets and bathrooms were not clearly signposted, and people’s bedroom doors did not always have their name or other references to help them find their own space or avoid going into other people’s spaces. The service was wheelchair accessible throughout.

Staff did not always ensure people could access the care, support and treatment they needed when they needed it. Healthcare professionals were involved in people’s care and treatment, but we received feedback regarding delays to referrals being made when needed to ensure people received the right support when required.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Care plans included information around people’s identity, things which were important to them, their wishes and relationships they wanted to maintain. The registered manager and staff ensured peoples’ social and healthcare needs were fully considered and met. One person said, “I watch TV, listen to music, my [spouse] comes most days, and we go out in the garden and get fresh air, the garden is well maintained.”

People were supported to have access to any equipment they needed to remain safe. This meant people were able to remain independently mobile as long as possible and did not face restrictions.

Staff had received training in Equality, Diversity and Inclusion. This meant staff had knowledge and understanding about how to support everyone to feel valued and respected.

People, relatives and staff did not raise concerns of any form of discrimination within the service to us.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life, however, end of life care plans required more detail to ensure people’s wishes and preferences were fully recorded. For example, care plans for people’s future planning contained varied levels of detail regarding their advanced care plan and one person’s care records reflected the name of another service. We shared this with the registered manager who took action to address the recording error.

Advance care planning enables a person to express and have documented their preferences and priorities of how they wish to be cared for as their illness progresses.

Many staff told us the people, and their relative, received compassionate end of life care at Tall Trees. One staff member said, “End of life care comfort is a priority for our home, ensuring comfort using relaxing music, in accordance with the [person’s] preferences, using the aroma therapy, using anticipatory medication and reassurance for [people]. Emotional support and encouragement for families to be with their loved ones during this difficult period.”