We carried out a review of the data available to us about Box Tree Cottage Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Box Tree Cottage Residential Home, you can give feedback on this service.
We found the following examples of good practice.
On arrival at the home visitors were asked to complete a test for COVID-19.They were also were required to wash their hands and were given personal protective equipment (PPE) to put on.
The home had an ample supply of PPE. All staff had received training in the correct use of PPE, and how to take it off and put it on safely. Staff had worked flexibly to change shifts and work extra hours so that there was no need to use agency staff. Because of the size of the home it was difficult to implement social distancing for people living there. However outside areas were being used for staff breaks and meetings to enable social distancing for staff.
People were supported to have regular contact with their families and friends via video calling. People were supported to take part in activities that they enjoyed with staff.
Testing was carried out for both people living in the home and staff on a regular basis. If anyone had symptoms of COVID-19 they were tested immediately.
Cleaning of the home, including frequently touched surfaces, had increased to reduce the risk of transmission of infection. There were ample supplies of cleaning equipment. Staff had been made aware of the correct cleaning fluids to use to prevent the spread of infection. Uniforms including shoes had been purchased for all staff. Staff changed into their uniform at the start of each shift. They then changed out of the uniform at the end of their shift and this was washed in the home.
Boxtree Cottage Residential Home provides accommodation and personal care for up to 14 adults requiring support with their mental health needs. At the time of our inspection there were 12 people living at the service who received support with personal care.
People’s experience of using this service and what we found
People were happy with the care home and the staff that provided their care.
People felt safe living at the home because staff knew what they were doing, they had been trained, and cared for people in the way people wanted. Staff assessed and reduced risks as much as possible. There were enough staff. The provider obtained key recruitment checks before new staff started work.
People received their medicines and staff knew how these should be given. Medicine records were completed accurately and with enough detail. Staff supported people with meals and drinks. They used protective equipment, such as gloves and aprons to prevent the spread of infection. Staff followed advice from health care professionals and made sure they asked people’s consent before caring for them.
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.
People liked the staff that cared for them. Staff were kind and caring, they involved people in their care and made sure people’s privacy was respected.
Staff kept care records up to date and included national guidance if relevant.
The service was well managed by a registered manager with regular input from the provider. The senior staff team were passionate about giving people a high-quality service.
People were asked their view of the service and action was taken to change any areas that they were not happy with.
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 20 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.
The service did not have a registered manager in post. There was both a home manager and care manager in post to deal with the day to day running of 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.
This inspection was carried out on 15 June 2017 and was an unannounced inspection. At the last inspection on 18 March 2015, the service was rated as ‘good.’ At this inspection we found the service remained ‘good.’
Staff were knowledgeable of how to report incidents of harm and poor care. Staff helped people in a manner that supported their safety and people were looked after by staff in a caring and patient way. Staff encouraged people to make their own choices and live as independently as possible. People’s privacy and dignity were promoted by staff and people were treated with respect.
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 care arrangements took account of people’s wishes including their likes and dislikes. People’s care plans recorded their individual needs, choices and any assistance they required. Risks to people who lived at the service were identified, and plans were put into place by staff to monitor and minimise these risks such as for those people who required support with their mental health needs.
People were looked after by enough, suitably qualified staff to support them safely with their individual needs. Where needed, staff were flexible around when they needed to work to support any short notice absences.
Staff enjoyed their work and were supported and managed to look after people. Staff understood their roles and responsibilities in meeting people’s needs and they were trained to provide effective and safe care. Staff were supported to maintain their skills by way of supervision and appraisals. Pre-employment checks were completed on new staff members before they were assessed to be suitable to look after people.
People were supported to take their medicines as prescribed and medicines were safely managed by staff who were trained, and whose competency had been assessed. Where there had been any errors in the administration of people’s medicines, these had been identified and dealt with to reduce the risk of recurrence.
The service was flexible and responsive to people’s needs. People were encouraged to maintain contact with their relatives and friends when they wished to do so. Staff assisted people to maintain their links with the local community.
People were supported to eat and drink sufficient amounts of food and fluids. People’s choice about what they wished to eat and drink was promoted and supported. Staff monitored people’s health and well-being needs and acted upon issues identified by assisting people to access a range of external health care services.
There was a process in place so that people’s concerns and complaints were listened to and acted upon and where possible resolved to the complainants satisfaction.
Arrangements were in place to ensure the quality of the service provided for people was regularly monitored. People who lived at the service and staff were encouraged to share their views and feedback about the quality of the care and support provided. Actions were taken as a result to drive forward any improvements required.
Further information is in the detailed findings below.
Box Tree Cottage Residential Home is a care home registered to provide accommodation and personal care for up to 14 people who have mental health support needs. There were 14 people living at the home at the time of our visit. The home is a medieval thatched cottage and accommodation is provided on two floors. There are internal and external communal areas, including a lounge, dining areas, an outside smoking area and a garden for people and their visitors to use.
This unannounced inspection was carried out on 18 March 2015. At our previous inspection on 01 October 2013 the provider was meeting all of the regulations that we assessed.
There was a registered manager in place. They had been in post since August 2013. 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.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. There were formal systems in place to assess people’s capacity for decision making and when appropriate applications would be made to the authorising agencies for people who needed these safeguards. At the time of this inspection people were not currently deprived of their liberty.
People who lived in the home were supported by staff in a respectful and kind way that maintained their safety, but also supported their independence. People had individualised care and support plans in place which recorded their likes and dislikes, needs and wishes. These plans gave staff guidelines on any assistance a person may require, as well as how to respect people’s choices and preferences.
Risks to people were identified by staff. Plans were put into place to minimise these individual risks to enable people to live as safe and independent a life as possible. There were arrangements in place for the safe storage, disposal, management and administration of people’s prescribed medication.
Staff cared for people in a patient way. Staff took time to reassure people who were becoming anxious in an understanding manner. There was an ‘open’ culture within the home. People were able to raise any suggestions or concerns that they might have had with staff members or the registered manager and feel listened too.
There were a sufficient number of staff on duty. Staff were trained to provide effective care which met people’s individual support and care needs. Staff understood their role and responsibilities and were supported by the registered manager to maintain their skills through supervision, appraisals and training.
The registered manager had in place an on-going quality monitoring process to identify areas of improvement required within the home. Where improvements had been identified there were actions plans in place which documented the action taken.