The Trees

Updated 2 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 25 October 2017 and was unannounced. The inspection team consisted of one inspector and an Expert by Experience. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before we visited we reviewed the information we held about the service including notifications. Notifications are about events that the provider is required to inform us of by law.

During our visit we spoke with five people who used the service and completed general observations of people living in the home, as most people were unable to fully communicate with us. We contacted two relatives by telephone the day after the inspection for their feedback about the service provided. We spoke with five members of staff, the registered manager, the deputy manager and the provider’s representative.

We looked at all or parts of the care records for three people, the training and induction records for four staff and two people’s medicine records along with other records relevant to the running of the service. This included policies and procedures, records of staff training and records of associated quality assurance processes.

We also consulted other professionals and commissioners of the service who shared with us their views about the care provided.

Updated 2 December 2017

We carried out an unannounced inspection of the service on 25 October 2017

The Trees provides accommodation for persons who require nursing or personal care who are living with learning disabilities. The Trees is a purpose built home and provides care on a short and long term basis for up to 19 adults who have been diagnosed as having learning disabilities, mental health conditions, and physical disabilities. The service consists of three units, Beachwood, Ashwood and Cedarwood, each unit provide communal and living quarters for people who used the service. There were seven people receiving care and three people in respite care at the time of our visit. The service was last inspected 30 November 2015 and the rating for that inspection was Good.

There was a manager registered with the Care Quality Commission (CQC). 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.

At the previous inspection in October 2015 we found staff had difficulty recognising when people showed signs of distress, so they could administer 'as required' medicines appropriately. At this inspection we found improvement had been made. Records showed a distress assessment tool had been implemented and added to individual medicine care plans where people required PRN medicines when they were in distress.

People were observed to be living in a safe environment and kept safe when staff supported them. Risks were assessed and managed. Sufficient staff were in place and safe recruitment process were followed.

There was an training programme in place that provided in depth and relevant knowledge and skills to fully equip staff to meet the individual needs of people. Staff received regular supervision and felt well supported by the management team. The principles of the Mental Capacity Act 2005 (MCA) were considered when supporting people. People were supported and encouraged to follow a healthy and balanced diet. People’s day to day health needs were met effectively by the staff.

People experienced positive caring relationships with staff that treated them with kindness and compassion. Staff showed good awareness of people’s needs and preferences. People were treated with respect and dignity. People were supported to express their views and be actively involved in making decisions about their care. People were supported to live as independently as possible.

People were aware how to raise concerns or complaints and were encouraged to do so if needed. The provider followed their procedures to ensure any complaints or concerns were dealt with in a timely manner.

Staff spoke highly of the registered manager and the service provided. A number of systems were in place that enabled people, staff and relatives to give their views about the service. Robust quality assurance processes were in place. The rating of the service was displayed appropriately.