Archived: Treetops Nursing Home

Updated 19 July 2016

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 6, 9 and 10 May 2016 and was unannounced. The inspection was carried out by one adult social care inspector.

We had not requested the service complete a provider information return (PIR); this is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make. However, before our inspection we reviewed the information we held about the service, including the previous inspection report and notifications the provider had sent to us. We contacted the local authority safeguarding team, the local Healthwatch organisation and the local authority commissioning team to obtain their views about the service. None of the organisations we contacted raised any concerns about Treetops Nursing Home

On the first day of the inspection we spoke with three people who used the service and two visiting relatives/friends. We also spoke with the registered manager, the nurse in charge, a senior carer, three members of care staff and an external activities coordinator. In addition we spoke with two health care professionals. On the second day of the inspection we spoke with three carers and the chef. We also spoke with a further three people who used the service.

Some of the people living at the home were unable to give their verbal opinion about the care and support they received. We therefore carried out observations in the public areas of the service. We used the Short Observational Framework for Inspection (SOFI) on the first day of inspection during the lunch time period. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at the care records for four people who used the service and the records relating to the administration of medicines for all the people who used the service.

We looked at a range of records relating to how the service was managed; including five staff personnel files, training records, quality assurance systems and policies and procedures.

Updated 19 July 2016

This inspection took place on the 6, 9 and 10 May 2016. Our visit on the 6 May was unannounced.

Treetops Nursing Home is a purpose built home which provides accommodation for up to 33 older people who require support with personal care and nursing needs. At the time of our inspection there were 29 people using the service.

The service was last inspected on the 13 June 2013 and met all the standards.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the end of this report.

There was a registered manager in place at Treetops Nursing Home. 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.

People who used the service told us they felt safe and that staff were kind and caring. This was confirmed by our observations on both days of the inspection.

Staff had received training in safeguarding adults procedures and were able to tell us of the correct action to take should they have any concerns about people who used the service. Staff were aware of the procedures to follow should they observe poor practice in the service.

The systems for managing medicines in the service needed to be improved to ensure that people always received their medicines as prescribed.

Staff were safely recruited and received the induction, training and supervision they required for their roles. People told us there were enough staff on duty to meet their needs in a timely manner, but on the second day of the inspection we found improvements needed be made to the deployment of staff. We have made a recommendation about the deployment of staff during busy periods of the day.

Care plans included information about the risks people might experience, such as those related to falls, skin integrity and nutrition. We found risk assessments had been regularly reviewed and updated to take into account people’s changing needs.

We saw there were risk assessments in place for the safety of the premises. All areas of the home were clean and well maintained, although we noted there was limited space available for the storage of equipment people needed.

Procedures were in place to prevent and control the spread of infection.

Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply to the premises.

Care records were personalised and provided good information about the care people required. We found care plans had been reviewed and updated regularly.

Systems were in place to help ensure people received the care they wanted at the end of their life. One of the visiting healthcare professionals we spoke with praised the quality of end of life care provided by staff atTreetops Nursing Home.

A timetable of activities was in place to help promote the health and well-being of people who used the service. We saw that people were supported to access local facilities and resources.

The registered manager had introduced a system to involve the relatives of people who used the service in reviewing the care provided at Treetops Nursing Home.

People we spoke with told us they would be confident to raise any concerns with the managers or staff. Relatives and friends of people using the service told us they found the managers to be approachable.

All the staff we spoke with told us they enjoyed working at Treetops Nursing Home and considered they received the appropriate training and support they required for their role. Records we looked at showed regular staff meetings took place and were used as a forum to discuss required standards of care and improvements which could be made to the service.

The service had a number of quality assurance measures in place, including audits relating to care plans and medication records, we noted these had been sufficiently robust to identify some of the issues we found during the inspection but had not been actioned yet.