Treetops Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. People were supported to have choice and control over their support, staff respected their choices. People’s needs were regularly assessed and reviewed to provide appropriate support. Staff supported people to lead as healthy lives as possible, people had access to health professionals when their needs changed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The management team met with people, before they moved to the service, to check staff could meet their needs. The pre-admission assessment process covered all areas of a person’s life including their cultural or spiritual needs. Staff used recognised assessment tools such as Waterlow score to assess people’s skin integrity. These initial assessments were used to develop the person’s care plan, which were reviewed at least monthly to make sure they were up to date and met people’s needs. People told us staff understood their needs and supported them in the way they preferred.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People told us they were supported to eat and drink what they liked. People confirmed their dietary preferences were supported. One person told us, “I’m a vegetarian and I like jacket potatoes. (Deputy manager) has bought different things for me to try but I haven’t liked them yet.” Staff followed ‘Food First’ for care homes guidance published by the local community health trust to make sure people were offered food and drink which met their needs. When people had been assessed as at risk of losing weight, they were offered food fortified with extra calories. People were offered a balanced diet including fruit and vegetables, brown bread and high fibre foods. People who were living with diabetes were offered the same meals as everyone else. The kitchen staff told us they were informed if people’s blood sugars were high or low so they could offer a meal appropriate to their needs.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. People told us they were kept informed about their health and were involved. One person told us, “Yes, I have regular appointments, and they arrange a doctor if I need one. When I had to go to Kent and Canterbury hospital, staff went with me.” Staff attend handovers each day between shifts, and these were recorded on the digital care planning system. Staff shared important information with colleagues, including any changes in people’s physical or mental health, accidents or participation in activities. Appointments were recorded in the diary which was reviewed during the day to make sure people had the opportunity to plan for them and the appointment was not missed.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and, where possible, reduce their future needs for care and support. People were supported to have regular health checks, an optician and podiatrist visited the service regularly. The provider had attempted to source a local dentist who would visit the service, but this was not possible. The provider had arranged for a dental hygienist to assess people’s oral health and provide recommendations. These had been recorded in people’s care plans and people were provided with the tools such as mouthwash and soft toothbrushes, to follow the guidance. The district nurse visited the service to support people with their health. People were supported to attend health appointments, this could be alone, with family or staff. People were supported to stay as physically active as possible. A fitness trainer visited each week, and people took part in seated exercises. Staff encouraged people to stay active by playing games such as catch. Health was considered when activities outside of the service were planned and people had enjoyed a trip to the local bowling alley.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent. There were systems in place to monitor people’s health and the outcomes for people. Staff used recognised assessment tools to monitor people’s weight and skin integrity, these were reviewed monthly. The outcome of the monthly review was used to plan any changes to people’s support such as referring people to the dietician if they had lost weight. Staff monitored people’s health conditions such as constipation, following professional guidance about when to give appropriate medicines. The outcomes were monitored make sure the medicines were effective and gave the outcome the person wanted. Staff had received training to enable them to monitor people’s vital signs such as blood pressure to identify when they were unwell or if treatment was effective.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People told us they were encouraged to make decisions and choices. One person told us, “I make my own choices, choose what I wear, what I eat, what I do. I like the jacket potato, and if there’s nothing, I like they’ll cook me something else.” Another person told us they were quite happy for staff to make decisions for them, “I’m not fussed about choosing what I wear, I let the staff choose, but I like to choose what I eat when they come round [with the menu].” Staff described how they followed national guidance by assuming people had capacity. We observed staff asking people about all areas of their care including how they spent their time, staff asked people if they wished to speak to us during our assessment. People were asked if they wished their pictures to be placed on the service’s Facebook page. When people had changed their mind, the provider had quickly removed the pictures. When people had been assessed as not having capacity to make decisions, these were made in people’s best interest. Records were maintained about how decisions had been made and who had been involved including relatives and health professionals who knew people well. Staff were aware of people’s representatives, who had been given legal authority to be involved in decisions. Deprivation of Liberty Safeguards (DoLS) had been applied for as necessary. There was a process in place to track and monitor applications and when authorisations needed to be renewed. When authorisations had been received these had been recorded in people’s care plans, there were currently no conditions on the authorisations in place.