Treetops Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this newly registered service. This key question has been rated Good. This meant people were safe and protected from avoidable harm. Potential risks to people’s health and welfare had been assessed and there was guidance for staff to mitigate risk. Accidents and incidents were used for learning, safeguarding concerns had been reported and investigated. There were enough staff to meet people’s needs, staff had received training appropriate to their role. Staff received their medicines as prescribed. The service was clean and odour free, the building and equipment had been checked to make sure they were safe.

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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. There were effective systems in place to learn from accidents and incidents. Staff told us they were supported to be open about mistakes they made, they described how they had been supported to learn and develop to reduce the risk of these happening again. Accidents and incidents were recorded and analysed to identify any patterns or trends. When incidents had occurred, staff involved people to develop a solution to the issue. For example, a person had previously been assessed as safe to go out by themselves. Following an incident, this was reviewed with the person and a new risk assessment was put in place, which the person was happy about. The provider understood their duty of candour when things went wrong issuing apologies, where appropriate.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Staff were aware of their responsibility to make sure people’s needs, choices and preferences are shared with other services. When people moved to another care service, their care plan was confidentially shared with the new staff. Information included people’s communication needs and cultural or spiritual needs. When people went into hospital, staff made sure important information including any advance decisions, such as resuscitation decisions, were sent with them.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. People told us they felt safe living at the service. One person told us, “No, [not had any accidents here] not while I’ve been living here. They look after me well.” The provider shared concerns quickly and appropriately. Staff understood their role to protect people from harm and abuse. Staff described the signs of abuse and were confident to raise any concerns had with the management team. They were confident the management team would act to protect people and knew how to raise their concerns with other agencies, if the management team did not act. The management team understood their responsibility to report concerns to the local authority and work with them to keep people safe.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Potential risks to people had been assessed and people had been involved in planning how mitigate them. People told us they felt safe when being supported by staff and had not had any accidents. One person told us, they were frightened when staff in the hospital had used the hoist to move them. Since moving to the service, staff had worked with the person to build their strength and confidence, so they could transfer between furniture such as their bed and armchair. The person was very pleased as they no longer felt frightened. Another person was at risk of developing skin damage but was not comfortable using the mattress they had been assessed for before moving into the service. They had discussed this with staff and a different mattress was offered which also reduced the risk of skin damage. The person told us they were now very comfortable, and staff confirmed their skin had remained healthy. People had been supported to take positive risks to remain independent. People had discussed what they wanted to do, such as go out independently, staff had developed a risk assessment with people to make sure this could be achieved.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider had made improvements to the safety of the service. Fire safety systems had been improved to the required standards and fire risks were regularly reviewed. People had been involved in the redecoration of the service and a change of flooring had been made to support people’s safety. The provider was in the process of having new Wi-Fi equipment installed around the service. This was to support people’s leisure activities and choices, such use of computers but also to support future equipment use to keep people safe. The provider completed the required checks on equipment to make sure it was safe for people to use. This included regular checks on electrical equipment brought into the service.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. People told us there were enough staff to support them and came quickly to support them. One person told us, “When I use the call bell they come quickly.” Relatives thought staff were trained and knew people well. A relative told us, “I think they know what they’re doing, they pick up on (relative’s) mood changes etc and know how to look after them.” We observed people did not have to wait for their support and staff were responsive to their requests, such as drinks. Staff also had enough time to chat and spend time with people. The provider used a dependency tool to calculate how many staff were needed to support people safely, this included the skill mix of staff needed to meet people’s needs. Staff were recruited safely, checks had been completed to make sure potential staff were of good character. Staff confirmed they had completed an induction when they started at the service. They worked with more experienced staff to learn about people’s needs and completed their mandatory training. Staff explained they had been supported to study for recognised qualifications in social care. There was a system in place to provide staff with regular supervision to discuss their practice and any training needs they may have.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People told us staff followed infection control when providing support. One person told us, “The staff wear gloves and aprons [when they do my personal care], and when they have a cold, they wear a mask.” People also told us they thought the service and their rooms were clean. Another person told us, “The home is nice and clean. Every day they come in and clean my room.” There were cleaning schedules in place and covered all areas of the building and equipment including mattresses. There were systems to dispose of waste including clinical following national guidelines. Processes were in place to enable visitors during an outbreak of infection including providing information and personal protective equipment. The management team knew who to contact for support during an outbreak of infection. The provider had considered infection control when planning the refurbishment of the building. The bathroom had wall coverings which were easy to clean, and vinyl flooring had been fitted to areas including bedrooms and communal areas. Regular audits had been completed to check infection control protocols were being followed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People told us they received their medicines as prescribed. One person told us, “They give me medicines on time. They know I can’t do it myself.” Relatives told us they were happy with the way medicines were managed. There were systems and processes in place to order, store, administer and dispose of medicines. Staff had received training to administer medicines safely and their competencies had been checked. Staff followed guidance provided by the manufacturers, such as rotating the position of pain patches to reduce skin irritation. When medicines required specific storage and administration, staff had followed these requirements. Some people were prescribed medicines ‘as and when’ including pain relief, staff were given clear guidance to follow. The guidance included when and how much medicine to give and what action to take if the medicine was not effective.