Archived: Treefields Resource Centre

Treefields Resource Centre is a respite service providing short stay support to people with a learning disability. It can support up to six people at a time. The service is in Rotherham, in a quiet residential area.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

People told us they valued their time at Treefields. They described it being like a holiday, with one person who had just arrived for the weekend telling us they were “really happy” about being there. Staff supported people to tailor their stay to reflect their interests, and staff demonstrated a good understanding of people’s needs. People described how they often stayed at the service at the same time as friends, and records showed staff tried to ensure they coordinated stays between people who got on well, as well as arranging stays at different times for people who did not get on. Staff spoke to people with respect, and there was a genuine warmth in the interactions between staff and people using the service. A relative told us they were always welcomed and said they really valued the service.

People were supported in a safe environment by staff who were deployed in sufficient numbers to meet their needs. The environment was well managed, with appropriate safety checks and auditing taking place, including audits of infection control procedures and fire safety.

Care plans were detailed and reflected people’s needs. They were regularly reviewed to ensure any changes to people’s needs were incorporated, and people and their relatives, where appropriate, were encouraged to be involved in these reviews. We noted, however, that improvements should be made in relation to how the provider obtained people’s consent. Risks were assessed and monitored safely.

Medicines were safely managed, and audits ensured managers had a good oversight of this. We found, however, the provider did not have appropriate records in place for when people had their medication on an “as and when” basis. The registered manager told us work was ongoing in this area.

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. We did note, however, that work was required to better evidence how consent was obtained.

Staff were recruited safely, with appropriate background checks being made. Records showed staff received training in a wide range of relevant areas, and staff exhibited a good knowledge about how to support people using the service.

There was a registered manager who was relatively new in post. They oversaw management of the service using a range of audit tools, and were supported by a deputy manager and a team of senior support workers. We identified the provider had failed to make certain, legally required, notifications to CQC when suspected abuse had taken place. The registered manager told us they were not aware of this legal requirement.

Rating at last inspection:

The last rating for this service was good (published August 2017)

Why we inspected:

This was a planned comprehensive inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This unannounced inspection took place on 13 July 2017. The home was previously inspected in July 2015 when we rated it as ‘Good’. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Treefields’ on our website at www.cqc.org.uk’

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

On the day of our visit there were four people staying at the home. The people who agreed to speak with us said they enjoyed visiting the home and were very happy with the care and support they received during their stays.

Systems were in place to protect people from the risk of harm. Staff were knowledgeable about keeping people safe and were able to explain the procedures to follow should any concerns be raised. Risk assessments had been completed to help keep people safe and encourage their independence.

There was a stable staff team who knew the people who stayed at the home very well and provided individualised care and support. People were enabled to continue with their usual routines, such as attending day centres and taking part in their hobbies and interests.

There was a robust medication system in place which ensured people received their medications in a safe and timely way from staff who had been trained to carry out this role.

The recruitment system helped the employer make safer recruitment decisions when employing new staff. A structured induction programme was undertaken, which included staff completing essential training at the beginning of their employment. An on-going training and support programme ensured staff maintained and developed their knowledge and skills.

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 support this practice.

People received a well-balanced diet that they were involved in choosing, shopping for and helping to prepare.

People’s assessed needs were checked and updated prior to each visit to Treefields, and this information was used to update their support plans. Care files provided detailed information about the areas people needed support in and reflected their abilities and preferences, which enabled staff to provide individualised care.

The provider had a complaints policy to guide people on how to raise concerns and there was a structured system in place for recording the detail and outcome of any concerns raised. This was also available in an easy to read version that used pictures to help people understand the process.

There was a system in place to enable people to share their opinion of the service provided. We also saw an audit system had been used to check if policies had been followed and the premises were safe and well maintained.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. All staff had contributed to a dignity pledge. Staff had received training in relation to safeguarding people who use the service. People using the service told us they felt safe. One person told us: 'If anything is wrong or staff do something I don't like, I tell someone. It's safe here.'

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

Audits took place to ensure that the service was safely run.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. People said that they had been involved in writing them and they knew what was in their care plans.

Audits and reviews took place to ensure that care was delivered in a way that met people's needs.

Is the service caring?

People were supported by kind and patient staff. We saw that care workers showed patience and gave encouragement when supporting people. We looked at questionnaires completed by relatives of people using the service. One relative said: 'I know he is in good, kind, safe, caring hands.'

People's preferences, interests and plans had been assessed. Care and support had been provided in accordance with people's wishes.

Is the service responsive?

The service supported people in accessing the community to pursue their interests and aspirations. Staff acted on people's needs and in accordance with their wishes. Where people's health needs changed, staff ensured that their support accommodated their changing needs.

People using the service told us they knew how to make a complaint if they needed to. We looked at complaints records and found that they were responded to in a timely manner.

Is the service well-led?

The service worked with other agencies and services to make sure people received their care in a joined up way. Staff communicated effectively with other services so that people's needs were met.

There was a quality assurance system in place, where external staff carried out a quality monitoring programme. However, staff described that one aspect of this had not been kept up to the planned frequency recently.

At the time of the inspection, the home's registered manager had been on a period of absence. However, one relative had contacted the home to say: 'The centre runs as if he is still there.'

People we spoke with were extremely positive about their experience of receiving support at Treefields Resource Centre. One person said 'I really really love it here.' Another said 'it's wonderful.'

People were cared for in a clean, hygienic environment. We carried out a visual inspection of the premises, and found that all areas we checked were cleaned to a high standard. The home was in a good condition, which meant that it could be cleaned to an appropriate standard to reduce the risk of infection.

We checked the daily notes in people's files, and saw that when plans had been made for people to go out or take part in activities, there were always sufficient staff to ensure they were supported to do so.

We asked people using the service about the complaints arrangements. One person said: 'I know how to make a complaint, it's in my file.' They then showed us where there was information within their personal file which told them how to complain, should they wish to.