Background to this inspection
Updated
20 October 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by three inspectors 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.
Service and service type
Treetops Court Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependant on their registration with us. Treetops Court Care Home is a care home with nursing care. Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with CQC to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a newly appointed manager in post, who was in the process of registering with CQC.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 16 February 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.
During the inspection
We spoke with five people who used the service and 11 relatives about their experience of the care provided. We spoke with 11 members of staff including members of the regional management team, manager, deputy manager, unit managers, staff nurses, care home assistant practitioners (CHAPs), senior care workers, and care workers. We reviewed a range of records. This included four people's care records and multiple medication records. A variety of records relating to the management of the service, including; staff recruitment files, quality audits and policies and procedures were reviewed.
Updated
20 October 2022
About the service
Treetops Court Care Home is a nursing residential care home providing nursing and personal care to up to 70 people. The service provides support to people over the age of 65 who have dementia, mental health needs, physical disabilities. At the time of our inspection there were 47 people using the service.
People’s experience of using this service and what we found
The provider ensured annual safety checks being completed but on-going checks and building maintenance checks were not being completed consistently. This meant people were at higher risk if faults were not being identified and rectified quickly.
Medicines quality audits were not robust enough to effectively identify errors and were not being carried out consistently. However, no one had come to harm.
People were not supported to have maximum choice and control of their lives and did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Staff were safely recruited and trained, but not all staff had all relevant training to support the needs of all people in the home.
Most people told us they felt safe, relatives’ views on the service were mixed.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
The last rating for this service was requires improvement (published 30 October 2020). The service remains rated requires improvement. This service has been rated requires improvement for the last five consecutive inspections.
Why we inspected
We carried out an unannounced inspection of this service on 14 and 16 June 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well led.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has not changed following this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Treetops Court Care Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to the overall governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.