Archived: Seventrees

Seventrees is a care home without nursing. Seventrees provides care for up to eight adults living with a range of learning difficulties and mental health needs. At the time of our inspection there were eight people living at the home some of whom also lived with physical disabilities. The service is in a residential area and has an accessible garden and parking.

Rating at last inspection

At our last inspection in April 2018, we rated the service as ‘Requires improvement’.

Why we inspected

This was a planned inspection based on the previous rating.

People’s experience of using this service

Improvements had been made since our last inspection and the service was, overall, meeting the characteristics of a ‘Good’ service.

However, further work was needed to ensure that staff consistently acted in line with the principles of the Mental Capacity Act and its Code of Practice.

Recruitment checks were now being more robustly implemented.

Overall, the design and layout of the premises met people’s needs. Some improvements had been made to the décor and some fixtures and fittings had been updated. Further improvements were planned which included the installation of ensuite bathrooms and new carpets.

Staff understood how to recognise and respond to abuse and had a good understanding of risks to people’s health and wellbeing. Medicines were managed safely and there were sufficient numbers of experienced staff to meet people’s needs.

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 ensured that people who used the service were able to live as full a life as possible and achieve the best possible outcomes. The principles reflected the need for people with learning disabilities to live meaningful lives that included control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that was appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to eight people. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

Professionals were positive about the outcomes people achieved at the service. People continued to be supported to have enough to eat and drink and their dietary needs were met. Staff worked effectively with a range of other healthcare professionals to help ensure people’s health care needs were met.

People were supported by staff who were kind and caring. People were cared for with dignity and respect and staff were mindful of their need for privacy.

People received personalised care from staff who understood their needs well. People were supported to follow their interests and take part in activities that involved them in the local community.

Feedback about the registered manager was positive and people and staff felt the service was well led. There were systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving the best possible support.

Follow up

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

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

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At our last inspection we rated the service good. At this inspection we have rated the service as requires improvement as we found concerns in some of the areas we inspected. For example, the recruitment practices and checks were not always sufficiently robust.

Overall, the design and layout of the premises met people’s needs, but some of the décor in the communal areas was tired and worn and could be more homely and reflective of people’s interests and individuality.

Whilst staff felt well supported, they had not always been receiving regular supervision and none of the staff who had worked at the service for more than a year had had an appraisal

The leadership team understood the requirements of the Mental Capacity Act (MCA) 2005 although the documentation in place did not always support this. Action is being taken to address this.

Other areas remained good.

Staff understood how to recognise and respond to abuse and had a good understanding of risks to people’s health and wellbeing. Incidents and accidents affecting the safety of people were investigated to make sure that any causes were identified and action taken to minimise any risk of reoccurrence.

Medicines were managed safely.

There were sufficient numbers of experienced staff to meet people’s needs.

There was evidence that the care provided at Seventrees was being delivered in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. People were encouraged to live their life in the same way as any other citizen and their choices, independence and inclusion were encouraged.

People were supported to have enough to eat and drink and their dietary needs were met. Staff worked effectively with a range of other healthcare professionals to help ensure people’s health care needs were met.

People were supported by staff who were kind and caring. People were cared for with dignity and respect and staff were mindful of their need for privacy.

Staff understood the needs of the people they supported and this enabled them to care for them in a person centred manner that was responsive to their individual needs.

People were supported to take part in a range of leisure activities and follow their own interests.

The registered manager used complaints or concerns to understand how they could improve or where they were doing well.

Further work was planned to ensure that staff had information about people’s wishes and preferences for how and where their care should be provided at the end of their life.

Feedback about the registered manager was positive and people and staff felt the service was well led. There were systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving the best possible support.

People who use the service told us that staff asked for their consent. One person said 'They're good like that.' Another confirmed that they often refused a shower and that staff respected their wishes and offered a shower at other times.

We observed interactions between staff and people during our visit and saw that staff communicated with people in a sensitive and caring way. People who use the service confirmed they were happy with the care and support they received describing it as 'good.' They told us that the staff were kind to them and listened to them.

Medicines were administered safely. We spoke to two members of staff who confirmed they had received medication administration training and that this was updated every two years.

Appropriate checks were undertaken before staff began work. We reviewed personnel records which showed that all three staff had undertaken a Criminal Records Bureau (CRB) check or a Disclosure and Barring (DBS) check before they started work.

People who use the service, their representatives and staff were asked for their views about their care and they were acted upon. A survey involving staff and people who use the service was carried out annually.

We were told by a family member that Seventrees was a "nice home" and two people told us they liked living at Seventrees. One person had moved into the home in March 2012. The individual needs of the person had been assessed and significant positive outcomes had been experienced by that person. People experienced care, treatment and support that met their needs and protected their rights.

Through looking at safeguarding referrals that had been made, reviewing arrangements for staff training, talking to staff and reviewing care plans. We found that people were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff rotas, staff training records and observing staff supporting people demonstrated that there were enough qualified, skilled and experienced staff to meet people's needs.

The provider had in place systems that sought people's views, took account of complaints and comments and learnt from investigations into accidents and incidents. This meant the provider had an effective system to assess and monitor the quality of service.