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Inspection on 21/12/09 for The Trees

Also see our care home review for The Trees for more information

This is the latest available inspection report for this service, carried out on 21st December 2009.

it is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Good.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Annual service review Name of Service: The Trees The quality rating for this care home is: The rating was made on: two star good service 2 8 1 0 2 0 0 8 A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Fiona Stephenson Date of this annual service review: 1 7 1 1 2 0 0 9 Annual Service Review Page 1 of 7 Information about the service Address of service: Deveron Way Hinckley Leicestershire LE10 0XS 01455615523 01455615523 kmaxted@leics.gov.uk www.leicestershire.gov.uk Leicestershire County Council Social Services Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : learning disability mental disorder, excluding learning disability or dementia physical disability sensory impairment Conditions of registration: Number of places (if applicable): Under 65 Over 65 23 8 9 4 1 0 0 0 No one falling within category MD may be admitted into the home where there are 8 persons of category MD already accommodated within the home No one falling within category PD may be admitted into the home where there are 9 persons of category PD already accommodated within the home No one falling within category SI may be admitted to the home unless that person also falls within category LD ie dual disability No one falling within the category SI may be admitted into the home where there are already 4 persons of category SI already accommodated in the home No person falling within category MD may be admitted to the home unless that person also falls within category LD ie dual disability No person falling within category PD may be admitted to the home unless that person also falls within category LD ie dual disability Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Annual Service Review Page 2 of 7 Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service 2 8 1 0 2 0 0 8 The Trees is a purpose built home for people with learning disabilities, situated in a residential area of Hinckley. The home is a provision of Leicestershire County Council. The Trees is located close to a public bus route and train station. The town centre is approximately 1 mile from the home. There are shops and other local amenities close to the home. The service provides care on a short and long term basis for up to twenty-three adults who have been diagnosed as having learning disabilities, mental health conditions, physical disabilities and sensory disabilities. The home has five separate units within the main building, some of these have been adapted to provide services for residents complex needs. Annual Service Review Page 3 of 7 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information we have received or asked for since the key inspection in October 2008. This included: - The Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment document that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. - Surveys returned to us by people who live at the home, staff who work for the service, and health and social care professionals involved in the care of people who live at The Trees - Information we have about how the service has managed complaints. - What the service has told us about things that have happened to people living in the home. These are called Regulation 37 notifications and are a legal requirement. - The previous key inspection and the results of any other visits we have made to the service in the last 12 months. - relevant information from other organisations. - What other people have told us about the service. What has this told us about the service? The service sent us the AQAA when we asked for it. It was clear and gave us all the information we asked for. It told us of the improvements the service has made in the last 12 months. It told us that staff have received training to help them with Person Centred Planning and Health Action Plans. The Fire Risk Assessment has been revised, and two staff have received training in Hate Incident Monitoring. Two staff have also completed training to become communication facilitators. Comment cards have been revised to get more information from people who use the service. The AQAA also told us of improvements the service hopes to make in the next 12 months. These include further improving the effectiveness of communication with people who use the service; having more staff involvement in the person centred planning process; better menu planning coupled with the introduction of a picture format to support people who use the service in knowing the healthy options; improving the picture format to help people in their understanding of how to make a complaint; and continuing to look at developing community opportunities that reflect the needs of the individual. The AQAA told us that there are 36 permanent staff. It told us that a considerable number of staff had undertaken training to work with people with learning disabilities (LDQ) and had undertaken the National Vocational Qualification in Care (NVQ) to level Annual Service Review Page 4 of 7 2 or above. It did not tell us the exact numbers. The AQAA informed us that the service has not received any complaints. We at the CQC have not received any complaints about the service. It also told us that a Safeguarding Adults referral was made and investigated. We received six surveys back from people who live at The Trees. Staff helped support people living at The Trees complete the questionnaires, and to interpret the questions so that they could more easily understand what was being asked. All six gave positive responses about living at The Trees. They communicated that they felt that staff were nice to them, and that staff and managers listen and act on what they said. They communicated that they knew how to let staff know if they were unhappy about anything. We asked whether people using the service could do what they wanted during the day, evening and week-end. People told us they could. One respondent couldnt but this was because they had an agreed and planned structure to their day. We received 13 replies from staff who work at The Trees. Eleven staff told us they were being given training that was relevant to their role, with two not answering this question. Ten staff felt they got regular support and meetings to discuss how they were working, one felt that they often got support, one felt they sometimes got support, and one felt they never got support. Twelve staff felt there was usually enough staff to meet the individual needs of people who live at The Trees with one person saying there was only sometimes enough staff. Nine staff felt the there was always enough support, experience and knowledge to meet the different needs of people who live at the home, with four feeling there was usually this. Comments about what staff felt the service does well included: The Trees is a lovely environment for respite and the care for the service users is very good - they all seem happy and contented the needs and choices of service users are paramount... every physical and emotional needs is met with dignity and undestanding... service users are encouraged to tell us of any concerns and worries and know that they will be taken seriously staff seek/explore different modes of communication to ensure that a person is always heard, understood, supported, represented... I would have no worries if a family member or friend had to come to The Trees, as I know all their needs would be met, overall the service that The Trees provides is excellent. Staff comments about how the service could be better, included: giving R.S.Os an admin day to keep on top of paperwork responsibilities as it is easy to fall behind due to the needs of the service users clients are growing older and need more support, respite is becoming more challenging and more one to one support is needed Annual Service Review Page 5 of 7 often agency staff are used but this often puts pressure on permanent staff who are trying to do their own job as well as help the agency staff learn the care standards which are high in the home Four health and social care professional completed the survey. These were generally positive with most saying that the service supports people to live the life they choose where possible, and that staff have the right skills and experience to support peoples social and care needs. One person however felt that the care service only sometimes supports people to live the life they choose, and only sometimes do staff and management have the right skill and experience to support social and health care needs. They told us that the service: always appears caring on home visits or visits to the surgery they were very quick to spot changes in a persons eating skills and call in appropriate help they do well at organising communication/meetings between appropriate services for a patient provide short break service, manage a number of individuals with diverse and challenging needs - consistently - approachable One person said that there are sometimes inappropriate mixes of service users. Could be planned better, but would benefit from smaller environments We looked at the Regulation 37 notifications sent to us by the service. We received a number of notifications at the beginning of 2009 to inform us of a virus that had left both staff and people who live at the home, sick. We received one notification of a medication error, but we were satisfied that the service had taken prompt action to address the error. What are we going to do as a result of this annual service review? The next inspection of this service will be based on the Fees and Frequency Regulations 2007, and the assessment of risk of the service. We will be able to give more information about this once the new registration and inspection system under the Health and Social Care Act 2008 is agreed. Annual Service Review Page 6 of 7 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. 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