This unannounced comprehensive inspection took place on 8 April 2018 and was carried out by one adult social care inspector. We last inspected this home on 27 October 2015 when it was rated as ‘Good’ overall and in every key question.

New Treetops is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. New Treetops provides respite accommodation and personal care for up to six adults at a time who have learning disabilities. Nursing care is not provided by staff at New Treetops. This is provided by the community nursing service. At the time of this inspection there were five people staying at the home.

The service had a registered manager. 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 2008 and associated Regulations about how the service is run.’ The registered manager also managed another care home run by the provider and shared their work week between the two homes.

At our last inspection in October 2015 we rated the service good. At this inspection in April 2018 we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Although the care service had been developed and designed prior to Building the Right Support and Registering the Right Support guidance being published, it followed these values and principles. These values related to people with learning disabilities using the service living as ordinary a life as any citizen. They achieved this by promoting enablement, independence, choice and inclusion. They demonstrated how they delivered person-centred care and how they ensured people had easy access to the local community.

New Treetops provided people with learning disabilities and physical health needs with respite care in the mornings, evenings and weekends. During the day in the week people attended day services and New Treetops was closed. At the time of our inspection five people were staying in the service on respite. We inspected on a Sunday and therefore people were there for the entire day, although one person went back to their own home during the day. People’s level of need was varied, with some people being independently mobile and others needing support to mobilise.

Staff treated people with kindness and respect. The atmosphere at the home was jovial with people clearly enjoying staff’s company. Staff knew people’s preferences and communicated with people using their preferred methods of communication, such as signing. We found staff had caring attitudes towards people and spoke highly of them, their personalities and qualities.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put it into practice. Where people had been unable to make a particular decision at a particular time, their capacity had been assessed and best interests decisions had taken place and had been recorded. Where people were being deprived of their liberty for their own safety the registered manager had made Deprivation of Liberty Safeguard (DoLS) applications to the local authority.

People who stayed in New Treetops were protected from risks relating to possible abuse, to their needs and their health conditions. Staff knew how to recognise possible signs of abuse. Staff had assessed individual risks to people and had taken action to minimise these. Where accidents and

This inspection was unannounced and took place on 27 October 2015. The inspection was carried out by one inspector. The last inspection of the home was carried out on 5 December 2013. No concerns were identified with the care being provided to people at that inspection.

The service provides respite accommodation and personal care for up to six adults who have learning disabilities. On the day of this inspection there were six people receiving respite care. We met each of the people staying there and either spoke with them or observed staff supporting them. Throughout the year 24 people regularly used the respite service at New Treetops.

There is a registered manager in post. 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 2008 and associated Regulations about how the service is run. The registered manager also managed another care home run by the provider and shared their working week between the two services.

Staff took great care to make each person feel ‘special’ and to help them enjoy their stay. Before people arrived for each period of respite staff prepared their bedroom by placing their nameplate on the door and making sure the room was laid out ready for them, for example by making sure their choice of bedding and duvet covers were in place and any special equipment they needed. Staff were aware of the things each person liked to do, for example one person liked to help the staff with preparations when people arrived for their stay. In the evening we saw staff spending time sitting and talking to people, and sharing activities such as jigsaw. Some people went to a nearby club accompanied by a member of staff. We heard how staff organised outings and activities through discussion and agreement with people and from their knowledge of the things people enjoyed doing.

People were involved and consulted in drawing up and agreeing a plan of their care and support needs. Their care plans were comprehensive, well laid out and easy to read. The care plans explained each person’s daily routines and how they wanted staff to support them. The plans were regularly reviewed and updated.

There were enough staff to meet people’s complex needs and to care for them safely. On the day of our inspection there were three care staff, the registered manager and a clerical worker on duty to meet the needs of the six people who had booked to stay there that night. These staffing levels provided staff with plenty of time to give each person the support they needed at the person’s own pace.

The staff knew the foods people enjoyed and meals were planned to suit the dietary needs and preferences of the people staying there that day. A large notice board in the hallway showed the alternative meals offered, and this was displayed in picture format as well as text. People told us they enjoyed the meals.

People were protected from the risk of abuse and avoidable harm through appropriate policies, procedures and staff training. Staff received relevant training to effectively support each person’s mental and physical health needs. Staff were positive and enthusiastic. Comments from staff included “We treat people here as we would want to be treated ourselves.”

The home was maintained to a high standard and was equipped to meet the needs of each person who stayed there. Equipment included nursing beds, hoists with overhead tracking, large bathrooms and shower rooms with equipment such as handrails and bath hoists to help people move safely and as independently as possible.

Medicines were securely stored and administered safely by competent and well trained staff. There were safe systems in place to make sure staff understood each person’s medication and how it should be administered. There was good communication in place with families and carers to make sure any changes in medications were explained to the staff before the person arrived for a period of respite.

People were supported to maintain good health. There was good involvement with local healthcare providers and the home liaised closely with people and their families where health concerns were noted and where referral for treatment or advice was needed.

The provider had a range of monitoring systems in place to ensure the home ran smoothly and to identify where improvements were needed. People were encouraged to speak out and raise concerns, complaints or suggestions in a variety of ways. Regular resident’s meetings were held and people told us they could speak out in these meetings. People were also asked to complete survey forms seeking their views on all aspects of the service.

During this inspection we spoke to three care officer’s one care and support worker and the manager of the home. We met five people who stayed at the home.

All the staff we spoke to said they enjoyed working at Treetops, they felt they provided a good standard of care and felt well supported in their role. Two care officers said that the staff really worked well as a team.

Two care officers and the manager said they lacked funds for even the most basic of activities such as taking people out in a mini bus doing basic gardening projects such as growing vegetables and doing art and craft work. One care officer told us they had raised funds themselves so they could continue to do these activities with the people who stayed there.

The people we met appeared content and relaxed. They looked clean and well care for.

We found that staff received training and support which enabled them to meet the needs of the people who stayed in the home.

We found people were given the opportunity to make choices and we found staff had a good understanding to recognise and protect people from abuse.

The provider had systems in place that ensure people were safe and changes could be made to improve the service provided

On the day of our visit we were told that there were six people booked in for the weekend. We were introduced to all of the people and spoke with several of them. None of the people staying there were able to communicate their views on the home.

We were able to observe the care of four people who chose to sit in the lounge. We were also able to speak with the parents of one person. We spoke with the three members of staff on duty and with the registered manager. Comments included “The only thing I would change is to get a second lounge area” and “XXX is very comfortable here, and she walks around, she’s quite happy and gets on well with the staff.”

Throughout our visit we saw staff involving people in their care and allowing them time to consent to care through the use of individual cues, such as looking for a person’s facial expressions, body language and other signs. During our visit we saw that people appeared relaxed and contented. Staff appeared efficient and caring.

We visited New Treetops on 26 January 2012. The inspection was unannounced and took place over six hours and 20 minutes. The inspection started after lunch and lasted into the evening as people did not arrive to use the service until 3.30pm.

We met two of the three people using the service and spoke with four staff on duty and observed the practice of staff members. We were told that 19 people regularly used the service for respite, and that weekends tended to be busier. We also looked at a variety of records, including support plans for people using the service, and visited parts of the building.

People staying at the service were not able to comment directly on their respite stay so we went spent time in a communal area to help us make a judgement about people’s experiences of using the service .

We saw that staff treated people with consideration and respect, with some staff members being particularly skilled in their approach.

Staff were able to recognise when the person wanted physical reassurance and when they wanted their own space.

Staff told us about and demonstrated how they respected people’s dignity.

We saw how staff were observant to people’s changing moods and responded appropriately. Throughout the inspection, we observed that staff communicated appropriately with people, and the relationships between staff and people in the home were good.

Staff provided support in a caring manner making sure that people were comfortable and content. Some staff were particularly skilled in responding to the changes in people’s body language to help them interpret people’s wishes.

Staff told us that there were meetings to try and gather the views of people living at New Treetops, and we saw from paperwork and discussions with staff how work was being completed to promote choice.

People living at the home were not able to comment directly on the role of the manager.